When Physios hurt their backs!

When Physios hurt their backs!

It has been an interesting experience as a Physio with 25 years’ experience having recently injured my lower back worse than ever before. I have been treating people with these injuries for many years but gained some interesting new insights from the other side of the face hole.

How did I hurt myself?

I hurt my lower back lifting something awkward and heavy. The Christmas tree (normally consigned to the shed at this time of year) that required shifting to allow some renovations to said shed. I normally use a sack truck to move the Christmas tree as it is about 30 to 35 kg. On this occasion I had to lift it over a fence and changed my mind how I would lower it halfway through the lift. Awkward! I felt the strain but felt only minor discomfort and had lots more to lift. I continued to lift other tubs and boxes until my muscles tightened up so much (to protect me) and I had to lie down. The unexpected load that resulted from my ‘change of mind’ meant that my muscles could not take the strain and it was transferred to my ligaments and Spine. Damn!!

So … I finally did the right thing. I laid down on the floor for the rest of the afternoon and did not help my wife with the dishes or other chores. The next day I awoke very stiff and unable to put my socks on. Looking at myself in the mirror I noticed that my spine had a definite lean to it.

We call this a ‘list,’ … like a ship that lists before sinking. It is a protective mechanism that the body uses to take pressure off discs. It is always counter -productive.

I knew what I had done and promptly booked myself in with one of the other Physio’s in our team. Daniel  assessed me well and treated me exactly as I had taught him in a “training session” some five months earlier. He used traction techniques to reduce pressure on the disc. He used gliding techniques to ease pressure on the nerves. He used firm massage and dry needling to relieve the muscle spasms. I felt immediately better, but remained a little listed.

I returned home and carried on with tasks that I had been unable to complete the day before. I avoided heavy lifting and instead pruned trees avoiding bending over. The reaching and stretching however still proved too much for my irritated disc and the muscle spasm all returned as did the list.

Back on to the floor I went! More anti-inflammatories, more rest, and then over the following days more physio, more heat packs and stretching exercises. Walking is usually good therapy for people with a stiff back. It is however not recommended for people with a list. I found out why this is by trying to ‘walk it out’ while still a bit listed. And I ended up very stiff, very tight and back on the floor again!! My lesson here, don’t push activity or exercise until it all listing is corrected.

With more physio Daniel straightened me out again and three days later I returned to work. Having not been at work for well over a week I was very heavily booked and worked from 8 AM until 6 PM as usual. As a lot of my work involves bending forward, my back was pretty stiff the next day. Luckily, I had a rest day. Unluckily (or perhaps stupidly,) I chose to spend the day sitting and driving for a total of eight hours. Groan. Most people realize that sitting with an irritated disc is not recommended and I learned a lesson why this is so first hand. Climbing out of the car at 10 PM having just driven back from Adelaide for the second time on the day the ol’ list returned. The bad news, I had a full list of clients the next day many of whom I had already rescheduled once and really needed to be seen. So what did I do? I took some medication (“soldiered on “) and modified my work as best I could. I got Dan to straighten me out as best he could mid-afternoon, continued working until 6 pm. By the time I staggered home at the end of the day I was worse than ever!! The pain had now spread into my leg and I realised “oh this is what sciatica feels like”.

It seems I am either a slow learner, a terrible optimist, or a bit of a dill. Most likely a combination of all three. This time I was determined to correct the list before attempting anything. I spent all weekend lying down using the exercises and strategies I generally recommend to my clients. I did not lift, I did not sit, I even ate all my meals lying down. I took anti-inflammatory medication and paracetamol every four hours and nearly died of boredom, looking out the window at all the jobs I needed to be doing. With more physio on Monday and a trip to the doctor to arrange a prescription for some stronger medication, I slept much better and woke up pretty much straight after the third day of rest! The pressure on the disc bulge in my back had resolved but the muscles that had been holding me in that weird, crooked way did not want to let go. Marc our Senior Physio, released the pressure on the nerves and the tight muscles and I was straight!!! Hooray, straight for the first time in a fortnight. Now that I am straight I have started my Pilates, exercises to activate the core muscles and glutes to keep myself straight. I plan to walk slowly and correctly and to continue my Pilates to maintain the restored alignment and balance. I am grateful for the assistance I have received from our Physio team, the doctor and my family, especially my kids who have been putting my shoes and socks on for me over the past week.

To summarize the lessons learned for me and perhaps for others you may know who have had disc problems resulting in a listed / crooked spine:

1. Don’t continue lifting after hurting yourself.

2 Don’t try and walk out the list, or do physical jobs while listed … It will only make things worse.

3. Listen to your physio about the best positions / exercises to use

4. Lie down if listed and take medication until you can stand straight (be patient…this may take 2 to 3 days)

5. Prioritize your own health. We only get one body.

Tom Anthoney

Have you got the strength to power through?

Have you got the strength to power through?

Do you get part way through your trainings or games and start to get sore/tight for no apparent reason? It may not be that something is damaged, it may be you need to build up the strength of a particular muscle group!
Our muscles help us to move, dodge and burst into activity, but with repetitive use through games or training, these muscles can start to fatigue and not work as well as we would like. When these muscles start to get tired, our joints aren’t as protected as they were at the start of our activity, and they can start to work in different, less ideal ways, putting stress on different structures and often cause that annoying pain that creeps in half way through our activity. The key to getting through these niggles while we play is STRENGTH!

Often we think we are getting “tight” and that we need to stretch out the soreness, when in fact it is the opposite, we need those fatiguing muscles to tone up and work harder, like they were at the start of our training or game.

One of, if not the most, important muscle in keeping our lower limbs functioning in the right way and keeping our alignment correct is our glutes (buttock muscles). When these muscles start to tire our hips can start to roll in, our knees roll in and the arches of our feet start to flatten. This can lead to a number of aches and pains in the limbs, especially knee and hip soreness. They also work in tandem with our hamstrings, which are a commonly injured muscle group, especially in footballers (could this be related to common glute weakness??)!

The other muscle that works extremely hard when we are running and playing sport is our calf muscles, the ones connecting our knee to our ankle that propel us forward and spring us into the air.
These muscles can often feel tight during sport, and while this can be because of genuine “tightness”, it can also be because of weakness, and the more fatigued they get, the tighter they become. This leads to calf and ankle soreness, “shin splints” and general tightness in the lower limbs. Your physio can quickly and easily assess the strength and endurance of your muscles and see if they are a contributing factor to your pain, or, if they are in fact the key reason you are experiencing soreness. As a general rule we want the strength on our left side to match that of our right side, and there are certain limits we should be able to reach before fatigue, as a test to see if we are strong enough in certain areas.

If you are a sports person, try these exercises:


For “good” calf strength, you should be able to raise up on to your toes on one foot 20+ times without pain or discomfort, and should be able to do this on both sides.


calf stretch

For “good” glute/hammy strength, you should be able to raise your hips up on one leg 15+ times without pain
or discomfort, and again should be able to do this evenly on both the left and right sides.

glute exercise

*If any of these exercises cause pain or discomfort, cease immediately and contact your physio!

Stiff Back…. do I need a new bed??

Stiff Back…. do I need a new bed??

At this time of year after a long cold winter clients often ask if they need to buy a new bed.

They ask this as they often wake up feeling stiff in the back or the neck and assume the bed is a large factor in this.

More often than not we say No.

Unless you are sleeping in a hammock or a super soft bed with no support, often the bed is not the problem. Its you. Sorry –it’s a sign your body is not happy.

If your body is not happy during the day, from prolonged work postures, lots of sitting, driving etc etc it often “guards” to protect you with muscle tightness and stiffness.

This “guarding”often worsens when we stop moving at night.  So we get out of bed and feel like everything is “seized up” And the old bed gets the blame.


Please note the exercises and advice provided is of a general nature and should not be used as personal, professional advice. If symptoms persist we encourage you to see your GP or preferred health care provider.

To be sure if its your body or the bed that needs help, try this:

1. Sleep in another bed for 2-3 nights and see how you feel in the morning. No different ? Still stiff ?…. Its your body that’s not happy.

2. Loosen your body up a bit. Try the simple stretching exercises demonstrated on the video BEFORE you go to bed each night.  It will only take 2-3 minutes.

Try this every night for a week…except Saturday…..well its Saturday night!! Feel better less stiff in the morning? ……..its your body that’s not happy.

3. Tried step 1 and 2 still stiff in the morning?

Book in to see one of our Physiotherapists to have your body fully assessed and we will help make your body happy again. Ph (08) 8556 4416

4. If we can’t help you we will send you to see someone who can.

5. As the last resort we may suggest you >>> buy a new bed !!

My scan/image report sounds bad. Does damage = pain?

My scan/image report sounds bad. Does damage = pain?

Damage does not equal pain, this is why scans can be misleading!

Scans can be very useful for diagnostics and to point us in the right direction, but they can also cause worry and unhelpful beliefs that we should be in pain because of damage seen on scans.

What your body part looks like while you are lying in a tube does not correlate well with how someone feels and moves. A lot of people have problems found on x-rays and other scans but have no pain or symptoms at all!!
Below are some great examples of why we don’t need to be getting too worked up about what our scan results are showing, and how with the right treatment and mindset, you can beat your pain!

Intermittent Pain

In most cases, people will describe their pain as having varying intensities, and at times it is not there at all, which is great! This means there are times when your nervous system is happier than the times you are feeling the pain – These “happy” periods can be extended.
In terms of a scan, even when we are in these happy, pain free zones, an MRI or X-Ray will still look the same as when you are in pain, so you can live comfortably and pain free with your scan still looking like it does!


Degeneration is a term used to describe “wear and tear” that our body and its joints naturally experience through living life! Degeneration begins to appear even in our late 20’s (pain free individuals included!).
If you have one sore knee and one pain free, studies have shown that the “good” knee will show just as much degeneration, sometimes more, than the other knee, as they are both the same age and likely to have done similar amounts of work, so why would only one knee be sore if degeneration is the source of pain??


It has been shown that up to 87% of people in their 20’s had disc herniation’s/ protrusions, highlighting that this sort of movement or change to the disc is considered quite normal! Many people live with these things every day and have never had a painful back.  So a disc bulge seen on CT scan or MRI is not a recipe for long term back pain.

 Pinched Nerves

Nerves are very strong, resilient structures, but can be very sensitive when aggravated. They are designed to be stretched, squashed and moved in all directions, so a “pinched nerve” seen on MRI/CT may not be the main source of pain.  We sit on our sciatic nerve all day, and stretch nerves every time we bend and twist, and the majority of the time – no problem.
Whatever our spine looks like on an MRI, chances are it looked like that the day before you had pain as well, as these changes take years to develop, as long as there was not a major trauma or incident.

What all of this tells us is that what we see on a scan may not be the actual cause of your pain.

At Willunga Physio we look at your whole body the ‘whole picture’ to locate the source of your problem.  We check every muscle, joint, action and nerve that may be contributing and fix the cause of the problem.

Ice or heat for my stiff neck?

Ice or heat for my stiff neck?

When we get an injury we all want some relief, but we also want to make sure we aren’t doing any more damage to the area and to know that what we are doing is beneficial.

But what about when you’ve woken up and your neck feels ‘locked’? Every time you try to turn it you get a sharp pain or stiffness. What is best?

Which brings us to the age old question, should I apply Cold or Heat??

What does Ice do?

When cold is applied to an area, it restricts blood flow and causes constriction of blood vessels, hence causing the bleeding of an injury to be reduced, along with any inflammation.  It can be a very effective pain reliever (once you have got over the ‘cold’ bit).

And heat?

Heat application causes dilation of blood vessels and increases the blood flow to a muscle, which can have a relaxing effect and aid in pain relief.

Both are useful and both can provide relief, however it is important to know at what stage to use them and the symptoms to look for that can help you choose which medium to use!

So if you have injured yourself

As a general rule, if an injury is showing signs of inflammation, ie. It is hot, red or swollen, then Ice is recommended as this will reduce the inflammatory process.

Other signs of inflammation can be

  • pain at night or when you settle for the day,
  • throbbing pain, or
  • pain that is a dull ache/throb deep in the area of injury.

Usually inflammation occurs for 2-3 days post injury, so if you roll an ankle, pull a muscle, get a knock or have a definite injury, ice for the first 2-3 days is recommended, using it for 20 min every 2 hours.

For that sore back or neck

Heat is generally used for a more chronic injury, or if an injury has passed this inflammatory stage and is feeling more stiff and tight. Because of the increased blood flow, heat can help relax tight muscles, and with increased blood flow and nutrients to the source, can be a nice way to get some pain relief.

Signs to use heat may include

  • feeling stiff and tight,
  • waking in the morning with tight/stiff areas that improve as you get moving,
  • pains that feel better when you have a hot shower or do some exercises to warm them up
  • general aches and pains that have been there for a long time and haven’t recently been stirred up.
And my locked neck?

If you did something to injure your neck (twisted quickly of jolted it somehow).  Ice is best.  BUT if you just woke up feeling stiff and didn’t do anything to injure it, Heat will help relax the muscles and ease some pain.  As always, if unsure contact your friendly physiotherapist.

To sum it up:

ICE is best if – red, hot, swollen, acute injury (2-3 days), achey/throbbing pain, sore at night when resting.

HEAT  is best if – stiff, tight, feels good when shower or do exercises, morning stiffness, no acute injury.

4 easy tips to ease neck/back pain

4 easy tips to ease neck/back pain

  1. Take a “Smoko”!

THAT got your attention :).  Now, when your work colleagues get up and go outside for a ‘smoke break’, get up and go with them. Be sure to stand ‘up wind’, but a short break, regularly from our seated work posture is the best way to give your neck and back muscles a break.

Walking and rolling your shoulders for a minute gets you out of that static seated posture and gives your muscles a chance to re-charge. Often we work better after a short break anyway!

  1. Buy a good chair!

An easy way to take some tension out of your shoulders is to ensure your office chair is set up correctly. You will need a gas/hydraulic up/down chair to do it. Spend the $$, they are gold.

  1. Adjust your chair

Using the lever that lifts you up/down ensure your seat is high enough that you can drop your hands and shoulders down to the keyboard.

A low seat and the subsequent shoulder shrugging required to get your hands up on the keyboard is an easy thing to change.  Your shoulders will love you.  And if your feet then do not reach the ground you have just found the perfect spot to keep the Yellow pages.

 That other lever on the gas, up/down chairs adjusts the back rest angle, but also and more importantly the angle of the part you are actually sitting on.  Tipping this forward (even as little as 3-4 degrees) throws your weight forward onto your feet, so you sit on your ‘bum bones’ not your tail bone.

N.B. It can take a day or two to adjust but is worth persisting. The lumbar support in new cars also does this, and if all else fails a Lumbar Roll (from your friendly physio) strapped to your seat will help sit you up.


 4. Exercise

Our bodies need movement and different positions but winter is really conducive to sitting on the couch, drinking Milo. A 5 minute walk daily, can really help prevent back pain. 10 minutes a day is better and 25 minutes, Tremendous!  But 5 minutes will do….remember follow those smokers out or walk to the bakery, just get moving! Now would also be a good time to restart the exercises your physio gave you.