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Chronic neck pain: Physiotherapy treatments

Are you suffering from a pain in the neck? I’m not talking about your latest electricity bill, or an annoying co-worker, I’m talking good old fashioned inescapable neck pain. Over the course of a lifetime there is a 50% chance you will suffer from neck pain at one point or another.[1] This risk can be heightened by a number of factors: your age (another great part of getting older), your sex (women are more likely than men to experience neck pain[2]) and the type of work you do (I’m looking at you, computer using people). For most Australians neck pain is something that usually lasts 6-8 weeks, but for around 30% of people, neck pain can become a chronic source of pain, limiting the activities you can take part in and disrupting sleep patterns which in turn can cause other problems.[3] Neck pain is one of the most common complaints physiotherapists deal with and there are a number of scientifically proven exercises and treatments to ensure your neck pain doesn’t turn chronic.

What are common symptoms associated with neck pain?

To put it simply, the spine and neck are very complicated regions of the body and can cause a variety of symptoms and finding the right Northern Beaches physio is essential to pinpointing the cause. In all there are seven cervical vertebrae acting as building blocks of the spine in the neck and surrounding the spinal cord and canal. Within the neck, structures include the neck muscles, arteries, veins, lymph glands, thyroid gland, parathyroid glands, oesophagus, larynx, and trachea. This means that neck pain can present a wide array of related symptoms, requiring a skilled musculoskeletal physiotherapist to identify the source. Neck pain can culminate in the following symptoms:

  • Headaches
  • Numbness, weakness and tingling in the arms and fingers
  • Surrounding muscle pain, commonly the shoulders
  • Fever
  • Stiff neck
  • Sore throat
  • Even loss of bowel or bladder control

What are some of the causes of neck pain?

Neck pain just doesn’t come about for no reason, it is usually related to a specific issue with another part of the body, or begins as a direct result of an injury or overuse problem. When you first discuss neck pain with your physio they will conduct an analysis of your body in order to pinpoint the root cause in order to create the most effective program to treat it. Musculoskeletal physiotherapists and General practitioners have highlighted the following as the most common causes of neck pain[4]:

  • Degenerative disc disease
  • Neck strain
  • Osteoarthritis
  • Cervical Spondylosis
  • Poor posture
  • Pinched nerve

Is your phone being a pain in the neck?

As more people spend their days scrolling mindlessly through Facebook, the average number of hours spent on our phones is increasing rapidly, with Australians clocking up 10 hours of mobile screen time PER DAY.[5] Did you know that within 5 minutes of waking up over one third of Australians have already checked their mobile phone at least once, not even dinner time puts the brakes on mobile usage with around 70% checking their phones while eating with family and friends?[6] They are some seriously crazy numbers. We’ve even had to give it a name, text neck. Staring down at your phone causes your neck extensors to stretch unnaturally causing them to weaken over time and can add nearly 30kg of pressure to the back of the neck. This unnatural forward head posture has also been shown to inhibit breathing capacity which can lead to migraines and cause brain fog throughout the day. If you also happen to have a job that requires you to stare at a computer screen or you spend a few hours a day watching television, your risk of suffering neck pain increases.

What are the best treatments for neck pain?

Your Dee Why physio will most likely recommend a multi-modal approach to tackling your neck pain, with studies showing that a combined process is the most effective at shortening the duration and intensity of the pain.[7] A combination of strength and mobility exercises, postural and ergonomic changes, hands on treatment and dry needling have all been shown to be effective and are utilised by musculoskeletal physiotherapists around the world.

If you have been suffering from a sore neck, or any of the symptoms outlined above, you are only increasing your chances of your neck pain becoming chronic and affecting other areas of your body and daily life by not having it treated. It can be easy to shrug off neck, shoulder and back pain as a normal part of life, work and getting older, but nobody should have to put up with chronic pain. You might not be able to get rid of every pain in the neck in your life, but speaking with your Northern Beaches physio can certainly go a long way to getting rid of the actual pain.


[1] Hogg-Johnson S, Van der Velde S, Carroll L, Holm L, Cassidy D, Guzman J, Côté P, Haldeman S,
Ammendolia C, Carragee,14,15 Eric Hurwitz E, Nordin, M, Peloso P. The Burden and Determinants of Neck Pain in the General Population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Eur Spine J. 2008 April; 17(Suppl 1): 39–51.

[2] Ostergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P, Winkel J, Isacsson SO; Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. Malmö Shoulder Neck Study Group. J Epidemiol Community Health. 2005 Sep; 59(9):721-8.

[3] Mehanical Neck Pain and Cervicogenic Headache. Neurosurgery 2007: 60:S1-21–S1-27

[4] Bot SD, Van der waal JM, Terwee CB, et al. Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 2005:64(1):118–23.

[5] Australian consumers spending more than 10 hours of every day on their digital devices’, 2016, Ernst & Young, www.ey.com

[6] Mobile Consumer Survey 2017: The Australian Cut, Deloitte, https://www2.deloitte.com/au/mobile-consumer-survey

[7] William J. Hanney WJ, Kolber MJ, Schack-Dugre J, Negrete R, Pabian P, The Influence of Education and Exercise on Neck 
Pain. Am J Lifestyle Med. 2010;4(2):166-175.


Why you should choose a Titled Physiotherapist

With literally thousands of physiotherapists now at your fingertips and an infinite number of Google options to choose from, how do you know if the Dee Why physio you choose is appropriately qualified to treat your specific condition? Anyone who can legally call themselves a physiotherapist has studied for 4 years at university, covering multiple areas of practice including: Musculoskeletal injuries and conditions (joints, muscles, bones, tendons and ligaments,) Neurology (spinal cord and brain injuries) Cardio-respiratory conditions (heart and lungs) Paediatric issues (children). Fresh out of uni you could say a physio is a jack of all trades, but a master of none. It is after admission as a fully fledged physiotherapist that we can really delve into the more specific and advanced areas of practice and hone our skills to become experts in our field.

What is a Titled Physiotherapist?

If you think of a regular physiotherapist as a General Practitioner, a Titled Physiotherapist is the equivalent of a specialist. The Australian Physiotherapy Association (APA) defines a Titled Physio as “highly qualified physiotherapist with expert knowledge and skills”. That’s putting it pretty lightly. To be eligible to call yourself a “Titled Musculoskeletal Physiotherapist” you need to do your 4 years Bachelor of Applied Science (Physiotherapy), complete a 2 year Masters of Musculoskeletal Physiotherapy (making a substantial contribution to the field academically) followed by a minimum of 2 years full time clinical experience dealing primarily with musculoskeletal conditions. That’s nearly a decade of study right there.

What are the common areas of Titled Physiotherapy?

  • Sports medicine
  • Paediatrics
  • Animal physiotherapy
  • Musculoskeletal physiotherapy
  • Neurological physiotherapy
  • Gerontological physiotherapy
  • Cardio respiratory physiotherapy
  • Occupational Health and Safety
  • Continence and Women’s Health

What does a musculoskeletal physio specialise in?

Musculoskeletal Physiotherapists have expertise in the treatment of muscular and joint conditions. These rockstars have a comprehensive knowledge of anatomy, physiology, pathology, injury assessment and utilise up to date evidence based approaches to treating spinal and joint injuries. Musculoskeletal Physiotherapists are the experts in assessing the structures, contributing factors and mechanics causing your pain. Think of them as the pain doctors.

How musculoskeletal physiotherapy can help you.

  • Completely relieving or reducing your pain
  • Helping you to avoid future injury recurrences
  • Providing you with ongoing strategies and support to manage your injury or condition
  • Improving your flexibility, muscle strength, quality of movement and co-ordination
  • Enabling a quicker recovery and allowing you to your normal activities sooner
  • Assisting you to achieve your exercise or functional goals
  • Improving your fitness by structuring a personalised injury management training program
  • Prescribing exercises to do at home or in the gym to enhance your recovery

How common are Titled Musculoskeletal Physiotherapists?

Not quite as rare as hen’s teeth, but not far off. Did you know that less than 5% of physiotherapists attain the level of Titled Musculoskeletal Physiotherapist? Your local Dee Why physiotherapist, Damien Glover combines an expert understanding of anatomy and human biomechanics, the latest scientific methods and years of practical experience in the field to provide a multi-pronged program designed to combat a number of common musculoskeletal issues.

The multifactorial approach of a musculoskeletal physiotherapist to your examination allows us to accurately diagnose your condition or injury and highlight further influencing factors of what is happening with you. This deep dive into your physical health allows your Northern Beaches physio to design a bespoke rehabilitation program with short, medium and long term outcomes to ensure success and a pain free future.


Junior AFL is beneficial for children in more ways than one

In last week’s blog we looked at some of the physical, psychological and social benefits that playing a team sport can have on children. Today we’re going to be looking specifically at Australian Rules Football (we’ll just call it AFL for ease of reading from here on in!) and some of the great effects it can have on kids’ physical and social development. As AFL continues to grow in NSW, so does physiotherapists’, Doctors’, psychologists’ and education expert’s knowledge of how AFL and other ball sports positively affect children and their development into young adults. Unfortunately my love of AFL can only be channelled through being able to support the physical needs of players and unashamedly cheering on the GWS Giants from the stands. Us sports physiotherapists aren’t much help to others when we’re injured, and I seem to be a target for big hits and big injuries (ask me any time about the number of surgeries I’ve been through).

This year I am going to be sponsoring the Balgowlah Suns Junior AFL Club and helping kids and parents to get a sports physiotherapists view of the biomechanics, preparation and recovery that go into every game. When prepared for properly, AFL is one of the safest sports children can play, with less physical contact than rugby league, more hand to eye co-ordination skills and more aerobic fitness. Getting kids into safe and fun sports is essential in combating childhood obesity and improving social development skills as I spoke about in a previous article.

What are the physical benefits of AFL and programs like Auskick?

Children learn a variety of fundamental and advanced gross motor skills from kicking, handballing, catching, running, jumping and evading that will benefit them for future physical development and sports participation. Through regular training, children are also learning the basics of fitness conditioning and the basic principles and importance of health and nutrition.

  • Improved physical fitness
  • Increased hand-eye coordination
  • Better aerobic capacity
  • Strengthening muscles and bones

How does AFL improve psychological and social skills?

Children who play physically active team sports are more attentive, have a more efficient memory, enhanced creativity, better learning adaptability and problem solving and attitude regulations abilities.[1] AFL Juniors have to make rapid and complex decisions during the game while remembering certain structures of play and achieving pre-defined goals. This allows children to adapt to a variety of situations off the field more efficiently with the neuroplasticity of the brain creating new neural pathways at an astonishing speed in young kid’s brains. Yes, you read that correctly, football gameplay learning makes kids more adaptable. There’s more good news though.

Children who participate in team sports develop important social skills, a sense of belonging and camaraderie much faster than kids who don’t. The President of the International Council for Sport Science and Physical Education, Professor Margaret Talbot once stated ‘Sports and other challenging physical activities are distinctively powerful ways of helping young people learn to ‘be themselves’.[2] These benefits flow positively through children’s lives and the broader community is better for it too.

  • Better communication skills
  • Fosters a sense of self belief
  • Improves concentration and cognitive function
  • Increases teamwork skills
  • Builds a sense of mateship/belonging
  • Make a ton of new friends

Good preparation and recovery is vital

Preparation and recovery is much more than hitting the carbs the night before and a bottle of powerade in the morning (more on why you shouldn’t dose your kids with powerade in a following article). It is important to stay hydrated leading up to and on the day of the game and eating a balanced, nutritional diet is going to help keep kids fuelled up for the big game. Complete a warm up and cool down including stretching, slow jogging and running activities, with and without the football to minimise the risk of muscular and joint injuries.

Get a musculoskeletal screening test

Wouldn’t it be cool to be able to see into the future and prevent an injury before it happened? Musculoskeletal screening tests aren’t quite looking into a crystal ball, but they are becoming increasingly backed up by numbers and science. Do you think the pros step out on to the pitch and just hope that their body has it in it that day? They have an entire team of physiotherapists, sports scientists and strength and conditioning experts monitoring every step that they take. Musculoskeletal physiotherapists test a range of movements and take measurements to create a physical profile that will identify areas that may be more susceptible to an injury. Musculoskeletal screening tests have been shown to be an accurate and reliable indicator of specific injuries in AFL players.[3] Finding a Dee Why sports physiotherapy expert is crucial to ensuring any musculoskeletal screening tests are comprehensive and accurate, otherwise you may actually be putting yourself or your child at risk of suffering an injury.

AFL is an all round awesome sport for children to help grow and adapt so many skills that are going to benefit them in later life, not to mention they get a real kick out of it! If you have any questions about all sports physiotherapy or musculoskeletal screening tests for AFL or other sports, get in touch with The Beaches Sports Physio on the Northern Beaches at info@thebeachessportsphysio.com

[1] Erwin H, Fedewa A, Beighle A, Ahn S. A Quantitative Review of Physical Activity, Health, and Learning Outcomes Associated With Classroom-Based Physical Activity Interventions. Journal of Applied School Psychology. 2012;28(1):14–36.

[2] http://www.icsspe.org/

[3] Reliability of common lower extremity musculoskeletal screening tests Belinda J. Gabbea, Bennellb, Wajswelnerc, Finch. Physical Therapy in Sport 5 (2004) 90–97

Photo: High five mum by Mike Hauser (2008) https://flickr.com/photos/35314767
Attribution (http://creativecommons.org/licenses/by/2.0/)

7 easy ways to find an expert Dee Why physio

Searching for and finding the right physio for your needs online can feel like searching for a needle in a haystack. You could spend hours searching through Google for the right sports physio, musculoskeletal physiotherapist; even narrowing down your search to Northern Beaches physios is likely to give yourself an extra headache! So how do you find the best physio for your condition? Like many other health professions, physiotherapists have a vast array of areas of expertise.  All practitioners have to be highly educated and officially registered to practice with the governing body, adhering to strict standards of service.  Working out which physiotherapist can treat your specific condition requires more than simply typing in to Google. Luckily there are a number of hints and tricks to finding the right local physio for your needs, by following these tips below you will go a long way to finding that special someone.

Check for what areas the physiotherapist specialises in

Physiotherapists cover a huge range of areas of practice and not all physios are experts in the type of pain or condition you are suffering from. You wouldn’t go to a podiatrist to get an eye test, so why visit a physio who doesn’t specialise in the area of pain you are experiencing? For example, when it comes to musculoskeletal physiotherapy, did you know that only 5% of practicing physiotherapists attain the rank of “Titled Musculoskeletal Physiotherapist”? The Australian Physiotherapy Association (APA) defines a Titled Physio as “highly qualified physiotherapists with expert knowledge and skills. They undergo a rigorous selection process to ensure that they achieve and maintain exceptional standards of clinical experience and knowledge. The APA Title serves as a professional mark of distinction.” For issues like Back and neck pain, Nerve pain (especially sciatica, carpal tunnel), Chronic injuries, Arthritis/osteoarthritis and other aging related pain, postural dysfunctions including scoliosis, kyphosis (hunched back) and flat feet – don’t sell yourself short by visiting a physio not ranked in that top 5%.

Ask your doctor for their advice

Many Northern Beaches doctors work hand in hand with highly trained physiotherapists to treat long term and immediate physical pain for their patients. They are some of the best people to give advice on who to see in the local area with the skills and specialisation to help you recover faster.

Phone a friend

There aren’t many better ways to finding the right physio than getting a referral from a friend. Getting confirmation from a friend on the skills of a physio will give you much more insight than Googling away aimlessly for hours. They’ll be able to give you firsthand knowledge of their expertise, bedside manner and obviously on whether or not they were able to help their own issues.

Check on the Australian Physiotherapy  Association

Not checking to see whether a physiotherapist is registered with the Australian Physiotherapy Association is like playing Russian roulette with your musculoskeletal system. If they aren’t registered on there, you might as well go and see Doctor Nick from the Simpsons.

Consult Facebook and have a look at relevant groups on social media

It’s become increasingly common today for Facebook groups related to sports and health and fitness to share stories about their injuries and post reviews of their tips and experiences with various sports or injury related professionals. If you’re uncertain, put a post up along the lines of “Does anybody know an awesome physio that specialises in lower back pain in Dee Why” and you’re bound to get a few bites. Always check and verify their advice with other methods though!

Consult Doctor Google

Once you’ve narrowed your search scope down, it is important to check Google reviews and other community reviewed websites to check what the word on the street about the physio is. Keep in mind again, Google reviews aren’t the be all and end all, but they do play an important part in finding a reputable and skilled physio for your needs.

Ask for a referral from your local sporting club

If you play in a team or individual sport, it is likely that your club has knowledge of physiotherapists that are reputable and skilled in specific areas of the body. Sporting clubs don’t just recommend any old physio either, because they are made up of trained and skilled individuals themselves, the last thing they’d be doing is recommending a physio with a Kelloggs Cornflakes degree.

Finding the right physio can be a daunting task if you don’t know where to start. By following those tips and verifying claims and data between a number of different sources and referral points, you are much more likely to find a physio who is capable of looking after your pain or injury in the most professional and up to date way possible


4 Scoliosis tips from your local Physiotherapist

In my time as a physio on the Northern Beaches one of the most common concerns people bring up during their physical assessments is their ‘Scoliosis’. Scoliosis is one of those conditions that just sounds horrible isn’t it? I want to start by saying the likelihood of you ending up with a Quasimodo-like hump on your back due to the condition is AT LEAST a million to one. Scoliosis is simply derived from the Greek word for bent or curved and is used today to describe the lateral curve in the spine caused by the condition. Scoliosis commonly presents as one curve, called a C-curve, or two curves, called an S-curve and is classified as either structural or non-structural depending on whether or not there is an added rotation on the spine present with the curvature.

What are the signs of Scoliosis?

Unless you can turn your head 180 degrees to the back (in that case we have bigger problems than mere scoliosis) it might be hard to self-diagnose the possibility of scoliosis, but physiotherapists look for the following as indicators of scoliosis:

  • Your head is not centred directly over your body
  • One shoulder sits higher than the other
  • One shoulder-blade sits higher or is more prominently sticking out
  • You have unequal gaps on one side of your body between your arms and your trunk
  • One hip bone is more prominent than the other
  • You suffer pain around those areas that are imbalanced

What to do if you have been diagnosed with a scoliosis

Did you know that Usain Bolt was diagnosed with scoliosis early in his career? It’s certainly not a career ending condition by any stretch of the imagination. Depending on the position of the scoliosis in your spine, your physiotherapist will give you a number of exercises or stretches to regularly perform. There are also a number of things to avoid if you have been diagnosed.

  1. Getting sucked into buying lots of things to fix it

“When I first bought a tempurpedic pillow it made me realise I was basically sleeping on a pile of rocks up until that point.” Human being have been in our current form for at least 200,000 years. For how many of those years have we have nice soft mattresses and perfectly contoured pillows? There is no evidence to support the hype around sleeping paraphernalia. That being said, if you are having pain at night, it’s time to talk to your local musculoskeletal physio about it! Sleeping accoutrements aside, other nonsense things to avoid are posture braces, long term orthotics and consistently taping!

  1. Get strong

It is important to find yourself a local physiotherapist who is knowledgeable in a number of complementary treatment options. Recent studies have shown that clinical Pilates and Yoga can be an effective reliever of chronic discomfort along with other non-surgical options such as meditation, massage therapy and a well designed functional training program.

  1. Don’t sit for hours on end

You would be surprised at how much spine and neck pain is exacerbated simply by sitting and doing nothing. Unfortunately, whether you’re sitting at your work desk all day or on the couch watching cricket for hours on end, it’s likely that your neck and spine aren’t in their optimal positions. Get up at least every hour and stretch your body from side to side and have a walk around to avoid placing too much pressure on these areas constantly. If the pain is getting worse, walk on down to your Dee Why physio and pick my brain.

If you think you may have scoliosis, or you have been diagnosed with scoliosis but have been neglecting your exercises or you have never been given a full body assessment for your condition, it is important to visit a local physiotherapist with the skills and equipment to create an in depth program for you. Scoliosis is a relatively benign condition when treated correctly, but can lead to further complications in the future if it is neglected.


3 proactive tips for preventing common workplace injuries

Each year thousands of Australians suffer a work related injury that either causes them to miss time at work or diminishes their ability to carry out their role effectively. Safe Work Australia estimates that these injuries cost roughly $60 billion to the Australian economy.[1] Now that’s a lot of sick days (not to mention the sickies you chuck when the surf is up…) Not only that, but the way you carry out your job could be causing ongoing damage to your body that will eventually become painful, without you even knowing it. When most people think of workplace injuries, they think of one off accidents or injuries caused by repetition at physically demanding jobs. This couldn’t be further from the truth. With more people than ever working physically inactive jobs, many workplace injuries and illnesses are a result of poor posture, repetitive awkward movements and failing to identify aches and pains correctly to begin with.

With these tips you will be able to identify common workplace injuries and overuse problems, put in place proactive structures to avoid them and know when to see your local physio for further treatment.

Redesign your desk space

You’ve probably heard the term ‘ergonomic’ thrown around a lot in the last few years. There’s ergonomic keyboards, mouse pads, chairs, desks, pens, pencils, cups, water bottles, scissors and I bet somewhere somebody is trying to market ergonomic toilet paper to someone. Australians spend millions of dollars a year on ergonomically designed products that have no scientific facts behind them. Yep, you read that right. Most products are baloney. At its core, ergonomics is the study of how humans fit into their work environment. No fancy ergonomic pencils required. In fact, the most effective and proven ergonomic changes to your workspace don’t involve any new products at all. While people tend to focus on the type of chair they have, they tend to overlook how they hold their bodies while performing their work. For example, correcting your trunk position (or the position you end up in within that fancy chair), sitting with your body closer to your desk, having relaxed and symmetrical shoulders and feet flat on the ground can make a positive difference to your workspace. Try a few different positions for your most used items focusing on those principles and you’ll find that sore neck may just disappear.

Lift with your head (not literally)

About 30% of all workplace injuries are caused by manual handling tasks. Manual handling includes anything that involves lifting, pushing, pulling, holding, restraining, throwing and carrying. Manual handling related injuries can be minimised by a thorough and effective assessment of the risks. I know it’s easy to ‘just do it’ when it comes to the work, but that is often a sure-fire way to end up injured. Ensure you fully evaluate the layout of the workspace, the location of the item, the weight of the item, the duration and frequency of the tasks and try to streamline as much of the process as you can. Ask yourself ‘does it have to be done this way?’ Just because heavy boxes have always been delivered onto a high counter top for distribution does not mean that’s the best way to do it. Using mechanical aides such as forklifts, conveyor belts and wheelbarrows may be a better alternative. The importance of training how to do the task properly can’t be overstated. Inexperienced workers are much more likely to suffer a manual handling injury than well trained workers.

Recreate the work tasks for your physio to observe

It can be difficult for your local physio to get an accurate idea of exactly how a movement is being performed and under what conditions. As a musculoskeletal physiotherapist I regularly observe, evaluate and recommend alterations to the techniques of sportspeople who carry out a range of repetitive and awkward movements. Why should work tasks be any different? If you can’t start ‘a bring your physio to work day’, take some photos of your work area, or have someone take photos or video of you performing your regular duties in a work environment. This will allow your physiotherapist to evaluate your body movements, work area and advise of any possible changes that could be made. Plus, you’ll be able to feel like a professional sportsperson having your movements evaluated and corrected for optimal health and wellbeing. But seriously, if you work in a pub and want to bring your physio to work… I’m down!

Work doesn’t have to be one of the biggest causes of injury to Australians. Many injuries can be reduced or removed through simple alterations to your environment and being more aware of how you hold your body. A musculoskeletal therapist is perfectly trained to make these observations and give you the personalised tips to be able to go home every day happy and healthy. Without any of the gimmicks.

[1] https://www.safeworkaustralia.gov.au/statistics-and-research/cost-injury-and-illness-occupation


Part 1 – What is Posture?

Posture has been a buzzword in the past and it seems that it’s coming around again. Postural control is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. Poor posture was something that my Mum harped on about (love you Mum). She would constantly tell me to “stand up straight” or “pull your shoulders back”. I tried to do these things, admittedly I didn’t apply myself to them ritualistically, yet I tried. This nagging was put into the category of things that mums just loved nagging about like washing your hands before dinner or not picking your nose. It didn’t bother me that I had “bad posture”. Until a fateful day of tennis.

Yes, this is me at age 16. Year 11 of school was a tough year and I’m sure I studied plenty, but surely this was just an overexaggerated posture? But as more and more photographs from over the years surfaced the sinking realisation came to me; my posture wasn’t just bad. It was terrible. I was in a constant hunch.

For my final year of school I started taking an interest in how I could change my own posture. I took the same approach as most, beginning with doing my own research to see what would help before finally seeing the local physiotherapist. Religiously I would lie face down on my bed and pull my shoulderblades hard together to try and strengthen the area (Dr. Google told me this was a great idea, which is nonsense). I even had a friend help me tape my back as a regular occurrence so that I could learn to stand taller and with less of hunchback. Yet as the HSC drew ever nearer and as my priorities changed my posture was placed into the “come back to it later” basket and life moved forward. But it certainly influenced my career choices…


Posture is simply the human bodies position of strength in any given scenario. Hence, we have a favoured sitting posture, a favoured standing posture, riding posture, writing posture, handstand posture…the list goes on. Let’s run a mini experiment here. Please go and locate a mirror. Don’t worry, I’ll wait. Whip out that fancy smart phone of yours (that you are likely reading this article on) and take a pic of yourself standing side on in the mirror. Ideally this is done with minimal clothing on so you can see the contours of your body.

Done? What do you see?

If your body hunches forward into a position of comfort for you, then that is where your body has the most strength. If you notice that your hips shift forward and your ribcage shifts backwards this is your position of strength. If you have military posture you have either practiced this, or this is simply your position of strength. Maybe you see that you actually lean to one side, or that you have a really proud chest and your butt sticks out? The point is that it doesn’t matter what you look like. The reason you do whatever you do is because this is the most economical position FOR YOU IN THE GIVEN SCENARIO. What do I mean by the most economical position? I mean that in this position you must use the least amount of energy as possible. Humans as a species tend to find shortcuts to efficiency and posture is no exception.

What do we need muscular strength and energy for when we talk about posture? You guessed it, gravity. As Isaac Newton discovered, gravity is the enemy. The eternal force of gravity compresses us longitudinally as we are standing, causing our postural muscles to fire in order to attempt to (a) hold us upright and (b) decompress us.

The issues arise with poor posture or bad posture when:

a) the muscles, bones, joints, ligaments, tendons and nerve tissue that end up bearing the brunt of the load are unable to do that anymore. Our bodies have a set strength/endurance/tolerance for any given task. Holding ourselves upright is no different. If your body begins to ache after half a day of standing, it is likely that you have excellent tolerance of up to 4 hours of standing, yet at the 5th hour the muscles begin to fatigue and the body begins compensating as best as it can.

b) when the posture has been sustained for so long that the body has begun to adapt to always being in that posture. Over time, our body begins adapting to positions in which it is placed by forming small fascial adhesions (or Fuzz as coined by Gil Hedley – look up his Fuzz speech on YouTube). Ask anyone who has had their arm in a sling how stiff their elbow was at the end of 6 weeks… even if they were in the sling because of their shoulder! Every morning when you wake up you have a mini stretch which breaks down these mini adhesions and allows muscles and joints to function optimally. If we are constantly holding a hunched forward posture while standing for example, our body builds tiny fascial adhesions (aka Fuzz) that hold us into this posture.

Click to read my next article on whether we can change our posture!


Part 2 – Can we change our posture?

Practice doesn’t make perfect. Practice makes permanent. If you consistently practice your tennis shots poorly then you will always be a poor tennis player (note to all readers: letting your extremely talented better half try and teach you something that they are fantastic at will result in lasting  memories).

Hence poor postural practice makes poor posture permanent. Try saying that 5 times fast.

Some aspects of posture are definitely permanent because they are unmalleable. Bone morphology fits firmly into this basket. If my lower leg is genuinely twisted (for example those poor kids born with talipes equinovarus or kids with external tibial torsion) then no amount of brain power, muscular control or PRACTICE will be able to change how that bone looks. Yet the way bones interact with one another can certainly be changed. Hence poor postural practice makes poor posture only SEMI-permanent.

So bones can’t be changed yet the way they move with each other can. How about muscles? We spoke in the previous article about small fascial adhesions forming between muscles in times of immobility. We know that if enough of these adhesions form then they can hold us into a certain position. However the key piece of information that we need to take away from this is that by and large these can be reversed. They can be altered with manual work such as massage or myofascial release by physiotherapists and through stretching and applying movement to stiff areas.

Does this mean that posture can be changed?

The shortest answer I can give you is three letters. Yes. Yes of course we can change posture. Much like we can change the way that someone swings a golf club, or learns to play piano or learns to speak another language. This all relies on the neuroplasticity of the brain i.e the ability of the brain to adapt and change throughout a person’s life. This neuroplasticity means that the body can certainly learn an entirely new posture for any given scenario as long as the body can first physically move into that posture.

I guess that means its experiment time! As you’re sitting there please shrug your shoulders up as high as they can go. All the way up. Now attempt to hold them there for the next minute while you read the rest of this article.

You have moved yourself into a new and foreign posture. Firstly it will feel strange to have your shoulders up near your ears… which is fair enough because you probably look ridiculous. But then you will feel the big muscles on the top of your shoulders starting to come alive as their endurance capacity starts to get tested. This muscle normally doesn’t work in this fashion, in this scenario. This muscle (the upper trapezius) usually works to a much smaller degree when you are sitting or standing. It probably only works this hard when you are carrying something heavy in one hand.

But the point is that your body could adapt to this new posture. And with the right training it can become adept at maintaining this new posture.

However learning is all about consistency.

Your body just needs the right exercises, done with enough frequency, led by the right health care practitioner, in order to change for the long term.

Yes I hear you asking what happened to the slouched over little boy. Well there are two answers to that question. Firstly, he became a Titled Musculoskeletal Physiotherapist who loves nothing more than to help others change their posture. But most importantly, he proved to himself that it could be done by changing his own.

If you are having trouble with your posture then please don’t hesitate to call your local postural expert in Dee Why at The Beaches Sports Physio.


Physios are really just doctors to manage and prevent pain

Like doctors, physiotherapists are first contact practitioners. That means you don’t need a referral from anyone for a physio to examine, diagnose and treat your injuries. Physiotherapists can refer you to get scans but we don’t prescribe medicine. Physios are experts in back pain, shoulder pain, knee pain, ankle pain, hip pain, neck pain, headaches, muscle pain, pains in the butt… you get the drift. But we don’t just treat pain; we also aim to prevent it.

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New mums with wrist pain

Hi Northern Beaches Mums Community!

This short video compliments the content created exclusively for The Northern Beaches Mums regarding de Quervain’s tenosynovitis i.e. wrist pain in new parents. It describes how to test whether de Quervain’s tenosynovitis may be part of your wrist pain in the form of a 3 tiered test. The first 2 described are part of Finkelstein’s test while the third stage is Eickhoff’s Test. Please do them in order on the non-affected wrist first! Good luck!

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