Chronic Pain: Should Exercise Be Pain-free? By Meg Doyle

Do you have pain from an old injury that has just never completely gone away?
Do you find that your pain stops you from doing things in daily life?
Do you avoid certain movements due to being worried it will aggravate your pain?


What if I told you that doing movements that are slightly painful could actually reduce your pain levels?



Pain persisting longer than three months is considered to be chronic pain and is something that affects 1 in 5 Australians. It is a complex condition affecting a person’s emotional and social wellbeing, coupled commonly with fears of movement and increases in pain.

 Activity levels are significantly lower in those with chronic pain, with an increased fear of movement associated with the least amount of regular exercise. Insufficient levels of physical activity are the fourth leading cause of preventable deaths (heart disease, strokes, diabetes and cancers) annually world wide.


So, if you’re in pain and afraid of movement, how can you exercise and optimise your health in a way that you know is safe and beneficial for you?


Recent evidence has emerged stating that there are significant benefits exercising into pain over pain-free exercises for reducing chronic pain in patients. Why? Firstly, it addresses your fears of both movement and increases in pain, allowing you to increase your activity levels. It can also facilitate your body’s release of natural pain killers… who knew you could do that?!

An important thing to know is that pain is a warning signal sent by the brain, not your body, and it doesn’t necessarily mean that injury has occurred.

Let’s say you have avoided bending forwards for the past few years because you’re worried it will give you pain. If one day you attempt to bend forwards, there are pressure, stretch and movement direction signals being sent by your body to the brain saying “hey, we haven’t experienced this in a long time … is this okay?”. Your brain then may send a pain signal in an attempt to keep you safe, despite no injury occurring. If this movement is repeated in a safe and controlled way, eventually your brain will become accustomed to it and the level of pain will decrease.

So next time you’re moving and you feel a mild amount of pain, consider if it is a movement that you are fearful of, or avoid. If it is, persist within your limits and give your brain a chance to adapt.

If you suffer from chronic pain and would like to be guided through a safe exercise program with one of our Physiotherapists, please contact us on 8555 4099 or BOOK ONLINE.



Why we might work on your ‘form’ in an exercise

As Physiotherapists, we spend a lot of our time re-educating and retraining how our patients move optimally. Let’s look at the bridge, for example.



The bridge is a great exercise to increase the strength of the strongest muscle in our body – gluteus maximus. This muscle plays a big role in movements like running and squatting, and forms the rounded shape of our behind!. A problem a lot of people have is that they get cramping in the back of the thigh (the hamstring muscle) when performing a bridge. It can be so frustrating! So why could this be happening?

It could be due to a change in what we Physios call ‘motor control’.

Motor control determines the appropriate coordination of muscles to generate a desired movement, based on how our body is feeling and the world around us. For example, if you squat carrying a child in front of you, your body will activate your thigh muscles a lot more to account for the increased load, compared to squatting with only your own body weight.

Problems occur when we have a muscle that either doesn’t contribute enough strength, or is doing too much to help out, in a desired movement. In our bridging example, a common contributor to thigh cramping is that our gluteus maximus isn’t doing as much of the work as it could, so the hamstrings are then working overtime to pick up the slack – ouch!

This finding of an underactive gluteus maximus may shed light on a potential contributing factor to low back or leg pain if you have any. It is likely that retraining this muscle to activate more in this exercise will be one of many things your Physiotherapist would work on with you. This may include bridge technique changes such as including a pelvic tuck, or performing completely different exercise altogether to work on this deficit, before integrating it back into a bridge.


If you are experiencing pain or discomfort in everyday life, book in for an assessment with one of our Physiotherapists by calling 8555 4099, or click here to book online.


Physical Exercise To Increase Bone Mass – by Emily Smyth

Many of you may have heard of Osteoporosis, some of you may even have it. But what exactly is it?

Osteoporosis is a loss in bone density (qualified as a bone density below 2.5 SD). After menopause women can lose up to 20% of their bone density in the first 5 – 7 years. This loss of bone density weakens your bones and makes you more susceptible to breaking bones. While many people think osteoporosis is something to deal with in later life, research is now suggesting that what we do currently has a direct effect in later life. Young people tend to reach their peak bone mass in late teens and early twenties, with a gradual decrease after menopause.

Unfortunately, in modern society research has shown that the number of adults who are presenting with osteoporosis is on the rise. Around the world osteoporosis is responsible for 8.9 million fractures a year which is equivalent to an osteoporotic fracture every 3 seconds. Physical exercise is the only intervention which has been shown to increase bone mass. Research shows that young girls and boys who exercise regularly have a higher bone mass than their inactive counterparts. Reaching a high peak bone mass at a younger age and maintain this throughout life can reduce your chances of osteoporosis when you are older. So how does exercise improve bone density? Weight bearing exercises stress the bone causing them to increase bone density. While walking is classified as a weight baring exercise, research has shown that exercises such as Pilates and weight lifting are a more effective and global form of strengthening for your bones and muscles.

Below are my top three tips

  • Maximise your bone density before menopause– Stay active and include weight bearing exercises such as weights or Pilates into your weekly workout routine.
  • Minimise loss of bone density after menopause. Increase your weight bearing exercise and calcium and vitamin D intake. Pilates is a safe and effective method of building bone density
  • Reduce your risk of falls- If you already have low bone density it is important to reduce the chances you have of falling and therefore fractures. Specific strengthening and balance exercises such as Pilates can significantly reduce your risk of falling.

All of our Physiotherapists are extremely experienced in exercise prescription, especially Clinical Pilates. Why not speak to our Physiotherapists today about what can help you?

Call us on 8555 4099 or BOOK ONLINE.


We are hiring a new Physio!

We are looking for a dynamic team player to join our Physiotherapy team and take over an existing full-time or part-time caseload. The job is available from early November 2018 and entails Physiotherapy, Clinical Pilates, great clients, fun people to work with and inspiring PD.

Flexible working, excellent remuneration, regular staff in-services and ongoing CPD activities are supported. If you are looking to progress your career, join an innovative team and develop your skills, this is the role for you!

The clinic has strong community links, values good relationships with local businesses, as well as close working relationships with local gyms and GP practices.

Features of our clinic include:

  • Growing and vibrant business.
  • Busy timetable with over 45 classes including Clinical Pilates, HIIT Pilates and Mums and Bubs Pilates offered by three physiotherapists
  • Well-equipped exercise studio including Pilates equipment and an exercise bike.
  • Generous sized treatment rooms.

We are one of Australia’s leading providers of the PINC and STEEL Cancer Rehabilitation Programs which focuses on rehabilitating those with cancer and improving survival rates

Strong emphasis is on manual therapy and exercise rehabilitation. Previous experience with Clinical Pilates and Dry Needling are preferred though not essential.

To be considered for this position you will be an Australian Resident or Citizen, have sound clinical skills and full AHPRA registration. We are open to considering passionate graduates, but remuneration will be commensurate with experience.

Recruitment agencies need not apply.

Email your CV to or contact Shasta on 8555 4099.

Dry Needling Explained


Last month as part of my professional development I attended a dry needling course. Since attending the course I have had lots of questions about dry needling. I love learning new things and I have found it a great new addition to my treatment “toolbox”.  I thought I would take this opportunity to introduce you all to dry needling.

Historically dry needling (or a similar treatment technique) dates back as far as 3400BC. When the Otzi Ice Man (from 3400BC) was found in 1991, needle marks were noted on his bones around his hip. After investigation it was found he had arthritis in his hip – the examiners hypothesised that Otzi was receiving pain relief from the needles for his arthritis.


So, what exactly is dry needling?

Dry needling is a treatment technique where a thin needle is inserted into a hypersensitive point in a muscle. This causes a series of localised and systemic reactions resulting in the muscle spontaneously releasing. This release results in reduction of pain and an increase in joint range of motion.

Something that confuses many people is the difference between acupuncture and dry needling. Dry needling is a western medicine approach which uses physiological principles and trigger points to reduce pain and increase movement. This technique is only appropriate for musculoskeletal problems and does not play a role in medical illnesses. Traditional Chinese Medicine uses the body’s meridians to balance the chi within the body. This technique can be used for all different manner of illness and injuries.


Why choose dry needling?

Some people find the idea of dry needling a little overwhelming so they wonder why we choose it. Over the last two months I have treated many of my patients with this method. They have found it to be an effective, relativity pain free and efficient method of treatment. Many people find they are time poor and when they come to physio we may struggle to get to all the muscles we want to work on within the time frame. Dry needling is a much faster treatment and can encourage a faster recovery period when compared to soft tissue massage.


I have really enjoyed using dry needling on my patients over the last few months. It’s always great to learn new things and see how helpful they can be to my patients. If you would like to try dry needling feel free to call us on 8555 4099 or visit our website to book online.

*Please note: Dry needling may not be an appropriate treatment for everyone

Written by Emily Smyth (Physiotherapist)

Scoliosis? A curve in the spine? What is it and how is it best managed?


What is it?

Scoliosis is a deformity of the spine that causes it to curve abnormally from side-to-side. The most common type is called idiopathic scoliosis, which means there is no known cause of this condition.

Is it common?

Scoliosis affects around 2% of the population. The adolescent growth spurt is when idiopathic scoliosis most commonly presents, with approximately 80% of idiopathic scoliosis diagnoses occurring between the ages of 10 – 18 years old, and more cases found in females.


What are the symptoms?

–       Uneven hips or shoulders
–       One shoulder blade more prominent than the other
–       One side of the rib cage more prominent than the other
–       An appearance of being bent to one side
–       Difficulty breathing
–       Back pain



It is very important that scoliosis is diagnosed early, as abnormal curvatures of the spine can progress very rapidly during growth spurts in adolescents, or spine degeneration in the elderly, potentially leading to other health complications. Physiotherapists are well-equipped to assess, diagnose and treat scoliosis of the spine in all ages.


So, I’ve been diagnosed. What now?

If you have scoliosis of any severity, specific exercise methods are used to treat your specific curvatures with the aims to:

–       Decrease curve progression
–       Improve posture and function in everyday life
–       Reduce pain and discomfort
–       Prevent or delay surgery
–       Improve psychological outlook and overall quality of life

In addition to exercise, fitted braces and surgery are sometimes needed in more severe cases.


If you have scoliosis or are concerned that you or a family member may have it, call us on 8555 4099 to organise an assessment with one of our Physiotherapists, or click here to book online.


Written by Meg Doyle (Physiotherapist)

Can I exercise while I’m pregnant?

Exercise is very beneficial during pregnancy and can actually help to prepare you for labour and prevent complications. It is perfectly safe to exercise during pregnancy, as long as activities are performed at an appropriate level for you and your body. Please note, if you have been given restrictions by a health care professional regarding exercise, it is important to adhere to said restrictions.

What are the benefits of regular exercise during pregnancy?

  • Increased energy
  • Improved fitness
  • Reduced back and pelvic pain
  • Stress relief

How much should you exercise?

  • 30 minutes, 3-4 days per week

What kinds of exercise are appropriate?

  • Pilates for pregnancy
  • Gentle yoga
  • Walking
  • Swimming
  • Pelvic floor exercises

What exercises should you avoid?

  • Heavy weights (excessive pressure on core and pelvic floor)
  • High impact exercise (e.g. netball or aerobics – this can put too much pressure on your joints or cause your core temperature to rise to an unsafe level for your baby)
  • Wide and/or deep squats and lunges (excessive pressure on pelvic floor)
  • Significant changes in pressure (eg. swimming in very deep in water)
  • Anything which brings on the following symptoms

What are warning signs you need to look out for?

  • Headaches
  • Dizziness or feeling faint
  • Chest pain
  • Calf pain or swelling
  • Cramping in the lower abdomen
  • Feeling too hot

If any of these symptoms occur, ensure you contact your doctor, midwife or physiotherapist.

During this time, it is important to remember that your body is creating and carrying another being. Listen to your body so that you don’t push yourself too hard. Just keep yourself moving within your own capacity.

If you are pregnant and would like to start Pilates with us or would like some advice on what exercise would be appropriate for you based on your previous exercise levels, previous/current injuries or any pregnancy-related conditions, call us on 8555 4099 to make an appointment with one of our Physiotherapists, or click here to book online.


Post written by Lily Percoco (Work Experience Student) and Meg Doyle (Physiotherapist)

Clinical Pilates as a Rehabilitation Tool – An interview with one of our patients


We interviewed Kristin, one of our Clinical Pilates patients, about her experience using Pilates as a rehabilitation tool. Kristin has been attending regular Clinical Pilates classes here at InnerStrength of Bayside for the past 10 months. A big thank you to Kristin for sharing her experience with our community.

Could you tell us a little bit about your injury and how it limited you before starting Clinical Pilates?

I have hamstring tendinopathy and bursitis which caused me to stop my yoga practice because of the frequent hamstring stretches, which I previously really enjoyed doing. It got to the point where it was so painful that I couldn’t get out of a car and had difficulty walking and going up and down stairs.

How do you think Clinical Pilates has helped in the rehabilitation of your injury?

I’m getting stronger and I have a lot more awareness of the muscles that support the hamstring. My pain has definitely decreased, and I have returned to some gentle yoga practice.

Are there any other benefits of Clinical Pilates that you’ve experienced, outside of the rehabilitation of your injury?

I have increased strength, and more awareness of the smaller muscles in my body that I didn’t even know existed. I’ve noticed that those muscles are really supportive in returning to my yoga practice. I’ve gained flexibility too, which I never expected I would gain from Pilates.

Once you’ve recovered from your injury, do you think you’ll continue to do Pilates?

Yes, definitely.

Cancer and Exercise – By Emily Smyth

Recently, cancer and exercise has become a topic of great interest across Australia. With new research coming out and more information available it is becoming clear that exercise is a key component of treatment. Years ago when having chemotherapy or radiation therapy it was advised to rest and relax after therapy. In recent years we have greatly moved in the opposite direction, encouraging people to stay active before, during and after their treatment.

Exercise has many benefits throughout the cycle of a cancer diagnosis. It is a great tool for managing stress, reducing side effects from treatment, increasing energy levels, reducing pain and fatigue, preparing the body for surgery, rehabilitation post-surgery and an overall increase in quality of life. Research suggests that exercise can reduce your chances of mortality or cancer reoccurring by as much as 30-40%. This is quite a significant finding and has encouraged many people to exercise.

People diagnosed with cancer are encouraged to reach the same level of exercise as those who do not have cancer. That is 150 minutes of moderate/intense exercise a week and 2-3 strength training sessions a week. Often the thought of 150 minutes of exercise is overwhelming at the start. However, try starting at a slower pace and increasing it as you can. It is important to speak to your medical professional before starting any programme to ensure it is the correct programme for you. At InnerStrength of Bayside, we run the PINC programme which utilises a mixture of Clinic Pilates and at home exercises to help you achieve your goals.

Not only is activity important once diagnosed with cancer but active lifestyle has been substantially linked with a decreased risk of colon, breast and endometrial cancer (see information here from the National Cancer Institute) with less substantial but positive results indicating the same of multiple other forms of cancer. While many people struggle to include exercise into their daily lives, often people don’t fully understand the health benefits associated. Exercise is associated with a reduction in all-cause mortality (inclusive and exclusive of cancer). I believe that if the benefits of exercise were turned into medication it would be the worlds most used medication.

Here at InnerStrength of Bayside, we are accredited in PINC Cancer Rehabilitation. If you have any questions in regards to the PINC programme, feel free to contact us on 8555 4099.

Knee pain – Why you may be given exercises for your hip

Patellofemoral pain (PFP) is common source of pain at the front of the knee and can be caused by changes in the way the knee cap moves over the end of the thigh bone. The thigh muscles (quadriceps) are responsible for moving the knee cap and control its positioning.  PFP is a very common patient presentation at physiotherapy clinics, including ours!

As with most injuries, some form of exercise is generally prescribed by your physiotherapist as it aids recovery and rehabilitation, and PFP is no different. Strengthening the quadriceps muscles in the correct way is very important with this condition due to their close relationship to the knee cap (it’s inside the quadriceps tendon!).

The best available evidence suggests that strengthening of your hip muscules is beneficial for improving pain and function in people with PFP. This combined with quadriceps strengthening is more beneficial than only strengthening your thigh muscles. This is because the hip muscles control your thigh bone position relative to your shin bone, and if certain muscles aren’t as strong as they could be, the result may be increased rotation of the thigh bone. As the knee cap sits on the end of the thigh bone, it makes sense that it could upset the harmony at that joint!

Everything is connected, meaning the location of pain isn’t always the only source of the problem.

If you are experiencing pain, book an assessment with one of our Physiotherapists by calling 8555 4099 or click here to book online.


Written by Meg Doyle – Physiotherapist

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