Corticosteroid Injection for Tennis Elbow


You may have heard of corticosteroid injection (CSI) or autologous blood injection (ABI) to help relieve pain from your tennis or golfers elbow. CSI is when corticosteroid is injected to your tendons where it has the ability to act as an anti-inflammatory. CSI is a very strong drug in which it can control symptoms of pain, however, there are risks of long-term use of CSI. The risks include:

  • Induced osteoporosis 
  • Impaired ligament repair 
  • Injection site reaction

ABI is a medical procedure whereby your blood is injected into your tendon to stimulate a healing process for the tendon. Although, these procedures may seem promising to reduce your pain, evidence has suggested that CSI provides short-term pain relief (Coombes et al., 2010), but there were worse outcomes a year after CSI (Coombes et al., 2013). Comparatively, ABI has shown to have a better effect than CSI, but only lasting effects of 6 months to one year after multiple injections (Chou et al., 2016; Elmajee et al., 2016).

A more preferable, non-invasive and friendly treatment for tennis/golfer’s elbow is to visit a physiotherapist for the management of your elbow pain. Physiotherapy has more benefits and have fewer to no risks compared to CSI and ABI. Tennis/golfer’s elbow is a condition where the tendons of your elbow are affected and painful. Although, tendons LOVE load, they are very sensitive to change of loads. Change of loads are:

  • Increased activity of the arms above what it is normally used to. For example, if you normally work at a computer job, then you start gardening.  
  • Change of tools. Tools come in different weight and size and a slight change of tools can change the load of the tendons. 
  • Using the arms in a different way 
  • A quick change of arm movement. For example, quickly catching a falling object may be a movement you’re not used to and can be the tipping point of what your tendon can tolerate 

At Capital Physiotherapy, a physiotherapist can help explore management strategies of your elbow pain. If you require advice on CSI, ABI, and physiotherapy, we are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at or do an online booking here.

Stiff Back from Prolong Sitting Can Lead to Shoulder Pain

Shoulder pain is one of the most common issues treated by physiotherapists in this day and age. While there can be many causes of shoulder pain, poor posture is one of the main factors. 

The “hunched” position or curved upper back as a result of prolonged desk and computer work can change the way your shoulder moves in everyday activities and cause our upper back to become stiff. Over time muscles can become tight at the front of the shoulder, pulling it forward. As well as this, muscles at the back become weak and cannot support the shoulder blade correctly and the joints of the upper back become stiff, restricting movement. This changes the position of the shoulder blade and causes impingement and pain during everyday activities such as lifting and dressing.

Common signs and symptoms include:

  • Pain felt at the front of the shoulder 
  • Pain with lifting to the front and side 
  • Decreased range of movement
  • Feeling restricted and stiff in the upper back 

When we have good posture, our shoulders can move freely without pain and restriction. Here at Capital Physiotherapy, we can help strengthen and retrain your posture so your muscles can support your shoulders correctly and allow the shoulder to move correctly. As well as this, we can help release tight muscles at the front of the shoulder and tight joints in the upper back to aid movement and decrease pain. 

To learn more about our physiotherapy programs and exercises, email us at or make online booking at

Shoulder Impingement

The shoulder is a “ball and socket” joint, which means the shoulder can move in all kinds of directions. The cause of shoulder pain is not only isolated only to the shoulder, as many different factors may play a role in shoulder pain such as the neck, your posture, and how you use your arms.

A common shoulder condition in physiotherapy is called Rotator Cuff Impingement, which can be presented as pain in the front, back, or top of the shoulder. The rotator cuff are muscles that act to keep your shoulder joint centred in the socket of the shoulder blade, allowing your shoulder to move in many different ways. The tendons of the rotator cuff travel through and around the shoulder, which may be susceptible to impingement. When there is weakness to the rotator cuff, it can cause the shoulder joint to be off centred and move in the direction where it may irritate the tendons of the rotator cuff.

As mentioned above, muscle imbalance is one of the many ways to develop a shoulder impingement. Your posture, neck, and how you use your arms in your daily life can affect how impingement happens.

You may consult with a physiotherapist at Capital Physiotherapy to discuss about your shoulder pain and investigate if you have a Rotator Cuff Impingement. The physiotherapists at Capital Physiotherapy are trained to assess and treat shoulder conditions like impingement. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at or do an online booking here.

Cervicogenic Headaches

Are you experiencing headaches? A large proportion of headaches are migraines and tension-type headaches; however, a common type of headache physiotherapists can assess and treat are cervicogenic headaches. Neck pain and headaches are frequently associated with headaches (Ashina et al., 2015), indicating the structures around the neck and shoulder may contribute to the headaches.  

Cervicogenic headaches are characterised by 

  • Pain and headache starting in neck and behind head and travels to the front
  • Usually only on one side 
  • Headache does not move from left to right 
  • Headaches are associated with posture, sustained positions such as sitting at a computer for too long, or turning neck in a particular position 
  • Neck pain 
  • Tight neck movement 

The development of cervicogenic headaches may involve your joints and muscles, which have pain generators that can create a headache. Your daily habits, posture, trauma to the head, or stress are ways you can develop a cervicogenic headache. Physiotherapists can trial different treatments to help relieve your headache, which may include:

  • Exercise: An important factor in long-term effects to help with strength and endurance of postural muscles and optimally using your muscles. High quality evidence has supported the use of exercise to help with long-term effects of headaches    
  • Dry Needling: A technique in which acupuncture needles are strategically placed to relieve tight muscles and improve range. This technique is short term and should be reinforced with stretching and exercise
  • Deep tissue massage: A technique that uses firm pressure to help relieve pain generators that travels up to create a headache. 
  • Joint Mobilisation: A technique that focuses on loosening up the neck joints to improve movement. This technique should be reinforced with active treatments such as self-mobilisation, massage, stretching and exercise
  • Taping: A short-term technique to help with postural awareness  

If you are experiencing headaches, you can visit Capital Physiotherapy to further assess and treat your condition. At Capital Physiotherapy, there are a wide range of treatments that can be done to help relieve and allow your take control of your condition. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at

Runner’s Knee Pain (ITB Syndrome)

ITB Syndrome (Iliotibial friction syndrome) is one of the most common causes of “Runner’s Knee”. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.
It arises at its proximal end from the tendons of the tensor fasciae latae and gluteus maximus muscles. From its origin, the Iliotibial tract travels along the lateral side of the thigh and across the knee joint, inserting on the lateral epicondyle of the tibia.

Sign and Symptom:

  • Pain with activities that require repetitive activities involving knee flexion-extension
  • Burning pain at the outer aspect of the knee.
  • The pain tends to be worse when running or coming down stairs.
  • There may be an audible snapping sensation the knee bends due to the band flicks over the bony tubercle.
  • There may also be some swelling on the outer side of the knee.
  • Pain is also exacerbated when running a long distance.
  • The onset occurred most frequently at the lateral knee after 2-3 km of running, or hiking over 16km.

At Capital Physiotherapy, all our physiotherapist is able to assess your running and come up with strategies to help you during your run. At capital physiotherapy, we have clinicians who have ample experience returning athletes back to sport. If you’ve got lingering pain that is sticking around longer than expected, book in with one of our friendly physiotherapists and get some recommendations on what to do. We are conveniently located at South Yarra, Footscray and Balwyn so choose a clinic most convenient for you. You may drop an email at or do an online booking here.

Facet Joint Stiffness

Back pain is a common condition that everyone experiences at some point in their lives. It may become debilitating to the point it can stop you from enjoying activity, working, or even sleep.  

Back pain can involve multiple components of your spine, which includes:   

  • Joints
  • Muscles 
  • Ligaments
  • Nerves 

Back pain is not only limited to mechanical issues, as levels of pain can increase due to stress, duties of work and daily activities, sleep pattern, eating and drinking habits, which can be addressed in later blogs. Today’s blog topic will focus on the lumbar facet joint pain, which are the connecting points on the sides of your spine that allows and restricts certain movements such as bending forward and backward, twisting, and side-bending. The facet joints can become stiff or irritated due to various reasons, including:

  • repetitive or overuse twisting or rotating 
  • abrupt/unexpected movements of the spine
  • increased loads to the spine (i.e. weight, running, jumping) 
  • excessive side-bending or twisting of the spine

Your spine is especially strong and can withstand many aspects of load to it. However, sometimes, excessive movements that don’t allow the facet joint to rest can irritate the facet joints. Rest assure, physiotherapists are specialised in treating and planning programs to help reduce and prevent future back pain events.

If you have been experiencing back pain that includes but not limited to:

  • Pain or tenderness in lower back 
  • Local tenderness/ stiffness alongside the spine of the lower back 
  • Pain, stiffness, or difficulty in certain movements (i.e. side-bending, standing up straight) 
  • Referred pain down the butt or legs

At Capital Physiotherapy, we have clinicians who have experience in treating back pain. The service may include deep tissue massage, mobilisation, dry needling and exercise, depending on your presentation. We are conveniently located at South Yarra, Footscray, and Balwyn. You may drop an email at or do an online booking here.

Warming Up

Many people neglect the warm-up part of physical activity. Some people simply don’t have enough time because they arrive late to training and want to get into it as soon as possible. Others feel it’s simply a chore and unnecessary to complete. While it does take some time to complete a good warm up, doing a warm-up has a tremendous amount of benefits which you shouldn’t ignore.

Increase Muscle Temperature

Pretty obvious that a warm-up is suppose to increase your body temperature. But why is this so important? Think about your car engine on a cold day; for the best performance you should actually leave it running for a bit before the trip. Same thing with your body. If your muscles are cold when you jump straight into activity, you won’t be able to move as well. There is a good chance you will perform poorly simply because you haven’t taken the time to warm-up. 

Joint Lubrication

Not only should your muscles be warm, your joints need be warm-up as well. As per your muscles, getting blood pumping to your joints allows your joints to move the way you want. Think about if you are trying to use a pair of rusted scissors; it’s difficult to move and takes a lot more energy to move it. This can also impede with your performance with your activity if you don’t have a proper warm-up. It’s best to warm up and scrape off that rust rather than during your activity.

Injury Prevention

Likely the most important reason to complete a good warm up, you reduce the chances of getting injury. Using the rusted scissors example, not only does it not work properly, it also has a higher chance of breaking. Warming up increases blood flow and elasticity of your muscles, which reduces the chance of sustaining a muscle injury. If your muscles are compromised, there is an increased load onto your joints, which also increases the risk of injury.

Mental Preparation

Aside from physiological preparation, getting mentally prepared sport is equally or even more important. Even if your muscles are warm and joints are loose, it is difficult to perform your fullest if your head isn’t in the game. While general warm-ups works the body, specific warm up drills that are related to your sport or activity is very important to get your mindset in the game. To be able to switch on as soon as your activity begins allows you to perform your best.

It is quite unfortunate to sustain an injury because your didn’t have a proper warm up, so take that extra time out of the game and prevent that from happening. If you have unfortunately sustain an injury, best to check up with a physiotherapist to get you back to your activity as safe and efficiently as possible.

At capital physiotherapy, we have physiotherapist who are familiar with all injuries from all types of sports, work or daily activity. If you’ve got any inquiries about your injury, or are in need of a solid warm up routine, come by one of our clinics conveniently located at Balwyn, Footscray and South Yarra. You can also send an email at or book online at of our physiotherapist will place you in a rehabilitation program best suited for you and give some advice towards how to safely return to activity.

Tips On Continuing With An Exercise Program

As physiotherapists, we highly promote exercise as a form of therapy to keep your body strong and healthy. Really, there should be no restrictions to what type of exercise you do as long as you remain within your skill level. This can range from your gym based exercise to a group fitness class to dancing on your own. As much as it is beneficial to exercise, many would agree it is difficult to start and even more difficult to sustain. The right exercise to engage in is definitely based on individual preferences. So, how do we find which form of exercise is right for you?

Keep it fun

The truth is, not everyone likes to exercise. Exercise requires work, takes time and just isn’t fun for everyone. This point is really important for those who don’t like “exercise”. If you are able to view “exercise” as an entertainment, it wouldn’t even be considered “exercise” anymore. It would be just like watching a good show on the tele. Easy enough right? However, if the show is boring, you would stop watching it. This means you have to find the right show to continue to watch it for a long time. Same with exercise; if the exercising like a drag, the likelihood of continuing drops significantly. So go experiment with dancing, team sport, gym activities, you name it. Make sure it’s something you enjoy.

Bring a friend, or even friends

It makes it that much more entertaining if you exercise with a friend. Bringing a motivated individual also increase your own motivation. This is definitely true if you make it into a competition. Within the gym, you can’t expect to jump from 10kg squat to 30kg within a week. This needs to build up. And if you miss a day, you are giving your friend an advantage. This level of competition motivates people to continue your program. Not just the competition aspect, it’s simply more fun to chat to someone about the things you are doing. So bring a friend to fuel that motivation. It’s good fun and healthy for all of you.

Get some advice

For some people, there is that fear of starting exercise for because you’ve never been before. If you fall under this category, it’s helpful to get started with a bit of guidance. You can definitely turn to someone who has more experience in the field of exercise, including personal trainers, specific sport instructors and even friends who have a bit more experience with exercise. For other barriers to exercise like you’ve hurt yourself doing exercise or unsure if your injuries has healed enough to continue, it might be a good idea to consult with a physiotherapist to make sure you are healed and strong enough to continue the specific exercise.

At capital physiotherapy, we strongly promote exercise as a form of treatment for rehabilitation, recovery, strengthening, injury prevention and entertainment. If you are seeking advice on safety of exercise, come down to get a thorough assessment and some recommendations. We are conveniently located in Balwyn, Footscray and South Yarra so send us an email at and lets get you on track with your goals.

Bone Bruising

You’ve probably had your share of experience with bruising. It is a very common injury associated with collision with someone or an object. This happens frequently if you are playing a competitive sport and collide with someone while chasing the ball. Another frequently culprit of bruising is the table corner which you just forgot about and bumped into it really hard. Not the most pleasant feeling in the world, but generally it gets better within 1-2 weeks. 

On occasions, there are times the bruising feeling feels a lot more deeper than the usual bruising feeling. Sometimes this feeling can last a while and seems to be healing really slowly. In this case, you might have suffered not a bruising for your muscles but your bones.

Bone bruises are similar to muscle bruising but occurs within the bones instead. There is comparatively less blood going through the bones compared to the muscle, which is why healing process takes longer. To get a formal diagnosis of bone bruise can only be done through MRI, but the treatment of this injury does not require this formal diagnosis. It is important to ice it down, give it time and do everything within pain free level to allow for optimal healing to occur.

For the active individual, pain free levels can be rather difficult to sustain. Telling a footy playing who has mild pain to not play yet is rather difficult. However, it is essential as the pain interferes with muscle function and increases the risk of injury. It is a good idea to check up with a physiotherapist to ensure you return to sport in a safe manner. 

At capital physiotherapy, we have clinicians who have ample experience returning athletes back to sport. If you’ve got lingering bruising pain that is sticking around longer than expected, book in with one of our friendly physiotherapists and get some recommendations on what to do. We are conveniently located at South Yarra, Footscray and Balwyn so choose a clinic most convenient for you. You may drop an email at or do an online booking here.

Back Pain – Sacroiliac Joint

Adding on to our repertoires of back conditions, a common source of pain in the lower back is the sacroiliac joint (SIJ). We’ve already talked about this topic just a bit in the pregnancy blog. Let’s go into a bit more details about it. 

This joint is the connection point between the lower back to the pelvis. This is an extremely stable joint held by many ligaments in the front and the back which make the joint relatively immobile. Furthermore, muscles above and below the joint act together in a sling-like fashion to stabilize the SIJ.

Pain coming from this joint occurs more frequently in females. One of the reason for this is due to the shape of the hips. The female hip is wider in comparison to the male hip which allows the forces of gravity and the weight of the body to act on the joint with greater leverage. Another reason is ligaments can be laxed from child bearing. During pregnancy, ligaments become loose to prepare for childbirth. Unfortunately, that means the stability of the SIJ is compromised and can lead to pain.

To add to this condition, the laxed ligaments does not go back to the way they were before after childbirth. Once a ligament is relaxed and stretched out, it’s rare for the ligament to return to its original length. This means it is very important to strengthen the muscles around the joint to increase the stability of SIJ and prevent SIJ related back pain from returning.

Again, SIJ is not the only thing that can cause back pain. There are many structures in the back that can give rise to pain, so it’s a good idea to get an expert to take a look. At capital physiotherapy, we have physiotherapist would have seen many presentations of back pain. We understand everyone’s pain presents uniquely and will individualize our treatment pain to best manage your pain. 

If you’ve got concerns regarding your back, Contact us at or visit one of our clinics located in Balwyn, Footscray and South Yarra to get started on a management plan that is best suited for you.