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

Pelvic instability or pain during or post-pregnancy? What is it and what can you do to manage it?

By Meg Doyle


What is pelvic instability or pelvic girdle pain?

Pelvic girdle pain is a condition that is very common in both pregnant and post-natal women, with a prevalence of approximately 63% at the 30th week of gestation and 31% at 3 months post-partum. It occurs due to factors such as muscle spasm, muscle weakness, increases in the hormones which cause soft tissue to lengthen and relax, and previous musculoskeletal concerns such as low back pain.


This condition is not harmful to your baby but it has many uncomfortable and painful symptoms including:


  • Pain over the front of the pubic bone (pubic symphysis) or sacral region (sacroiliac joint)
  • Pain in the area between the anus and vagina (perineum)
  • Low back pain
  • Pain radiating down the legs
  • Clunking or grinding sensations in the pelvic area
  • Pain with every day tasks such as walking, going up and down stairs or turning in bed

So, what can you do to begin to manage this condition yourself when you are pregnant?

It is important to begin managing this type of condition as early as possible so that pain and discomfort can be kept under control for the duration of your pregnancy. There are many different things you can try, as including:

  • Keeping your knees together, but not crossed
    • Try sleeping with a pillow between your legs
    • Get in and out of the car with your knees together (try swivelling on a plastic bag!)
  • Avoiding standing on only one leg
    • Try sitting down to put your pants or shoes on rather than standing
    • Take stairs one at a time
  • Avoiding carrying heavy things on one side of your body, including babies or toddlers
  • Icing the painful area for a maximum of 10 – 15 minutes as needed
  • Seeing your Physiotherapist for soft tissue massage, joint mobilisation and advice
  • Doing specific strengthening exercises of the gluteal and/or deep abdominal muscles which support the pelvis, as prescribed by your Physiotherapist
  • Wearing a pelvic support as prescribed by your Physiotherapist
  • Avoiding specific tasks that increase your pain as you are able
  • Planning rests between more strenuous tasks
  • Keeping active within your limits (eg. reduce your time walking if that is what aggravates your pain)

If you have any concerns about how your pelvic pain may affect your labour the birth of your child, speak with your obstetrician or midwife.

If you are unsure if what you are experiencing is pelvic pain, call to our clinic on 8555 4099 or BOOK ONLINE for an assessment with a Physiotherapist.

Emily’s Time at Think Pink

In March I spent an hour a week teaching Pilates to the lovely ladies at the Think Pink Living Centre in the CBD. The Think Pink Living Centre is a facility which is devoted to provide support and help to women diagnosed with breast cancer. I really enjoyed my experience working there and teaching Pilates to women who had recently undergone a mastectomy. As we know exercise is becoming a crucial part of the journey to recovery after a cancer diagnosis. Pilates is a wonderful way to incorporate mobility, core strengthening and shoulder stability work into cancer rehabilitation. I hope that some of the women I thought can take exercises from the class that they found most helpful and use them daily.
Not only was it great to see women show up to the class but it was great to see them coming together to provide support emotionally. I saw some great friendships blossom through the support groups Think Pink organise. I hope our close relationship with the women in Think Pink continues and we can work together to help as many women as we can.

Call us at 8555 4099 or Click Here to Book Online

By Emily Smyth

New Pinc & Steel Australia Website

PINC & STEEL Australia provides support to people affected by cancer, helping them take their first steps on the road to recovery.

There are now more people surviving a cancer diagnosis and if people don’t get rehabilitated after cancer it can affect their ability to work, their families, their physical, emotional and social well being and their long-term health.

Cancer rehabilitation and exercise can reduce side effects of the disease and debilitating cancer treatments, and can improve functional ability, quality of life and ultimately, survival.

Through this new Australian website you can
–  Learn about the Pinc and Steel Programs
–  Find a Pinc and Steel Physio Australia wide
–  Apply for funding
–  Donate to the Pinc and Steel Foundation to help fund someone through a cancer rehabilitation program.

Please contact us on 8555 4099 or click here to learn more about the Pinc and Steel Programs.

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.



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 milllion 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.


Clinical Pilates for Chronic Back Pain

Research suggests that both Clinical Pilates and general exercise programs delivered by Physiotherapists are both safe and effective in managing chronic back pain (1).

Clinical Pilates offers a tailored exercise program, which is designed and monitored by your physiotherapist.

In addition to Clinical Pilates, regular exercise is a very important part of back pain management. Here are some tips:

1. Choose an exercise that you enjoy, and that you can participate in pain free. Running, swimming, cycling, yoga and dancing are all great activities that you may choose to do.

2. Work exercise into your daily routine e.g. riding to work, or walking home from the station.

3. Being active has numerous other benefits including cardiovascular and mental health. Strength and balance training is also important for bone health and preventing falls, especially in people over 60 years old.

Physiotherapists stay up to date with the latest research in order to provide high quality care to patients. They also consider their clinical experience and the patient’s wishes when deciding on a treatment regimen.

To learn more about Clinical Pilates, or to book a class, call InnerStrength of Bayside on 8555 4099 today or CLICK HERE  to book online!

(1) Wajswelner, H., Metcalf, B., Bennel, K. (2012) Clinical pilates versus general exercise for low back pain: randomized trial. Medicine and Science in Sports and Exercise. 44(7): 1197-1205

What is Foam Rolling? by Emily Smyth

Foam rolling is soft tissue release technique that is great and easy to do at home. It works to release muscle tightness and knots which may have formed in muscles. By releasing these knots you help to re-establish muscle movement patterns and encourage pain free movement. In recent years the popularity of foam rolling for athletes and physically active people has sky rocketed. Personally, as a physio, foam rollers are one of my favourite pieces of equipment. They offer so much more than just soft tissue release and can be incorporated into core strengthening and balance exercises.

Often when speaking to my patients about rehabilitation and at home programmes, I discover that a significant amount of them have a foam roller however are not sure how to use it. As they are such an effective and versatile piece of equipment there are many different techniques and ways to use the roller. At times you may find it can be overwhelming and people may avoid using them. To try and help you with a few different ways it can be used I have outlined my top three foam roller exercises you can do.

Emily’s top three foam roller exercises: 

  1. Thoracic (upper) Back Rolling.
  • This is one of my favourite techniques with the foam roller. It is a great way to open up the chest and release muscle tension after a long day at work.
  • Begin with placing the foam roller on your back at the bottom of your rib cage, with your bottom on the ground.
  • Support your head with your hands keeping your elbows wide and your knees bent.
  • Once you are feeling confident begin by lifting your bottom up and pushing the foam roller up your back towards your shoulders. You may be able to focus more on one side by leaning your weight over towards either the right or left hand side.
  • Continue until you feel the muscles begin to release, approx. 30-60 seconds.

2. Iliotibial Band Rolling (ITB).

  • Rolling your ITB is a great way to reduce the possibility of causing injury to your knees and keeping the legs nice and flexible. Unfortunately rolling your ITB can be quite painful, however the pain reduces the more consistent you are with your rolling.
  • Begin rolling by placing the roller on the side of your leg right under where you can feel your hip. You should be right on the side of the leg.
  • If pain levels are high you can reduce the pressure by placing your opposite foot on the ground in front of you.
  • Roll your leg along the roller until right above the knee joint.

3. Top Taps on the roller.

  • This exercise is an example of how to use the roller for a balance and core strengthening exercise.
  • Begin by lying down on the roller ensuring that your head and bum are supported on the roller. Support yourself using your hands (the wider the arms the greater the level of support).
  • Depending on your core strength float one or two legs into a 90/90 position, aka Table Top (90 degrees at the hip and knee). Try to keep your spine stable.
  • Ensuring that you experience no pain in your lower back slowly lower one leg and tap your toe off the ground then return it to 90/90. Repeat this on both legs 12 times.

Please contact us on 8555 4099 or BOOK ONLINE for one of our Physiotherapists to create your own personalised Foam Roller program!

5 Reasons why Clinical Pilates is Important Post Child Birth by Emily Smyth

1)  Clinical Pilates is a safe form of exercise and is easily modifiable. Your Physio can vary each exercise, to still allow you a good workout, despite sore wrists, stretched tummy muscles or other common aches and pains.

2) Clinical Pilates assists the recovery of your body by strengthening your abdominals, back and pelvic floor and assisting in maternal weight loss.

3) Clinical Pilates helps to prevent incontinence and prolapse.

4) Clinical Pilates is a convenient way to exercise – we have Mums and Bubs classes, suitable from 6 weeks post child birth as well as morning, evening and weekend Clinical Pilates classes for you to join.

5) Clinical Pilates is low impact, but still provides an opportunity to strengthen your muscles, this will raise your metabolic rate and allow your body to burn more energy.

Call us on 8555 4099 or BOOK ONLINE now!

Acute low back pain: What to do before you see your Physio – by Luci Minogue

An episode of acute low back pain can come on at any time, without warning. It can be as simple as reaching forward to open the kitchen drawer and you suddenly experience intense pain in your lower back and possibly down your leg also.

We know that seeing a Physio as soon as possible is important to our patient’s recovery. Therefore, at InnerStrength of Bayside, we leave emergency appointments most days to allow for this. Treatment will be multifaceted and will consist of advise in ways to to minimise your pain, hands on treatment if indicated, stretching and strengthening exercises to do and possibly taping of your lower back.

Here are some things you can do whilst waiting for your physiotherapy appointment.

  1. Listen to your body – if a movement, position or activity increases your back pain or particularly your leg pain, avoid it. You may not be able to move around as easily as normal, but try to rest in positions or do movements which do not increase your symptoms, such as slow short episodes of walking, stretching your back into extension (standing and leaning backwards through your lower back or lying on your stomach and pushing up through your arms with your hips on the ground, or stretching into flexion (lying down and hugging your knees into your chest).
  2. Stay active and avoid complete rest – the old advice to rest in bed when you have back pain is now outdated and has been shown to lengthen your recovery time as you are likely to stiffen up and your muscles become weaker. There will be times that you need to rest, but otherwise try to do short walks or activities that either relieve or do not increase your symptoms.
  3. Heat – try lying down in the most comfortable position you can find, this could be lying on your back, stomach or on your side, putting a heat pack or hot water bottle over the area of pain for approximately 20 minutes. It should be a comfortable warmth, not too hot. Repeat this every 2 hours. If this does not help or increases your pain, you can try ice.
  4. Stay positive – up to 70% of people will experience low back pain at some stage of their lives. With appropriate treatment you are extremely likely to overcome this episode of pain and return to your normal activities and lifestyle. Our Physiotherapists will be able to advise you on ways to prevent this episode from happening again.

Please call us on 8555 4099 or BOOK ONLINE to make a Physiotherapy consultation.

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