5 Simple Exercises to Improve Your Trail Running

Do want to improve your trail running? Our resident Exercise Physiologist, Tim, takes you through 5 simple exercises and strategies to get you performing your best when conquering the trails.  

Triple Flexion 

Learn and become strong in a position of triple flexion through ankle, knee and hip (this is when your hip is up, knee is bent and your toes are facing up). This will help with stepping and running up inclines and improve, stretching and joint mobility. A great example is a step with high knee. This with help with improving your ability with running up inclines as the picture depicts. 

Triple Extension 

Learn and become strong in a position of triple extension through ankle, knee and hip (this is the typical ‘sprinters’ position where the leg is behind the body, the knee is straight and you’re up on the balls of your feet). This will help with powerful, more efficient running stride. This should be trained with both legs together like a squat to calf raise and single leg variations like a single leg hop.  

Ankle Stability 

Practice rolling your ankle. Yep, challenging your ankle movement, balance and stability as much as possible helps to improve your awareness and ankle robustness. This is called ‘proprioception’ and is absolutely imperative to do for reducing the risk of ankle injuries. Let’s face it, during a trail your ankle will roll a lot, now I’m not talking about rolling your ankle to the put you do an injury, but it will be wobbling around your shoe, sliding over loose gravel, twisting and turning and holding on to rock edges and maybe even having to stabilize and grip into soft sand. Hence, the need to get the muscles and joint receptors ready for this. Practice balancing on single leg, tandem walking, beam walking and use exercise to facilitate unstable surfaces such as foam mat or bosu ball. 

Master your Gait 

Can you mid foot strike? How about heel strike? Can you lengthen or shorten your stride and adjust accordingly to fast open flat track, rock gardens, undulating inclines, slippery surfaces, sharp declines, corners and everything in-between. This is a major point of difference compared to traditional road running were you quickly gain a good stride and try to maintain it; whereas off the beaten track your gait constantly changes. Practice difference running patterns at 6-12% incline on a treadmill and also sense how your stride becomes quicker when tackling tricky declines. 

Light, Vision & Depth perception

As we know there are vast differences between road running and trails one of these is the terrain but also light. Yep bright light from the sun or poor light from an afternoon or night run. The changes in light can affect our vision and is a very common occurrence in trail running; to do part of the track in deep covered forestry than immediately do some open track with the sun beaming down several times through the run. Therefore, your eyes need to constantly adjust to light sources. We also need to have adequate depth perception to be able to step, jump, run and balance along the trial without falling or tripping. A classic example is someone who wants to gain some momentum running down a rocky slope at speed, stepping and jumping from one rock to another. We need very sensitive depth perception as to judge and determine how far away the rock is away from our foot. I am sure we have all been there where we didn’t judge it that well and slipped, fell or got jolted back. We can practice all of this by setting up an obstacle course with balance equipment, practice hitting tricky terrain, completing a few evening runs or night runs with head torch and practice running in and out of darker areas to get your eyes used to adjusting. 

Written by Exercise Physiologist Tim

The Dancer’s Hip

A dancer’s hip is required to go through extreme ranges of motion. In order to achieve this, the hip must have adequate strength and control to allow these positions without discomfort or injury. Furthermore, these positions are expected from a very young age before the dancer is developmentally mature. Without the sufficient control around the hip joint, a young dancer is more at risk of injury later in life.

Here are some commonly seen hip injuries:

  1. Snapping Hip

This condition is very commonly seen in dancers and is often caused by tightness in the gluteal (bottom) muscles. Dancers often describe it as a moving or popping sensation in the hip. However, this sensation is in fact one of the hip tendons shifting over the joint. In the early stages it is usually described as more irritating than painful however, if left untreated, it may become sore. Risk factors for developing this injury include reduced turnout, decreased single leg balance and decreased core or pelvic control.

  • Anterior Impingement

The sustained and frequent extreme hip positions required in dance can lead to a compression within the hip joint. This is known as anterior hip impingement and is usually described as a sharp pain at the front of the hip. If left untreated, the inflammation around the hip joint worsens which leads to a further increase in pain. Risk factors for developing anterior hip impingement include decreased stability around the hip and a lack of control of leg movements.

  • Bursitis

Bursitis is a very common hip condition seen in our clinic. The bursa are small fluid filled sacks which reduce friction between tendons and the joints all over the body. Poor strength, control or biomechanics around a joint can lead to an “overload” of the bursa, causing it to inflame and become painful. With hip bursitis, dancers often describe a pain on the outside aspect of the hip. It is really important to address standing and dancing postures in order to reduce strain on the bursa.

Incorrect posture
Correct posture

As always, prevention is better than cure. If you feel like you may be developing one of the above hip conditions, give Physionorth a call on 4724 0768.

The best office stretches!

There is an increasing proportion of the population that find themselves in a predominantly sedentary job position which can involve many hours spent sitting an office desk. Our bodies are designed for movement and inactivity due to prolonged sitting can bring about a myriad of postural related pains.

Of course, we can all improve our posture and decrease our chance of postural related pain by ensuring we sit correctly in our chair. Simple changes such as making sure our hips are positioned all the way back into the chair and sitting upright with a lengthened spine can make a large impact.

Office workers don’t have the opportunity to move around during the day, and often their complaints of pain are associated with tight muscles or joint stiffness. To combat this issue, here are 3 simple stretches that you can do right in your office chair:

Trunk rotation

  • Keep your feet on the ground and place an even amount of weight through both sides of the buttock
  • Twist your upper body to one side
  • Feel the twist occurring at your spine and not just your shoulders moving
  • You can use the hand on the side you are rotating towards to hold the back of the chair for an increase in the stretch
  • Hold for 30 seconds
  • Perform the same on the other side
  • This is a great stretch for someone who complains of stiffness in the mid back

Knee to chest stretch

  • Make sure you have moved your office chair out from underneath your desk so that you will have enough room to lift your knee up
  • Hug both hands around the back of one thigh and pull it as close towards your chest as it will allow
  • Hold this position for 30 seconds
  • You may feel a stretch into your bottom
  • Remember to perform the same on the other side
  • This is a great stretch for someone who complains of tightness in the buttock or low back

Side bend neck stretch

    • Place your right hand underneath the right side of your buttock
    • Relax your shoulders
    • Tilt your head to the left so that the left ear moves down towards the left shoulder
    • Feel a stretch along the right side of your neck
    • Hold for 30 seconds
    • Remember to perform the same on the other side
  • This is an effective stretch for someone who complains of tightness over the back and sides of their neck

If you experience any ongoing pain or discomfort from prolonged sitting please seek the assistance of one of our experienced and qualified physiotherapist’s at Physionorth who can tailor individual treatment regimes and exercise programs to suit you.

Call our friendly team on 4724 0768 for appointment bookings if discomfort persists!

Experiencing pain from netball?

As the number one sport for females in Australia, netball is a fast paced game that is great for teamwork, fitness and friendship.

Unfortunately, sometimes playing netball comes with the risk of injuries. The three main reasons you might be experiencing pain are:


2.Underlying muscle weakness or imbalance

3.Incorrect technique

Let’s discuss how these injuries can come about and what we can do to fix them.


Traumatic or ‘acute’ injuries are sometimes unpreventable, especially during collisions with other players or when your landing is disturbed.

It’s important to know what to do initially if you become injured during a game. The RICE principle is any easy way to remember the best steps to take to ease inflammation from an acute injury.

  • est
  •  I  ce
  • C ompression
  • E  levation

Follow the steps of RICE and book an appointment with a physiotherapist. We will be able to assess your injury, gauge the extent of damage and give you the best treatment, advice and rehabilitation program to get you back on the court as soon as possible! If you don’t rehab injuries properly (even if they seem minor), this may make you vulnerable to doing the same thing in the future. This is especially the case with ankle sprains, if rehabilitation is not completed after the first incident, instability may remain, and the athlete is much more likely sprain the same ankle again.

Underlying Muscle Weakness or Imbalance

Another common reason that you might be experiencing pain from playing netball is that some muscles are not working hard enough or are working too hard. If your muscles aren’t coordinating properly, they pull differently on your joints which can put them in non-optimal positions while you are playing. This decreased control of your joints may increase the impact on your joints and cause pain.

If this is the cause of your pain, you are more likely to be experiencing symptoms whilst playing or after the game. You may find that your pain settles significantly with rest from playing and training.  A physiotherapist will be able to do an assessment to determine how your muscles are working and provide exercises to strengthen or retrain as needed. Even niggly pain is worth getting fixed, you will be able to focus on the game and enjoy it so much more!

Incorrect Technique

Netball is a fast paced game, played on a hard surface, with lots of abrupt stopping, starting, and changing direction. If these movements are carried out often but with non-optimal technique, this can also overload the joints, put them in high risk positions and consequently cause injuries.

Incorrect technique is commonly paired with a degree of muscle imbalance and is also a cause of more ‘niggly’ pain whilst playing or lingering after the game. Again, you may find that symptoms correlate to when you are playing or training and settle down with rest. Training your brain and muscles to land, decelerate and change direction correctly will not only strengthen muscles and improve control but greatly decrease your risk of injury. If you’re interested in making sure that your technique isn’t putting you at risk, or causing your pain, come in and see us. It’s always better to prevent!

Our resident netball expert Caitlin is an accredited Netball Australia Endorsed Provider and will be able to sort out all your Netball related problems. To book an appointment, give us a call on 4724 0768 or book online at www.physionorth.com.au.

6 tips to Eliminate Headaches!

Most of us will experience a headache at some point in our life. For some, it is a rare event that lasts only momentarily. For others, it can be a regular occurrence that can affect day-to-day function and quality of life.

Headaches can reduce your ability to concentrate, work and do the things you love to do.

To read more about the causes of headaches pop over to our earlier blog: Headaches…can be a pain in the neck!

So how can you prevent headaches in the first place???
1. Strengthen your back muscles!

Prolonged sitting (usually at a computer), with poor posture (rounded shoulders, forward poking head, slumped lower back) is the most common cause of headaches. Your back muscles get fatigued from sitting for long periods causing you to slump forward. Strengthening the muscles in your upper back will help prevent this.

 An easy exercise to incorporate into your day to day routine is a row with a band.
To do this exercise, pop an elastic band around a pole at about chest height. Stand tall and hold onto the ends, then pull the band in towards your chest, squeezing your shoulder blades towards each other. Make sure your shoulders are relaxed down as you do this movement and if your neck is relaxed.

2. Wear a posture brace

If you have to sit for long periods, a posture brace is a great way to assist you, to keep your back and neck in a good position.

At Physionorth we love the Posture Medic braces because they are slim line and comfortable. Pop into the clinic if you’d like to give one a try!

3. Maintain good neck strength

Many people lack strength in little muscles in their upper neck called the deep neck flexors (DNF). These little guys keep your head in a nice upright position and prevent that poked chin posture that commonly causes headaches.

A nice way to strengthen the DNF’s is to pop onto your hands and knees, (ensuring your back is in a nice neutral position with a small curve in the low back). Then imagine your spine is a string and someone is pulling the string  from the base of your skull, in a horizontal direction. At the same time tuck your chin in slightly. Maintain this position and slowly rotate your head from side to side 10 times. If you find this position too difficult, you can also perform this exercise by sitting down and leaning forwards, placing your elbows on a desk (then following the above instructions).

4. Maintain your upper back movement!

There are quite a few muscles that connect your upper back to your neck. If these muscles get tight, they pull on the neck and can cause headaches. To prevent this happening make sure you keep your upper back nice a loose!


Start sitting nice and tall in your chair, then rotate around to one side as far as you can, using the back of the chair to twist you a little further. Stop when you feel a nice stretch in your upper back. Slowly return to face the front, then repeat to the other side.

5. Stretch your neck!

Likewise, if your neck muscles are tight, it will compress your neck vertebrae and has the potential to cause headaches.


One of my favorite stretchs for the neck is the levator scapulae stretch. To perform this stretch place one hand behind your back then turn your head so you’re looking into your opposite arm pit. Hold onto the top of your head and gently press downwards if you want a more intense stretch.

6. Move!

Walking, running, yoga, and pilates are all great ways to improve mobility and prevent neck pain and headaches. So find a form of exercise that you love (and will stick to), and get moving!

7. Fidgit!

At the end of the day our bodies weren’t designed to sit in one position for long periods of time. Studies have shown that people who fidget during the day suffer from less neck and lower back pain, than those that don’t fidget!  It’s also a great idea to get up and walk away from your desk as much as possible. Do take regular breaks to stretch and unwind!

I hope you found my quick guide to headache prevention helpful. Please remember:

Headaches should not be accepted as part of normal everyday life!

If you’re suffering from headaches and can’t relieve them yourself, please call to speak to one of our friendly physiotherapists! We can help alleviate your headaches for good!

If you’re unsure about whether we can help you or want some clarification on the above exercises:

Call our team on 4724 0768 for a FREE no obligation 10min phone consultation! (*conditions apply).

The Ultimate Foot Massage for Mothers Day

Let’s face it, mums probably have the hardest working feet around. Working, heels, chasing children, shopping and exercise, take their toll on a part of our body we all take for granted. The good news is that a foot massage is a simple way to erase tension and help prevent issues like bunions, plantar faciitis and spurs (or relieve them if they are already a problem).

Here’s my quick guide, so you can treat mum to the ultimate foot massage this Mothers Day (or any day for that matter)!

To start get mum to lie down on her tummy. Ensure she’s comfy and there’s no distractions! Place a towel roll under her ankles, so her knees are slightly bent and heat up a heat pack and pop it on her feet. Make sure you have a little bit of massage oil, light moisturizer or magnesium cream so that you can glide across the muscles. Start on the calf muscles, as these cross the ankle and attach onto the foot. If the calf muscles are tight they restrict ankle movement and contribute to foot pain. Run both your hands up the calf, then separate them and slide down the sides of the muscle and repeat. Do this slowly and apply as much pressure as feels comfortable (make sure you ask if the pressure is ok).  Repeat for a couple of minutes.

Next you want to gently work out the little knots in the calf. Run your hands up the calf muscle again and see if you feel any ‘bumps’ in the tissue. If you do, pause on the knot and hold pressure to that spot or use your thumb to rub it gently in circles until it releases.

Now take the heat pack and place it over the calf muscle. Use your fist to run up and down the length of the foot. Repeat for a couple of minutes to warm up the foot.

Then hold the foot so that your thumbs are on the sole of the foot and fingers are resting around the other side of the foot. Use your thumbs to rub up the center of the foot then separate them and run them down the sides. If you find any ‘knot’s gently rub your thumbs in circles over these areas or sustain gentle pressure over them until they release. Now grasp the foot with both hands and gently slide down the foot, applying a pulling force to gently traction the foot. Then slide fingers over the toes and then gently pull each toe to apply a gentle traction. Hold this for a few seconds.

Get mum to turn over and repeat the above techniques on either side of her shin. You can also repeat some of the foot massage techniques mentioned above in this position (like the picture). Finish with a gentle stretch, pushing her foot back towards her body.

All done! You are now the favorite child ;-). Happy Mothers Day.




The Urge

Often when we think Women’s health, the most common dysfunction people immediately think of is leakage. Whether that is leakage during a certain activity such as sneezing, laughing, coughing (stress urinary incontinence) or leaking on the way to the toilet (urge urinary incontinence).

Some people often don’t associate other symptoms such as urgency, frequency and increased nighttime voids as bladder related issues.

In actual fact, if I were to ask Women what is more bothersome to them, the leakage or the urgency coupled with or without frequency and nighttime voids, the later would be what is impacting their quality of life more. Leakage on most occasions Women can manage e.g they might be happy to wear a panty liner during exercise in the event that they might have a small leak. But urinary urgency has a significant impact on quality of life.

Urinary urgency is defined by the International Continence Society as the complaint of a sudden compelling desire to pass urine, which is difficult to defer.


Often the urge is very unexpected and unprovoked, and can literally happen at any time.

The issue with urgency is that it’s often followed by a fear/anxiety/stress response because the urge is so difficult to defer that you are compelled to find a place to toilet immediately.

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Chronic Pain and PTSD

What is pain? A simple three-word question about something so pervasive in life it “should” be simple to answer.

Pain is the most common reason people seek medical attention. All pain is real, and for many people, it is a debilitating part of everyday life.

Pain is like a public service announcement from your brain about a credible threat. Pain is not actually coming from your broken wrist or your sprained ankle. It is, in fact, a result of the brain evaluating information, including danger data. This detection system can be influenced by sensory and emotional experiences, as well as personal beliefs and culture, which essentially motivate us to do something to escape it.

However, chronic pain isn’t so clear cut. Chronic pain produces a state of stress. As time passes, the pain systems become more sensitive and hyper-responsive. For some people, the stress resulting from chronic pain can become consuming, and have the potential to significantly worsen and prolong the pain.

The following link is great for understanding chronic pain. It also highlights the powerful influence our mind has over our perception of pain.

Approximately 15% to 35% of patients with chronic pain also have Post Traumatic Stress Disorder (PTSD).

PTSD is a severe, long-lasting psychological reaction to a distressing event, which can cause significant impairment.

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Questions to ask before going ‘Under The Knife’

Weighing up conservative versus surgical approach to therapy for musculo-skeletal injuries

It is most likely not a question of ‘if’ but ‘when’ we will experience a musculoskeletal injury in our lifetime. Sometimes it is quite clear to us whether we need physiotherapy or surgery, such as a mild ankle sprain versus a complete anterior cruciate ligament (ACL) rupture. However, often times it isn’t so clear cut.


What is Orthopaedic Surgery

Orthopaedic surgery is performed by a medical specialist trained to deal with problems that develop in the bones, joint and ligaments, and sometimes in the nervous system. The goal of treatment is to relieve pain and restore function.


What do we mean by ‘Conservative Management’ (involving physiotherapy)?

Physiotherapy is a clinical health science which involves assessing, diagnosing and treating through physical means to minimise pain and restore function.  A physiotherapist will assess the stability of your joints (and/or stiffness), your flexibility and look at the way you move. They will then give you exercises to improve the way you move, to offload painful joints, mobilise stiff/painful joints, improve your stability with exercise prescription and give you tips for pain relief.

When both approaches aim to minimise pain and restore function it becomes quite difficult to determine which approach is best for you.

Is Surgery a ‘Quick Fix’?

In some cases, the ‘quick surgical fix’ is not always the best way to go, and certainly not always the quickest.  Post-surgery there is often a long recovery process involving physiotherapy to restrengthen muscles, facilitate motor relearning (your brain will have to ‘relearn’ how and when to activate certain muscles), and fix any compensation strategies your body has adopted as a result of your injury. Multiple studies now indicate that physiotherapy can have equal or more effective outcomes than surgery without the risks or the costs.

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Pros & Cons for Cortisone Injections

The cortisone injection debate: Pros and Cons

Imagine you are two weeks out from the local triathlon festival and your shoulder has progressively worsened. You hear of a ‘miracle treatment’ called the corticosteroid injection (or ‘cortisone shot’) and naturally you are drawn towards the proclaimed fast and effective results. However, there is a saying ‘if it seems too good to be true, it probably is’. This saying can in many ways apply to the uneducated and inappropriate administration of the corticosteroid injection for many musculoskeletal conditions. While this medicine has been widely used to treat inflammatory pain since the 1950s, it is worthwhile being familiar with the pros and cons of corticosteroid injections to help dictate your decision.


What is a corticosteroid/cortisone injection?

Corticosteroids are medicines that mimic your body’s natural corticosteroid hormones (cortisone and hydrocortisone) produced by the adrenal glands above your kidneys. They are not the same as anabolic steroids sometimes misused by athletes and body builders, and they don’t increase your muscle strength.


Corticosteroids that are used appropriately can help a variety of conditions such as arthritis and common sports-related injuries, including:

  • Tennis elbow
  • Golfers elbow
  • Bursitis of the hip, knee or shoulder
  • Frozen shoulder
  • Plantar fasciitis
  • Carpal tunnel syndrome
  • Herniated disc
  • Rotator cuff injury
  • Tendonitis

In some cases, they can reduce inflammation, relieve pain, and improve function for up to several weeks or even months. When cortisone injections work, they work really well. Still sounds like a miracle right? However, many studies have drawn attention to the common side effects, and the detrimental and failed outcomes that can result from cortisone shots.

Studies have found that people who had corticosteroid injections for tennis elbow had significantly less pain in the short term than those who had no treatment. However, they had much lower rate of full recovery six to 12 months down the track and a significantly higher rate of relapse. It is because of these statistics that many health professionals are concerned that reducing inflammation might mask serious injury.  Studies have shown that high concentrations of cortisone or repetitive use can lead to tissue damage, which can lead to softening of cartilage in joints and/or weakening of tendons.

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