Tag: Parramatta Physiotherapy

Focus On Buttock Pain

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A “pain in the butt” is often used as a funny expression, but when it happens in real life, it can be anything but amusing. Whether it’s a dull ache or a sharp jab, pain in the buttocks can make sitting, walking, or even sleeping a challenge. There are a variety of possible causes, and an accurate diagnosis is essential for effective treatment. Here’s a breakdown of five of the most common causes of buttock pain.

1. Piriformis Syndrome

This condition occurs when the piriformis muscle—located deep in your buttock—irritates the sciatic nerve that runs beneath it. This can lead to pain, tingling, or numbness in the buttock and sometimes down the back of the leg. It’s often mistaken for sciatica but isn’t caused by a spinal issue. Overuse, prolonged sitting, or direct trauma to the buttock can all trigger piriformis syndrome.

2. Sciatica

Sciatica refers to pain caused by irritation of the sciatic nerve, typically due to a herniated disc or spinal stenosis in the lower back. While the source is in the spine, the pain often radiates through the buttock and down the leg. It’s usually felt on one side and can be sharp, shooting, or burning. Sitting for long periods often makes it worse.

3. Sacroiliac (SI) Joint Dysfunction

The sacroiliac joints connect your pelvis to the base of your spine. When they become inflamed or move abnormally—due to pregnancy, arthritis, or trauma—they can cause deep pain on one or both sides of the buttock. SI joint pain often worsens with activities like standing up from a seated position, climbing stairs, or even rolling over in bed.

4. Gluteal Muscle Strain

Just like any other muscle, the glutes can be overstretched or injured—especially during exercise, heavy lifting, or sudden movement. A strain or tear in the gluteal muscles causes localized buttock pain that tends to worsen with movement, especially walking uphill or climbing stairs. It may also feel sore to touch.

5. Ischial Bursitis

Also known as “Weaver’s Bottom, ” ischial bursitis occurs when the small fluid-filled sacs (bursae) that cushion the bones in your bottom become inflamed. It’s commonly caused by prolonged sitting on hard surfaces or repetitive motion like cycling. This condition leads to a dull ache or sharp pain at the base of the buttock, especially when sitting.

What to do if you have persistent buttock pain?

In most cases, the first step in resolving pain is getting an accurate diagnosis. Many different conditions can refer pain to the buttock, so it’s essential to seek a professional opinion. Your physiotherapist can rule out any serious causes and help identify contributing factors. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Cauda Equina Syndrome: What is it?

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Cauda equina syndrome is a rare condition that you may not have heard of, however it can have catastrophic consequences if it is not recognised and treated quickly. This condition occurs in up to two percent of cases of herniated lumbar discs, causing loss of lower leg function, incontinence and lower back pain. It is one of the few medical emergencies related to back pain and can be devastating if symptoms persist.

What Causes Cauda Equina Syndrome?

At the end of the spinal cord, there is a bundle of spinal nerves arranged in a formation that resembles a horse’s tail. (In Latin, cauda equina means “horse’s tail”.) These nerves are housed within the spinal canal in the lumbar region.

If, for any reason, these nerves become compressed, signals to the bowel, bladder, and lower limbs can be disrupted. Left untreated, this compression can result in permanent paraplegia and incontinence. Common causes of compression include disc herniation due to disc degeneration, tumours, inflammatory disorders, spinal stenosis, or complications following surgery. Trauma-related caudaequina syndrome—such as from knife wounds or motor vehicle accidents—can affect people of all ages.

Signs and Symptoms

This syndrome can be difficult to diagnose because its symptoms mimic those of many other conditions. However, there are certain warning signs that health professionals are trained to take very seriously.

These include:

Sudden loss of reflexes in the legs Unusual and rapid onset of bladder or bowel incontinence, or sexual dysfunction Pain in one or both legs Motor and sensory loss Tingling or numbness in the saddle region (groin and inner thighs) Bilateral sciatica

These symptoms are often associated with severe lower back pain. If you suddenly experience more than one of these symptoms—particularly incontinence—seek immediate medical attention.

Treatment Options

Treatment will depend on the severity and underlying cause of the syndrome. However, in most cases, cauda equina syndrome requires urgent decompression surgery to relieve pressure on the affected nerves. The longer the delay between symptom onset and surgery, the lower the chances of a full recovery.

Most patients will require physiotherapy, pain management, and psychological support—even if treatment is delivered promptly. While this is a very rare condition, public awareness is essential, as early intervention is crucial to prevent permanent damage.

None of the information in this article is a substitute for medical advice. Always consult a qualified health professional regarding your specific condition.

Meniscal injuries

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The knees take a lot of stress when doing medium- or high- impact activities such as running, jumping, hill-walking and playing field sports. The meniscus is commonly damaged during these activities, and can be a cause of significant pain and movement dysfunction if damaged.

What is the role of the meniscus?

The meniscus is a thin, fibrous cartilage lining the bones of the knee. Its main function is to absorb shock when performing weight-bearing activities such as walking, running or hopping.

The meniscus in the knee is c- shaped, and there is one on the outside (lateral) and one on the inside(medial) knee joint. The medial meniscus is more commonly damaged than the lateral meniscus, because of the fact that more weight is transferred through the medial knee joint in normal movement.

What causes meniscal damage?

Twisting forces most frequently damage the meniscus. For example, if a soccer player’s foot is planted on the ground and their body rotates around the knee, the meniscus will often be unable to withstand the pressure and will sustain a strain or a tear. This can be of varying degrees, to a few stretched fibres right up to a large tear involving multiple areas of the cartilage. A locking, clicking or clunking may be felt in the knee upon movement. Your physiotherapist will be able to perform clinical tests to check whether the meniscus is likely to have been damaged or not.

How can physiotherapy help?

Depending on the extent and location of the injury, many patients have excellent functional outcomes with physiotherapy management. This typically involves strengthening the muscles around the knee as well as increasing the range and training task-specific activities. Sometimes, a referral to an orthopaedic doctor can help to determine whether or not surgery may be appropriate. If you have any doubts, talkto your physiotherapist about your options.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Four Tips For Reducing Knee Pain

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Knee pain comes in many forms with many different causes. While treatment for every person and condition will be different in each case, here are a few tips that may help to reduce knee pain throughout the day.

1. Choose supportive footwear

One of the biggest culprits for ongoing knee pain is wearing unsupportive or high-heeled shoes to work. High heels often lead to tight calves and altered gait patterns, while unsupportive shoes can allow rollingin of the ankles, which can, in turn, place extra stress on the knee joints. Having an assessment with your physiotherapist to see how your shoes might be affecting your knee pain is a worthwhile investment.

2. Adjust your sleeping position

While most of the time, our knees get a well-deserved rest during the nighttime hours, there are a few sleeping positions that can place additional stress on the knees. Lying on your side with bent knees can place tension on the outer thigh muscles and also the knee joint itself. Try to keep your knees straightened to at least 30 degrees and if you sleep on your side, place a pillow underneath the top knee to reduce stress on the joint. Alternatively, if you sleep on your back it may be helpful to place a pillow under your knees so that they rest in a slightly bent position, to unload the joint. Try experimenting with different pillow arrangements to see which combination works best for you.

3. Avoid sitting or resting too much

When knee pain strikes, your first instinct is probably to get off your feetand stop exercising. The truth is that our knees, like all our joints, are designed for movement and regular exercise helps to keep them healthy. If you are having pain with high impact activities such as running, try switching to swimming and cycling before stopping exercise altogether. Resting in a sitting position for prolonged periods can also place excess stress over the knee cap and knee joint. When sitting for long periods, try to stretch your legs out ahead of you and avoid crossing your legs.

4. Seek physiotherapy treatment

Many of us see putting up with pain as a sign of strength however, a small niggle that is easily treatable can turn into a larger problem over time. This may seem like an obvious point, yet the first step to recovery is often just seeking treatment.

Our physiotherapist is happy to discuss your condition with you and share their tips to help you stay pain-free.

Some Surprising Facts About Posture

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Your posture is one of the first things other people notice about you and can affect so much more in your life than just spinal health. Healthy posture has been linked to better respiratory health and has even been shown to affect your confidence. In this article, we explore a few other surprising facts about posture.

Ideal posture doesn’t mean having a straight back.

Many people think having good posture means standing as straight as possible with your shoulders pulled back. This is actually a relatively unnatural posture and requires a lot of energy to maintain. Ideal posture, where the spine rests in its most comfortable and strongest position, is where the neck has a gentle curve backwards, the thoracic is curved gently forwards and the lower back curves back again. These curves create an elongated ‘S’ shape and can be seen when viewing a person from side on.

There are four common postural patterns other than ‘ideal posture’.

For those who don’t have ideal posture, four common variations are seen, these are; kyphosis (excessive curve of the thoracic region), lordosis (excessive curve of the lower back), flat back (loss of the normal spinal curves) and sway back (where the pelvis is pushed in front of your centre of gravity and the upper body leans back to compensate). Each of these postures is often accompanied by a typical pattern of joint and muscle stiffness that can lead to pain and injury. Your physiotherapist is able to assess your posture and identify any ways this may be contributing to your pain. They can also help you to change your posture with strategies to increase spinal mobility and strength.

Regular movement is just as important as your posture.

While ideal posture has been shown to reduce the amount of stress and tension found in the spinal muscles, holding yourself rigidly in one position is also not healthy. Ideally, our spines will be flexible and able to move through their full range without pain or stiffness. Regular movement is the key to healthy joints, including the spine. If you finding yourself sitting or standing for long periods, try to find time to stretch as well as working on your posture.

Posture can affect your ability to breathe

Your ribs are attached to the 12 thoracic vertebrae in the thoracic region of the spine. When this part of the spine is bent forwards (this is called a kyphosis) the ribs are unable to move as freely. This can impact your ability to breathe to full capacity if the thoracic spine is help permanently in this posture. In extreme cases this can affect overall health and well being as well as contribute to neck and lower back pain.

Your physiotherapist is able to provide advice and exercises to help you improve your posture based on your individual habits, muscle strength and length.

The Two Minute Workout Challenge

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Adding movement to your day when you work in an office or at home can be difficult. When it comes to exercise, making more movement a part of your daily routine can make a big difference to your overall health if done often enough. There are a few quick and easy suggestions to add more movement to your day, starting with something as simple as boiling the kettle.

As the average kettle takes 2-3 minutes to boil, challenge yourself to see if you can complete these three exercises while waiting for your cup of tea. You can focus on one each day, or work through one different one each time.

1. Challenge your balance.

Standing on one leg is something many of us assume we can do, yet rarely take the time to check. This is an essential skill that can deteriorate without being noticed until everyday activities, such as getting dressed, are impacted. Being able to stand on one leg is important for putting on shoes, trousers and reduced balance can be a risk factor for falls. Start by seeing if you can stand on one leg with your eyes open for the entire time the kettle is boiling.

Test both legs and if this is too difficult, make sure you are close to a bench that you can use to support yourself. To increase the difficulty, try balancing with your eyes closed, then progress to balancing on your tiptoes.

2. Heel Raises

Start by keeping your knees slightly bent and lift both heels off the ground at the same time. You can begin with repetitions of 5, have a quick rest then repeat. Challenge yourself to increase the speed of your heel raises and see how many you can fit into your waiting time. As you bend your knees, aim to keep your knees over your second toe. If you feel this is a little too easy, you can progress to single-leg heel raises, which will also improve your balance! You can start a daily competition with the people in your household to see who can complete the most.

3. Squats

Squats are a great exercise to keep your large muscles working. You can start with small squats and reps of 5, aiming to slowly increase your number and progressively squat to a lower position. As with heel raises, when you start to find squats to be less of a challenge, you can move to single-leg squats. Don’t hesitate to ask our physio for tips on how to stay active throughout the day. There are many more ways to fit movement into your routine.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

LCL Tears

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What is the LCL?

The knee is one of the largest joints in the body and has only one plane of movement. This means it bends and straightens but does not twist (much) or move from side to side. To keep the knee from moving in other directions, the knee is supported by many strong ligaments, with two of these being found on either side of the knee. The inside ligament is the ‘Medial Collateral Ligament’ (MCL) and the outside one is the ‘Lateral Collateral Ligament’ (LCL). The primary role of the LCL is to prevent the lower leg from moving too far towards the midline in relation to the upper leg. Both the LCL and MCL are extremely strong ligaments and provide lots of support to the knee during movement however, they are still vulnerable to injury.

How do tears happen?

The LCL is injured less often than the MCL, however tears do still occur. The most common way the ligament is damaged is through a force causing the knee to move inwards in relation to the upper leg, or a twisting of the knee. This can be seen in sports that involve changing directions or with a direct force, such as a rugby tackle. This injury can also occur from a simple fall and as with all sporting injuries, it is not only athletes who can be affected, anyone can tear their LCL in the right circumstances.

What are the symptoms?

Following an injury to the LCL, common signs and symptoms are a ‘popping’ sound at the time of injury, immediate pain with weight bearing and swelling and a feeling instability. The severity of the injury will impact how much each of these symptoms are felt and LCL tears are classified as either Grade I, II or III, which helps to direct treatment. A grade I tear is where a few fibres of the ligament are stretched and damaged, a grade II is where this a partial rupture of the ligament with some instability of the knee and Grade III is a complete tear.

How are LCL tears diagnosed?

Your physiotherapist is able to perform clinical tests to evaluate if there is any instability of the knee from an LCL tear. An MRI can confirm this diagnosis and an X- raymay be required to rule out any associated fracture. It is possible for nerve damage to occur at the same time as an LCL Tear, which will result in weakness and loss of sensation in the lower leg. Severe injuries are more likely to involve injury to other parts of the knee and your physiotherapist will make a full evaluation of all your injuries on assessment. Most LCL tears are managed well with just physiotherapy and support of the joint, however severe tears and associated nerve damage may require surgery. Your physiotherapist and medical team will work together to help determine the best course of action for each individual injury.

How can physiotherapy help?

For tears that don’t require surgery, your therapist will advise you on how to best support and protect the injured joint. In the first 48 hours, RICE protocol (Rest, ice, compression, and elevation) is applied to reduce any pain, swelling, and inflammation. Following this period, you will be advised on how best to mobilise the joint whilst preventing any further damage. Return to sport will be dictated by healing times with a full recovery expected by 6-12 weeks. Following ligament damage, balance, strength, and proprioception are often impacted and your physiotherapist will develop a program to address this, which is an important part of preventing further injury. Tears that are repaired surgically will require a longer program of rehabilitation and close liaison with the medical team.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Tips to Optimise Your Physiotherapy Sessions

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Physiotherapy treatment can be life changing, helping you recover from traumatic injuries, chronic pain and get you on the road to your best performance levels. There are ways to make sure you are optimising the effects of your treatment time.

Here are a few tips from our team to help you get the most out of every session.

1. Ask your therapist questions about your condition

Understanding your condition and how to best manage it is one of the most important factors for a successful recovery. Effective therapists allow time for you to ask questions in a non-judgmental environment. There are no stupid questions, if you don’t understand what is happening in your own body it is harder to follow advice and stick to protocols. This can also help you to cope with pain and feel less helpless in your recovery.

2. Follow your therapist’s advice and do your exercises

Home exercises are a key part of your recovery, especially when treatment times are limited. Try to stick to your exercise program as seriously as you would a medicine schedule. It is also important to ensure that you are doing your exercises correctly at home. Don’t be afraid to double and triple check your technique before leaving your appointment.

Your therapist will also provide you with advice regarding activities to avoid, how to stretch, when to rest and how to avoid further injury. If you’re not sure about something, ask your therapist to write it down for you.

3. Track your progress

Nothing can be more disheartening than feeling like the appointments and exercises you’re diligently attending to are making no difference. As therapists, we make regular measurements to track your improvement and know that while your symptoms might be staying constant, you are actually moving more and increasing stress on your body as you recover. Set your own measurements to help you track your recovery. This can help you stick to treatment and feel more positive as you complete your recovery journey.

4. Set goals and work with your physiotherapist to meet these.

The goals of recovery are different for everyone. Some of us want to be able to reach peak performance, such as running a marathon. For others, just getting through the day with a little less pain would be a huge success. Know your own goals and take the time to discuss this with your therapist, who will guide your treatment to help you meet these milestones.

Our physiotherapist is happy to discuss your condition with you and share their tips to help you stay pain-free.

The Hidden Benefits Of Learning A New Skill

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 When thinking about getting fit and exercising more, our first thoughts are usually that we should join a gym or start jogging. While these are both worthwhile activities, we know that if you dislike the activity you’re doing, the long-term benefits are usually not enough to keep you committed. There are a few things that are often overlooked when talking about exercising more, particularly the fact that you can often improve your life in more than one way if you find the right activity. 

Finding the right activity can boost your confidence an increase your daily activity levels.

We all have different tastes in food and the same is true for exercise. Some of us chase the thrill of learning a new skill; others prefer the challenge of pushing their limits of endurance while others love being surrounded by nature. Exercise is good for everyone, but finding the right activity for you is going to make it much easier to make it a committed part of your lifestyle. 

We are also more likely to enjoy doing activities that we are good at. Some people have great balance, while others have great eye hand coordination and someone who is an excellent dancer might be a terrible runner. Consider what you are personally good at and try to choose your activity based on this. Finding something that suits your routine is also an important component to making a new activity a part of your lifestyle.

Sometimes it is simply a lack of imagination that fails to get us off the couch. Jogging is not for everyone, but one of these sports might be. 

Here’s a quick list of less common activities that you may not have thought of trying; rock-climbing, volleyball, soccer, hula-hooping, slack-lining, golf, mountain biking, hiking, standup paddle boarding, roller skating, skateboarding, dancing, Pilates and yoga, just to name a few. 

Learning new skills can be good for your brain. 

Many people think that as they get older, learning new skills becomes too hard. The truth is, that with a bit of patience, you can surprise yourself with your ability to learn new things at any age. The brain is capable of incredible change and adaptation to new stimulus. Learning new things can be a great source of confidence and exercise has been shown to improve your brain function overall.

Many activities can help you meet new people and open you up to new communities. 

Even solo sports often have well connected communities of like-minded enthusiasts. Surfers have surf clubs, or often meet each other in the water, rock climbers are always looking for more people to take adventures with and people who wake up at 5am to do boot camp together become great friends. As we leave high school and university, it can be harder to create new social connections. Using exercise as a way to make new friends can have a significant impact on your overall wellbeing. In many activities, the communities are extremely supportive of beginners and you might be surprised at how friendly they are to newcomers. 

Your physiotherapist is able to give you great advice on which activities might suit your ability level and they can give you some tips to ensure you stay injury free when starting your new hobby.

De Quervain’s Tenosynovitis

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 De Quervain’s Tenosynovitis is a condition that causes pain and swelling on the thumb side of your wrist. It occurs when the tendons that move your thumb—the abductor pollicis longus (APL) and extensor pollicis brevis (EPB)—become irritated and inflamed as they pass through a small tunnel near the base of your thumb. This swelling can make it hard and painful to move your thumb and wrist, especially when you’re gripping something or twisting your wrist. If it’s not treated, the tendon sheath can thicken, making thumb movement even more difficult.

What are the symptoms?
The most common symptom is pain near the base of your thumb, often described as a dull ache or sharp pain on the side of your wrist. This pain might spread up your forearm and tends to worsen when you move your thumb or wrist, especially when gripping, pinching, or twisting. You might also notice swelling, a snapping feeling when you move your thumb, or even a bump where the tendons are inflamed. In some cases, moving your thumb becomes stiff or painful, and there is tenderness at the base of the thumb.

How does it happen?
This condition often results from overusing your thumb and wrist. Activities like golfing, playing musical instruments, fishing, carpentry, or even frequent texting can strain these tendons. New mothers are especially prone to it because of the repetitive motion of lifting their babies. Over time, constant gripping, twisting, or wringing motions can irritate the tendons and cause swelling. If this continues, scar tissue can develop, making movement even harder.

How can physiotherapy help?
Diagnosing De Quervain’s Tenosynovitis is usually straightforward. Your therapist will ask about your symptoms and perform a simple test called the Finkelstein test. In this test, you make a fist with your thumb tucked inside your fingers and then bend your wrist towards your little finger. If this causes sharp pain along the thumb side of your wrist, it’s a strong sign of De Quervain’s.

The primary goal of therapy is to reduce any pain and swelling of the tendons. This may include splinting the wrist to rest the tendons. Interventions to reduce inflammation, including ice or heat and the use of non-steroidal anti-inflammatory drugs (NSAIDs), may be recommended. Your physiotherapist will also address any musculoskeletal factors that might be contributing to tendon stress through poor biomechanics. Muscle stretches and strengthening exercises may also be prescribed.

If rest and splints aren’t able to reduce symptoms sufficiently, a corticosteroid or platelet-rich plasma (PRP) injection can help lower inflammation and ease pain. In very rare cases, surgery might be needed to release the tight tendon sheath and give the tendons more room to move. This is usually a simple outpatient procedure, and most people recover quickly.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your injury.