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

Full Body Assessment at McLaren Vale, Aldinga, Seaford, Sellicks Beach and Mount Compass

Full Body Assessment at McLaren Vale, Aldinga, Seaford, Sellicks Beach and Mount Compass

At Willunga Physio we use a unique 7 step process to thoroughly assess the whole body, including nerves, joints and muscles, to make sure we don’t miss anything and get you back on track as soon as possible. This process can be completed with appointments in rapid succession to get to the bottom of your issue in days – not weeks/months!

Below is a quick video with snippets of Marc taking a client through the process, highlighting the thorough process and how large improvements can be made within a session.

Our longer appointments allow us to leave no stone unturned, and to test multiple areas of the body to figure out which dysfunction throughout your body is the underlying cause to your condition. It may be in the area you are experiencing pain and discomfort, or it may be a completely remote part of your body that you had no idea was involved! With this process you can be confident that there is no guessing, because we only treat the spot that gets us the most dramatic improvements and the fastest results.

Step 1   We listen to you and ensure we are working towards your goal.

Step 2   We check out the “injured” area first for any “nasties”, or things that may require a scan or further review, in which case we can organise this and refer you on. We then check the neural tension in all areas of the body – because the nerves are the most sensitive structures in the body, and muscles protect nerves, so by fixing the nerves first, everything else we do will work better and last longer!

Step 3   Once nerves are clear, we assess your whole body, head to toe, and come up with a list of dysfunctions or “unhappy signs” – these are the things in your body that aren’t 100%, and could be contributing to your condition.

Step 4   We then test all of these “unhappy signs”, by releasing them one at a time, and measuring how much we had found, if at all, they improve your presenting issue – once we release the underlying cause, lots of your dysfunctions will improve, and it will be obvious to both us and the client that this is an important spot to fix in order to fast track their recovery!

Step 5   When we have found the underlying cause, and everyone is confident that this is the key spot that needs to be fixed, we will work on this point to get as much improvement as we can, as fast as we can.

Step 6   We will teach the client strategies to look after this spot between appointments, exercises to improve this area, and self release strategies to speed up their recovery.

Step 7   When the client is going well, we can look at any residual bits of tightness that may be left, and progress their exercises to a suitable level. We also then push appointments out to “tune ups”, where every fourth tune up is half price and we are just working to keep you good, instead of fixing you when you are broken!

Preparing for a walking holiday

Preparing for a walking holiday

Tom Anthoney, our Practice Principal, has just returned from a 5-day hike in sunny Queensland. Hiking from Noosa, 95kms to Rainbow Beach. He carried a pack weighing in at 20kg, which included all his food, tent, cooking gear and First Aid Kit.

So, what’s the best way to prepare for such a walk?

Tom suggests buying or borrowing the best boots and pack you can afford.  A well fitted pack, that transfers the weight through your hips/waist is most important.

Taking the time to adjust the pack, before you set off, so that is sits high on your shoulders is crucial. And the best trip (passed down by other hikers) is to bend forward at the hips before adjusting the hip straps.  Bounce/hitch the pack up high on your back before tightening the hip straps.  When you return to upright the pack almost ‘floats’ on the shoulders. And well fitting boots means good support, no friction of rubbing.

Finally, a roll of physio tape is essential, Tom used it to secure padding for blisters, for supporting ankles and could use it to fix rips in tents, packs or even boots…ESSENTIAL

Now a bit about the walk

The walk, known as the “Coolaloo Great Walk” starts on the beach just north of Noosa and gradually winds its way inland. Tom and his old mate Greg accidentally added a few kilometres to the walk by following the beach for a little longer than supposed to (the surf was amazing – had to be seen). After re-finding the track, they arrived at Camp One just before sundown. (NB. There are four designated campsites on the track – roughly 20 km apart).
All food on the trail tastes “amazing” and the hungry hikers were glad to successfully road test the gas cooker and cook up the heaviest food first – pasta and Neapolitan sauce.

Day Two started with the devastating realisation that they (read Tom) had left the teabags back in the car. So coffee and muesli was the go! Then 20kms of gradual climbs to stunning views before climbing back down to camp by the Noosa River.

Day Three started with a dip in the dark waters of the Noosa River. They dragged themselves out to strap the packs back on and head back up again through the blackbutt forest into more rainforest. It’s amazing how much terrain can be covered just trudging along talking about football, comparing the great teams of bygone years.

Day Four was 90% rainforest walking. Many sectors of the track had been blocked by fallen trees during Cyclone Debbie. Fortunately, the Queensland Parks Ranger’s had been busy clearing these and only the occasional climb was required. Arriving at camp on night four, we were greeted with a note from fellow hikers who had gone ahead of us and two teabags. These were savoured like a fine wine – for the gesture as much as the flavour.

Day Five was all about the weather.
Rain, rain and more rain ….40ml in all as we completed our hike into Rainbow Beach. We were so wet, we decided that we could not get any wetter. Boots full of water, meant every step felt like a foot spa …. Bubbles caressing our tired feet! We reached the “end” of our walk and celebrated with a tired and drenched photo. All that was left was to stroll the 2kms into town fuelled by the thought of a nice hot shower and a cheeky beer or two.

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!

Does rubbing our shin splints really work?  –  NO

Does rubbing our shin splints really work? – NO

Does it really hurt? – YES

Shin splints is an umbrella term generally used to categorise different types of shin pain, and with pre-season kicking off and all of the dry/hard ovals around the place, this is the time of year people tend to have this complaint!

There are 2 main causes of common shin splints:

  1. Tight calves – puts uneven pressures on the lower leg and pulls in areas we don’t want!
  2. Over Pronation (flat feet) – This loads up the inside muscles of the lower leg that run on the inside of the shin, making them become tight and dysfunctional.Both of the above causes can be made worse from running in incorrect footwear, or running on a hard surface, whether it be on a road or a hard dry oval.

Shin splints responds well to particular stretches and exercises, again depending on the driving cause, and Dry Needling has proven to be an effective way to release the muscles causing the problem!

Here is a good exercise to begin with, this calf stretch may help to loosen the tight muscles causing your pain.

Try this stretch for 20 seconds each leg twice a day.

Where to from here?

Often the muscles that are to blame are quite deep in under the calf/shin, so to get into them with massage/trigger points can be very painful. Dry Needling however can get in deep to the tight, knotty areas without causing too much discomfort in the rest of the muscle, often getting a good release and getting very fast relief from shin splints.
Taping is also a good way to relieve this pain in the shins, by supporting the foot in the right position, we can offload the muscles that are being over worked and causing them to get tight, this can allow people to often continue their chosen sport/exercise without the pain in their shins with each step!

Diagnosis and Assessment

Diagnosis and assessment is crucial with shin splints, as it can have different causes and different muscles associated with it, it is important that the correct treatment plan is identified early, before it gets worse! Your physio can assess your contributing factors and often apply treatment to get you relief straight away. They can also arrange any referrals or set you on the right path for other treatments or changes that may need to be made (different shoes, orthotics, training regime changes, exercise programs, etc).


Written by Marc Elliott, Physiotherapist

Hamstring injury: could it be back related?

Hamstring injury: could it be back related?

The short answer is yes.

Hamstring injuries can be back related, and in almost all hamstring cases there would be some involvement whether directly or indirectly from our back and nerves.

How many times do we hear, “I’ve done a Hammy!” Especially from those Weekend warriors who work hard all week then get out to sports on the weekend and ‘ping’ goes the hammy.

Our hamstrings attach to the bottom of our pelvis, which works hand in hand with our lower back, hence any change in back position affects our pelvic position which in turn affects our hamstring length.

The nerves supplying our hamstrings come from the lower back, so any tightness or jammed joints in the lower back can affect the way the nerves are running down the leg and impact on their ability to glide and move with our hammies. We know, muscles protect nerves, so if we have a tight nerve coming from our lower back, the hamstrings will tighten to protect this nerve, and this tightness puts the muscle at a higher risk of damage if working hard.

This is why sometimes we can stretch and stretch a muscle but it just won’t seem to loosen off, because it may be protecting a tight nerve, and by stretching it you are putting the nerve under strain which actually makes the muscle tighten even further!  In this case we need to look at the back to free up this tight nerve.

If you suffer from hamstring tightness or injury why not try freeing your back up and see if it helps?

These are 3 simple back stretching exercises on our blog ‘Stiff back – Do I need a new bed?’

Try these exercises 1-2 times a day for a week.  If it helps you can confidently say your hamstring issues are back related.

Physio can help

The physios at Willunga are specially trained in the latest nerve testing and treatments.  We can assess  what contribution the nerve is having to your hamstring tightness, and how much is true muscle tightness. Neural tightness is often easily cleared, allowing tight muscles to let go and stretch properly.

What about calf muscles, Achilles tendons etc?…..more on this later