Osgood-Schlatter Syndrome

Osgood-Schlatter Syndrome usually occurs in children and would normally affects both knees. This can be classified as ‘growing pains’. The pain is usually located at the tibia tuberosity (the bump in the tibia) and can be very sensitive to touch. These tend to occur when the child is undergoing a growth spurt, as well as an intense period of exercise; specifically: soccer, basketball and ballet. Traditionally speaking, there are more boys being affected by this syndrome; however the gender gap is narrowing as more girls participates in sports.

Ongoing activity, without appropriate management by a physio, may result in an avulsion fracture, whereby a piece of bone is torn away from the main bone. In this case, a splint may be ordered to allow the fracture to union.

Osgood-Schlatter is normally treated conservatively when caught quite early. Physiotherapy is usually recommended to help guide rehabilitation. Treatment would involve reducing tight muscles in the quadriceps, hamstrings and gastrocnemius muscles; as well as some strengthening exercises. Taping may also help.

Physiotherapists can also liaise with your child’s coaches so that they can continue to train, but minimizing any activities that may aggravate the syndrome. This is important as stopping their training will stunt their skills growth. Stopping training will also result in muscle atrophy and tightness developing as you ‘wait’ until the pain goes away. This may then create a domino effect and result in other issues in the near future.

Our physiotherapists at Capital Physiotherapy are well experienced dealing with Osgood-Schlatter Syndrome. Not only are they qualified to assess the functioning of your child’s knee joint; but they also have experience working with different sports clubs. This means they are well placed to not just treat your child, but communicate with other stakeholders to ensure your child gets the best care they deserve. This holistic care is important for your child’s wellbeing and Capital Physiotherapy will deliver.

So don’t hesitate to contact us at Capital Physiotherapy and we will get your child back to their best!

Muscular Imbalance Causing Knee Pains

I have seen many people reporting of knee pains. Some who had a sporting incident, resulting in a traumatic damage to the knee; while others have been a gradual progression of knee pain. Initially the pain is described as mild, an annoying ache. With ongoing aggravation, the pain progresses in a sharper type, where it can eventually stop people from doing their daily activities. With these gradual progression type of pain, it is important that the knee is looked after quickly so that further aggravation and worsening of symptoms can be avoided.

The quadriceps muscles are made up of 3 main group of muscles. The first in the Vastus Lateralis; the second is the Vastus Intermedialis and the third is the Vastus Medialis Oblique. Each of these muscles attaches onto the patella and has its own direction of pull. The VL pulls the knee cap laterally (to the outside), while the VI pulls the knee cap directly upwards. The VMO, meanwhile, pulls the patella medially (to the inside).

Each of these muscles will interact in such a way that the knee cap is pulled directly up along the patellar groove. By keeping the knee cap moving smoothly along this groove, you can minimise the pressure around the knee cap.

As you can imagine, any issues with the quadriceps, will result in this finely tuned movement of the knee cap to be disturbed, causing issues in the future.

Improper training, could potentially result in the VL being overworked and getting much stronger than the VMO. You can see this when someone does a squat or a lunge and their knees are moving sideways. This results in an imbalance of the patella as it move up and down along the patella groove. The result of this would be increased friction along one side of the patella which will gradually become increasingly worsening knee pain.

Injuries to the knee will also affect the movement of the patella. The more significant and frequent injuries you have in the knee, the more your VMO becomes less activated. This will have the same impact as the above scenario over time; mainly a gradual worsening of pain; as well as wear and tear along your knee cap.

It is therefore imperative that you get your knee pain looked at as soon as you can. Further postponement as well as ongoing aggravation will result in worsening of your symptoms and finally preventing you from doing your exercises.

Come to our physios at Capital Physiotherapy. Our appointments are strictly 1-on-1 and we provide longer than industry standard appointments to truly understand, not just your body, but your exercise routine as well as a multitude of other factors that can affect you. It is only with a great understanding of your situation will you achieve the outcome you deserve.

So don’t wait any longer and call us now!

MCL and LCL injury

Other important ligaments in your knees are your Medical Collateral Ligament and the Lateral Collateral Ligament. These, along with the rest of the ligaments, work together to provide stability in the knee joint. The MCL, originates from the inside part of your femur (thigh) and attaches to the inside part of your tibia (leg). The LCL, on the other hand, originates from the outside part of your femur and attaches to the outside part of your tibia.


The MCL is important in providing stability in your knee, so that it does not bend inwards. Injuries to this ligament could be due to a prolonged stress on the MCL, such as during skiing. It can also be injured due to a traumatic incident, whereby you are tackled from the outside.


The LCL, meanwhile, is important in providing stability in your knee, so that it does not bend outwards. Injuries to this ligament are usually due to a traumatic incident, whereby you are tackled from the inside.



There are 3 grades of ligament tears:

  1. Grade 1=a small tear resulting in some pain but still allowing almost full function
  2. Grade 2=a moderate-significant amount of tear, causing significant pain and reduction in function
  3. Grade 3=a complete tear of the ligament, resulting in pain, instability as well as minimal function. A grade 3 tear may also involve damages on other structures as well.

It is important that after a knee injury and if you suspect an MCL or LCL tear, that you seek physiotherapy help as soon as you can. Our physios at Capital Physiotherapy are well trained to diagnose as well as clear other structures in the knee of any involvement in the injury. Your appointment is spent 1-on-1 for the duration of the session to ensure you get the most out of your physio. A treatment plan will be provided to you so that you have a clear understanding of what needs to be done to get you back doing what you do best!

Don’t hesitate to contact us at Capital Physiotherapy!

Patella Tendinopathy

A lot of people come into our rooms at Capital Physiotherapy with knee pains. Specifically, pain around the front of their knees. There are a few structures in this area of the knee, but we will be discussing about the patella tendon. The tendon is a part of the quadriceps muscle. The quads originates from the pelvis and inserts into the upper part of the patella. From here, the patella tendon starts and finishes at the ischial tuberosity, located in the tibia (lower leg).

The patella tendon is important as it is part of a pulley system for the quadriceps muscle. This adds leverage and consequently power to the quadriceps muscle. This will allow you to do intensive activities, such as jumping and sprinting. In saying this, you can imagine how much stress is placed on the tendon! In fact, the most common cause of patella tendinopathy are jumping and sprinting based sports.

This stress can cause issues in the tendon which will then lead to pain and subsequently, reduction in your activities! When stress is placed on a tendon, there are some micro tears, which heals when you look after the body. However, if you continually place the load on your tendon over a prolonged period of time, there is more aggravation than healing; resulting in pain. 

Usually, people will come in not knowing what’s causing the pain in their knees. This is because the pain would only come gradually. The pain would initially be described as an ache, but as physical activity continues, the pain becomes sharper, until finally you have to stop your sport.

Our physios at Capital Physiotherapy are well experienced with knee pains. While it’s important to get rid of the pain so that you can go back to your physical activity, what is equally important is finding the exact cause of the problem in the first place. During your consultation, our physio will spend their time 1-on-1 with you, to make sure they understand not just your body, but your training routine. They will develop a treatment plan that will not only get you pain-free, but also ensuring you do not have the same problem again.

So don’t hesitate, and get that knee looked after now. The sooner you get the knee looked after by our physios at Capital Physiotherapy, the better your prognosis and the quicker you’ll get back to your game!

PCL injury

We’ve talked about the ACL, now we come upon its equally important cousin, the Posterior Cruciate Ligament (PCL). Like the rest of the knee ligaments, the PCL works with them all to provide stability within the knee joint. It originates from the anterior (front) part of the femur and attaches to the posterior (back) part of the tibia. The ACL, as mentioned previously, originates form the posterior part of the femur and attaches to the anterior part of the tibia.

The PCL is important in ensuring stability within the joint by stopping the posterior movement of the tibia in respect of the femur.

Injury to the PCL is less common than an ACL injury. PCL tears are usually due to direct blows to a bent knee. This could be when you have an accident and your knee receives a direct blow from the dashboard. You may also be tackled in certain ball sports, while having your knees bent. Another common method is through extreme hyperextension.

Regardless of the cause, it is imperative that you get your injured knee looked at by a trusted physiotherapist. Prolonged sport activity is usually impossible due to pain as well as instability within the knee. Patients would normally report of a poorly localized posterior pain that is deep within the joint. Depending on the severity of the injury, your rehabilitation will differ. Conservative management is usually done before surgical intervention is advised. However, please talk to your physio before you make your next move.

Our physios at Capital Physiotherapy will ensure that you are looked after from the start. This means making sure we not only confirm a PCL tear, but also rule out other injuries. We will also provide a treatment plan that will include the goal of you going back to your chosen sport. This plan will include what we need to do, what exercises you require and many more important details to get you back to your best. By getting your injured knee early, you will have the best outcome quickly!

If you have any questions, please do not hesitate to contact us and we would love to be a part of your journey back living your life the way you want it to be!

Meniscus Injury

The knee joint is a relatively complex joint with multiple structures that works together to provide both stability and movement in the knee joint. A part of the knee that is quite commonly injured is the meniscus. This is an injury that Luke Hodge had back in May 2016.

The meniscus are 2 structures within the knee joint. As you can see from the picture, you have a Medial Meniscus and a Lateral Meniscus, both shaped in a circular fashion.

These structures has a few important functions within the knee joint. The most important function is they act as shock absorbers and load distributor. They are sponges that reduce the stress going through the bones; thereby reducing wear and tear in the joint.

The meniscus can be injured in several ways. Injury to the meniscus can be due to a gradual build of stress, which may occur with repeated or prolonged squatting/kneeling. An athlete may also injure their meniscus if they try to turn/pivot on their knees too quickly; this will result in a partial or a total tear.

Once a tear has occurred, it is important that the knee is assessed to find out how severe the injury is. Depending on the severity, a period of conservative management may be enough to get you back playing your sport. However, more serious injury such as the ‘bucket handle tear’, may require you to undergo an arthroscopy. In saying this, if you have a knee injury, come visit us at Capital Physiotherapy. Our physiotherapists have a lot of experience dealing with these types of injury. They will spend the time with you to make sure they get the right diagnosis as well as give you the correct treatment plan that you need to get better quickly!

So don’t hesitate, and get that knee looked after now. Capital Physiotherapy is ready to help you!

The Proper Squat Technique

Squats are one of the best exercises you can do in the gym (or at home!). This is because it is one of the few exercises that works multiple areas of your body. This makes it an efficient exercise to make you stronger quicker! However, when done incorrectly, squatting can cause a lot of issues to your knees. Improper technique results in imbalanced pressures around your knee cap, which will accelerate wear and tear.

Not only are squats great for your body, but they are easily done anywhere you’d like to exercise. While the gym is a great place, as you can use different bars with weights to challenge yourself. However, you can do squats at home or even at the park! The best exercises are the ones you can do anywhere. This means you won’t skip your exercise day and get the most out of it!

The most important factor while doing squats are to make sure your knees are positioned correctly throughout the movement. This means: 

1. Your knees do not move past your toes at the front 

2. Your knees do not move rotate inwards

By making sure you do not do the above, you reduce the chance of any wear and tear around your knee cap as well as reducing any issues that arise due to improper technique. By having your knees moving in the correct way, your knee caps are able to distribute the force much more evenly around its surface area; this reduces stress building up on only one area of the knee cap.

In addition, by doing the exercise correctly, you will gain the most out of your squat. Correct technique allows your muscles to function at its most effective; which means you can progress yourself and get stronger quicker!

Don’t hesitate to contact Capital Physiotherapy team if you have any questions and we’ll be able to help you!

Also, if you haven’t checked our previous article about Patellofemoral Pain Syndrome, please click here.

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome, or PFPS, can be a very debilitating condition which can stop you from doing a lot of activities. At its worse, most patient will report of pain and inability to walk far.

PFPS is a term given to describe pain around the knee cap. This is usually due to repetitive damage around the knee cap as it contacts abnormally with the femur. Most patient will report of having a gradual build up of pain. Initially, the pain is niggling but does not stop a person from doing their exercises. Continued activity result in increasing pain which will in turn stop them from participating further. With rest, the pain would abate. However, returning to sport is usually short lived due to the returning pain.

There are multiple causes of PFPS. This include:

  • Foot and ankle misalignment
  • Poor hip control
  • Poor core strength
  • Leg length discrepancies
  • Poor training schedule (not enough rest, sudden increase in intensity)

Usually there are multiple factors that contribute to PFPS. It is important that you seek a trusted physiotherapist that can do a comprehensive assessment on your body. Taking the time with the assessment will result in identifying the causative factors, which means a better prognosis! You can trust our physiotherapists at Capital Physiotherapy to understand your body and get you back on track! Our initial appointments are industry-leading 1 hour. This gives our physiotherapists time to do full assessment, to make sure you are looked after!

Depending on what caused your PFPS, you may expect your physio at Capital Physiotherapy to:

  • Reduce any muscular tightness
  • Give exercises to improve muscle control
  • Suggest different types of footwear, or refer you onto our trusted network of podiatrists
  • Help plan an exercise program to make sure your body do not burn out

Our physiotherapists are trained at making sure all your concerns are listened to and provide you the best care you need.

If you have any questions, please do not hesitate to contact Capital Physiotherapy. Our physio clinics are located in Footscray, South Yarra, and Balwyn.

BULGING Disc? Herniated Disc?

One of a common reason for lower back pain is due to a bulging disc. But what exactly is a disc?

The disc is a gel like substance that sits in between our bones in the spine, the vertebrae). These discs acts to help with: shock absorption, spinal stability and allows a more efficient movement from the spine. The discs are made up of two parts: the more elastic outer shell, which keeps the shape of the disc together, and the gel like inside.


In normal movements, the disc will get compressed and extend in certain parts, depending on the movement. For example, bending forwards will result in the front part of the disc to be compressed, while the back part will be distended.

When you have a ‘disc bulge’, what happens is, instead of the outer elastic part keeping the disc’s shape, it has protruded out (this is called Bulged Disc). Depending on the severity of the injury, the gel like content can actually seep out as well! (This is called a Herniated Disc). 


Apart from pain, this bulging disc may be severe enough that it touches the nearby nerve root. When this occurs, you may also experience the following symptoms: pins and needles, numbness, burning, electrical shocks as well as loss of power in your legs. 





Diagnosis and Treatment

It is important that you seek a trusted physiotherapist that will be able to do a comprehensive assessment on you to get the correct diagnosis quickly. Without the right diagnosis, your treatment will be ineffective.

At Capital Physiotherapy, our initial appointment is 60 minutes, instead of the normal 20-30 minutes. This allows our physiotherapists the time to complete a full assessment so that the right treatment be implemented. The quicker your back is treated, the better your outcome is!

We are well equipped at providing you the best care to get you back on your feet. Treatments may include:

  • Mobilisation
  • Massage
  • Electrotherapy
  • Exercise prescription, including building core strength
  • Pilates equipment, including: reformers and Wunda Chair.

Anterior Cruciate Ligament Injury

The knee joint itself involves a multitude of structures to keep it stable and strong. The Anterior Cruciate Ligament (ACL) is one such structure that helps achieve these objectives. It originates from the posterior (back) part of the femur and attaches to the anterior (front) part of the tibia. The Posterior Cruciate Ligament (PCL) meanwhile, originates from the anterior part of the femur and attaches to the posterior part of the tibia. These two ligaments crosses in the middle and provide specific stabilities to the knee.

The ACL is important in securing the knee joint by preventing the forward movement and rotation of the tibia (lower leg bone) in respect of the femur (thigh bone).

There are many ways that a knee can be injured. On the one hand, there could be an obvious traumatic incident, where you were tackled while playing football. On the other hand, it could also be due to an inconspicuous activity, where you were simply running and trying to turn one way and injured yourself.

Most ACL injuries, in fact, are done via the later method. There may also have been a factor of jumping/landing prior to the injury.

A full tear of the ACL, may actually not cause significant amount of pain in some cases. In fact, some athletes would feel that they can continue their sporting commitments, only to find themselves unable to perform due to significant instability in the knee joint.

It is highly suggested that you stop your activities and seek diagnosis immediately. Our physios at Capital Physiotherapy are trained to ensure you get the correct diagnosis first and foremost. They will spend the time that is required to make you feel at ease and give you the correct advice that you need. Our appointments are 1-on-1 which ensures you get the most out of your physiotherapy sessions. A treatment plan will be drafted for you, so that you can go back to your best quickly! Capital Physiotherapy is also able to get you crutches as well as braces if required.

In the meantime, make sure you RICE; Rest, Ice, Compression and Elevation!