The Slipping Vertebrae Spondylolisthesis

There’s lots of ways that the back can be injured. We’ve covered one condition that is relatively common one, which would be the bulging disk . Now let’s go over another condition, only not as common in everyday life activities: spondylolisthesis.

This word is a bit of a mouth full and it does describe something a tad more rare than the disk bulge. Let us first review some basic anatomy of the spine. The spine is made up of various segments called vertebra and each vertebra has a body and a tail portion. In spondylolisthesis, there is a fracture of a specific tail portion of your vertebrae called the “pars interarticularis”. Due to this fracture, the stability of the spine becomes compromised and a section of the spine can slip forward.

With this forward shift, lots of things can cause pain, including the disk between the vertebrae, the bones itself and even the nerves that come out the side. If the nerves are not involved, the pain would likely stay that the back. If the nerves are indeed affected, you can have various neurological symptoms like numbness and tingling down the leg.

Fracturing this part of your vertebrae is pretty difficult. The most common occurrence of this condition with be in dancing. This is because most dancers are required to arch their back while performing high impact jumping type movements. The combination of both movements causes much stress on the tail portion of the vertebrae, therefore placing dancers at a higher chance of getting this injury.

As common as back injuries are, diagnosing the exact structures can be rather difficult. If you have any issues with your back, it’s a good idea to get a professional to have a closer look and make sure everything is okay. At Capital physiotherapy, we have physios who have plenty of experience with identifying the correct treatment for back injuries. If you’re in the neighbourhood near our clinics located in Balwyn, Footscray and South Yarra, book with one of our friendly physiotherapist by emailing us at to get you back to the activities you love.

Sore Neck

Neck pain is a very common musculoskeletal condition that continue to rise. Statistics have suggested that adults will experience neck pain that interrupts their everyday activity including work, cooking, eating, playing with the kids and socializing. Since this condition is so prevalent, it would be useful to have some strategies to manage the pain and also some strategies to prevent the pain from returning.

Neck pain has much to do with how much load and stress you are putting on your neck. If your work requires you to be in front of a desk for long periods of time, the chances are your posture isn’t the greatest and therefore place more stress on the joints and muscles of your neck. If you are getting pains, you can do simple stretches to help your muscles and joints relax for a bit before continuing work. We’ve discussed this in a previous post Stretches for the Office Warriors.

Another way reduce the load and stress on your neck would be setting up your workplace correctly. This topic has been discussed in our Work Desk Ergonomic blog.

With regards to preventative measures, we highly recommend strengthen your upper back muscles to be able to sustain the load and stress which you are giving your neck. The upper back muscles that should be targeted is the trapezius. These muscles are located between your shoulder blade and extend up towards your neck.

A simple exercise to target this muscle with would be squeezing your shoulder blade together. This exercise is a beginner level exercise that targets the entire trapezius muscle. The proper technique for this exercise would be to focus more on touching the lower tip of your shoulder blade together rather than the top. This is because the upper trapezius tend to be overactive while to lower parts tend to be underactive.

It’s important to keep in mind that the strengthening process does not come overnight. You would need to continue strengthening exercises for at least 6-8 weeks to notice a difference with your pain levels. Moreover, exercises need to be progressed to make your muscles stronger.

For more tips and advice, be sure to drop by a physiotherapist to get a thorough check-up and recommendations to help manage your neck issues. At capital physiotherapy, we have friendly physiotherapist who have plenty of experience with neck related pain. If you are near the neighbourhood of South Yarra, Footscray or Balwyn, be sure to reach us by email at or contact us at 0401 865 333 to setup a holistic program to manage your neck related issues.

Perception of Pain

You’ve probably had your share of physical injuries whether it’s work or sports related. You’ve probably even had your boss, coach, coworkers or teammates try motivating you by saying the pain is all in your head. Sound familiar? As much as pain can stem from an injury, it is very true that the pain is felt in the head.

Take dental removals for example. With the advancement of medical techniques, people can go through dental removal without feeling pain during the time. How does that work? In this procedure, requires cutting the skin, pulling the teeth out and sewing up the gums. Wouldn’t you think it would cause at least a little bit of pain?

Our body has nerves that specializes in sensing pain. These can start almost anywhere in the body, from the skin, muscle, ligaments, internal organs, you name it. These nerves travel first to the spinal cord, then up towards the head and finally enters the brain. The brain is the organ that registers the sensation as a painful one.

If anything happens to the nerve anywhere in this pathway, it would be affect the way the brain interprets pain. Going back to the dental removal example, the dentist probably injected some type of drug into your gums before digging your tooth out. What this drug does is block the pain sensing nerves around the gums. Thus, the pain sensing nerves will not be able to send signals to the spinal cord, which no signal will be sent towards the brain, and no interpretation of pain will be done by the brain.

Pain sensation can also be reduced or enhanced simply from the different inputs to the brain. As explained, the brain is the organ that recognizes pain. Adrenaline is one of the things that blocks off pain sensations, so if you are playing footy extremely hard, there is a chance on an injury until the quarter has ended without noticing any pain. So your coach and teammates aren’t actually wrong, pain be reduced depending on how hard and how motivated you are playing the game.

On the flip side, if you are extremely stress, this can amplify the sensation of pain. Although the exact mechanism is not well understood, there is general consensus that emotional stress amplifies pain. That’s way when trying to recover from injury, it is important treat the pain holistically. At capital physiotherapy, we have experienced physiotherapist that understand the importance of a holistic approach to pain. If you’ve got some lingering pain that just isn’t going away, make an appointment with us by sending email at or visit our clinics at South Yarra, Balwyn and Footscray and we’ll customize a holistic program for you to get back to your favourite activities.

The Lingering Pain On The Inside Of Your Ankle

Did you just go on a run and now have lingering pain on the inside of your ankle? The pain might go away after a day or two, but as soon as you start running or doing some activity, it seems to make it worst. You’re pretty sure you didn’t roll your ankle during the run, but that ankle just seems to flare up with some activity. Sound familiar? If you’re so sure you haven’t rolled your ankle, there’s a good chance that your “tibialis posterior” muscle has been affected.

Some basic anatomy, this muscle begins from the inside of your lower leg down and its tendon runs behind the ankle to attach to the bottom of your foot. This muscle pulls the ankle inwards, helps point your toes and helps support the arch of your foot. Activities that have running and jumping places a lot of stress onto this tendon. If you recently increased your training or started a new training that requires running or jumping, there is an increase risk of sustaining injury to this tendon.

It’s a relatively long tendon, thus you can get pain anywhere along the line of this tendon. When the tendon first gets injured, there could be an inflammatory response which makes it difficult to even put weight onto that ankle. In these cases, your really need to resolve the inflammation first before placing more stress the tendon.

If the pain is lingering and not getting back to what it should be doing, you will likely need a progressive loading program before returning to your favorite activity. For this, it’s probably a good idea to see a physiotherapist to get into a individualized targeted program. At capital physiotherapy, we see many running related pain. Tibialis posterior injury is only one of many conditions which can cause pain in the ankle.

If you’re worried about what you’ve done to your ankle, give us a call at 0401 865 333, shoot us an email at or book in an appointment online and one of our friendly physiotherapist will take a good look at the ankle. We will set you up with a holistic, individualized program to get you back to doing what you love the most.

Complexity In A Common Ankle Sprain

Everyone has experienced some degree of ankle sprains. You might have experienced it when your walking along and just mis-stepped that small curve, running down the stairs and just lost balance or somethings playing sports you land simply land awkwardly. Having experienced it, have you ever wondered exactly what is it? Some ankle sprains take much longer to heal than others. Why is this so?

As common as the injury is, the structure of the ankle isn’t simple at all. On the outside of your ankle, it is stabilized by 3 ligaments: one in the front (anterior talofibular ligament), one in the middle (calcaneofibular ligament) and one in the back (posterior talofibular ligament). On the inside of your ankle, there are 4 ligaments that stabilize the ankle, collectively known as the deltoid ligament. There’s other bones and muscles in the ankle, but we’ll stick to the ligaments for now since we are talking about ankle sprains.

The most common ankle sprain is the inversion ankle sprain, in which the outside ligament in the front gets stretched or sometimes ripped. If it’s just stretched, it’s considered a grade 1 ankle sprain. If it’s partially ripped but still intact, it’s considered a grade 2. Lastly, the injury is considered a grade 3 when the ligament is completely ruptured. Intuitively, the healing time will vary depending on the extent of it injury.

Although the ankle sprain seems like such a common injury, the ankle itself is a complexed joint consisting of multiple tendons, ligaments, nerves and muscles. If you’ve got a bit of lingering pain, feels your ankle just isn’t normal or you’re getting recurring ankle injuries, it’s a good idea to go see a physiotherapist.

At Capital physiotherapy, we have movement experts that have much experience with ankle sprains. Our physios understand the structures around the ankle and can give some solid advice to help build strength and confidence in your ankle once again. If your in South Yarra, Footscray or Balwyn, give us a call or email us at and one of our friendly physiotherapist will help sort out your ankle worries.

Did I Wreck My Radial Nerve?

There are some days that your wrist feels weak when doing everyday activities like using the screwdriver, using the spatula or picking up a jug of water. Generally speaking, it’s usually nothing serious and giving it a rest for a day or two would usually fix it. However, what if resting just isn’t cutting it? What if it’s something else?

Basic Anatomy:

Nerves are a tricky thing, so let’s go over a bit more anatomy this time. The wrist is a complex structure consisting of 29 bones and 34 muscles that complete the dexterous movements of the hand. Along with this, you have 3 major nerves that supply the front and the back of the hand. If you’ve got lingering weakness with your grip, especially during the movement of opening your palm, you might have injured one of your major nerve. The particular nerve of interest with this opening of the palm and also the bending the wrist upwards is the radial nerve.

Radial Nerve Supply:

The radial begins in the side of your neck traveling behind your upper arm then into the back of the forearm. At the forearm, it supplies the muscles of the forearm that does the movements mentioned previously: opening the palm and bending the wrist upwards. Hence, that weakness felt when opening your palms or bending your wrist upwards if the radial nerve is irritated. Not only does it supply the muscles of the arms, it also has touch sensory input on the back of your forearm hand. So if you’ve got some lingering weakness and also feel some weird different sensation on the back of your hand/forearm, it’s quite possible the radial nerve is involved.

How Does It Happen:

Since the radial nerve travels from the neck all the way to the hand, anything that irritates the nerve along its pathway can be considered radial nerve irritation. One of the silliest (but common) ways is if someone (or yourself) sleeps on your arm. Having the full weight of a head on your arm the entire night can cause compression to the nerve leading to radial nerve irritation. In activities where you have to continuously use your forearms (screwdriver, hammer, racket sports, gym training, etc.), the repetitive contraction of your forearm muscles can also compress and irritate the nerve.

Again, nerves are not the easiest things to deal with. If you’re getting lingering symptoms like change in sensations in the back of your hand and especially weakness of your forearms, it’s best to get it checked out by a professional. Physiotherapist are movement therapist and are familiar with the anatomy of the arm. We can help identify where the nerve has been irritated to specifically and effectively treat the area of irritation.

At Capital Physiotherapy, we believe in a holistic approach from pain management to return to daily activity and then return to work or hobbies. If you’ve got worries with your arms, email us at to book an appointment with us at South Yarra, Balwyn and Footscray and our friendly physiotherapist will help you find out the cause of your worries and get you back to doing what you love.

Do I Have an Unstable Shoulder?

Shoulder instability is a catch all term used to describe the inability of the body to keep the upper arm in the center of the shoulder joint. Misalignment of the shoulder joint can arise as different symptoms, but generally most complain of some sort of weakness during overhead activities.

The Shoulder Joint:

Quick anatomy class, the shoulder joint is made of the upper arm bone (Humerus) and the shoulder blade bone (scapula). Notice the connection point between the humerus and the scapula. The head of the humerus is pretty big compared to the connecting surface of the scapula. In order to keep the head of the humerus centered in on scapula surface, the ligaments, muscles and cartilage structures around the shoulder joint need to work together in coordination.

How does it happen:

Unstable shoulder can begin with a single traumatic event causing damage to the surrounding structures of the shoulder. In the sporting world, getting tackled from behind or the side with your arm reaching overhead can easily damage the ligaments of the shoulder leading to shoulder instability. If you fall with an outstretched arm directly onto your side, there is a big risk for injuring both cartilage and ligaments.

Unstable shoulder can also occur with repetitive extreme range motions. A classic example would be the baseball throw position. Due to the repetitive action of placing your shoulder in an extreme range of motion, the ligaments can get overstretched and muscles can be strained. Other notable activities with these extreme shoulder ranges include swimming, weight training and overhead related work like light fixture installation.

What does it feel like:

If the muscle, ligaments or cartilage around the shoulder is injured, there is a chance that the humerus will be off centered when moving your arm around, especially during overhead activity. Pain and/or weakness at the shoulder would be the most common complaint, especially when performing overhead activities like hanging clothes, reaching for high cupboards, catching ball overhead and overhand throws.

Shoulder instability can be debilitating to a point where it interferes with your hobbies. If left unchecked, it may start affecting your activities of daily living as well. Simple task like hanging clothes, reaching of high cupboards and every reaching across the table may become more and more difficult. Before it gets to this point, it’s probably a good idea to get it checked out by a physiotherapist.

Physiotherapist are movement specialist and can help manage shoulder conditions like shoulder instability. At Capital physiotherapy, we perform a thorough assessment to identify which structures of the shoulder has been compromise. This way, we can directly target the deficit to get the best results as efficient as possible. If your shoulder is giving you grief, email us at or give us a call at one of our clinics at South Yarra, Balwyn and Footscray to start a holistic tailored program.

The Importance of Core Strength and Control in Breakdancing

Continuing on the topic of dancing, let’s talk about breakdancing. What really sets apart breakdancing from all other dances is the flashy moves executed on their hands. Basic movements like transitioning from crab position to prone position and handstands are considered easy to breakdancers. Experienced breakdancers can spin and jump from hand to hand for a good 30 seconds when performing some of the more advanced moves.

Much like any other dance, breakdancers requires a great deal of strength, body awareness, balance, flexibility and coordination. Lack in any of these components of fitness would definitely reduce the fluidity of bboy moves. However, I would argue the most important factor for any breakdancer would be the extraordinary core strength and control.

Let’s take the beginner downrock footwork “6-step” for example:

When we break down the move, it’s basically a transition move from plank to side plank to reverse table top by stepping your legs in a circle. The planks, side plank and reverse table top all have a component of core strength. Since breakdancers transition in and out of this position regularly, they should have extremely strong core strength.

Now consider the basic power move “flare”:

This is a move where both legs are off the ground for the duration of the move, which means the breakdancer will only be on their hands. Arm strength is definitely required for the move, but it is more important to be able to bring your body high enough to allow your legs to clear the ground. In other words, you need that core strength to elevate the body up.

With that said, core strength sets up a solid foundation to execute various moves in breakdancing. If your foundation is weak, the entire move would crumble. Check out one of our previous blogs for more information on core strength and stability:

If you seem to be you’ve been in the bboy scene for a while and seem to have plateaued despite the number of hours spent practicing in the studio, it might be worthwhile to get thorough analysis completed by a physiotherapist. As movement experts, we can pick up on subtle muscle deficiency that may be the reason why you’ve plateaued. We can incorporating an individualized strengthening program can greatly complement breakdancing.

It’s also common for breakdancers to be hiding their aches and pains to continue dancing away. If you’re looking for an alternative to improving your dance or have some muscle issue that you are unwilling to share with your fellow dancers, come talk to one of us at Capital physiotherapy. Contact us by phone 0401 865 333 or email and one of our holistic friendly physiotherapist will help you stay on top of breaking.

Physiotherapy and Post Transport Accidents (TAC)

As physiotherapists, we play an important role in helping our clients recover from their transport accident injuries.

We see a range of injuries from TAC:

  • Fractures
  • Head injuries
  • Whiplash
  • Spinal injuries
  • Post-surgery complications

We understand that it can be traumatic period for our clients and in Capital Physiotherapy, our therapists take a holistic approach to not just treat our client’s body parts but treating them as a human being, understanding their traumatic experience and how it may impact their daily activities and living.

We strive to achieve optimal recovery at the shortest time possible.

All our physiotherapist are well trained with post traumatic injuries. We provide a whole range of in-room services including dry needling, massage, and manipulation and also out of the room rehabilitation, for strength, flexibility, gait re-education and many more. We provide a range of individualise rehabilitation program and equipment, to help our clients get back their wellness and start enjoying their lives again!

We believe in early intervention to maximise return to work and health outcomes.

We are a fully bulk bill clinic for ALL TAC clients which means there will be NO OUT OF POCKET FEE for any of the TAC clients with both the physiotherapy sessions and equipment needed to for their rehab.

If you are under TAC and require physiotherapy attention, please do not hesitate to contact us at  0401 865 333 or email us at

Physios Guide To Begin A Gym Program For The New Year

It’s a brand new year, and you’ve vowed to sign up at a the local gym or join your friend who has been nagging you about starting F45 (and actually attend regularly).

But if you’ve never been a member of the gym or F45 (or any training group) it can be a confusing and intimidating place and therefore you bow out before even setting foot in the door for the first time. Lets get you started!!!

Now before you do undertake any fitness program especially as a newbie I highly recommend consulting a health professional such as a physiotherapist (physio).

Physios can help you get started by designing exercise programs which suit your personal capabilities/limitations.

An assessment by one of our skilled physio’s here at Capital Physiotherapy will provide you with a safe and effective program. This assessment will make sure you don’t injure yourself at the gym by going too hard or improper technique.

Our physiotherapists can also help with DOMS (delayed onset muscle soreness). Without a doubt you will experience this. Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles several hours to days after unaccustomed exercise. The soreness is felt most strongly 24 to 72 hours after the exercise. There is evidence that massage post exercise reduces DOMS.

Gym Do’s and Don’ts

  • Don’t be a hero and try and lift too much – you will either injure yourself or be so sore from DOMS you will never want to return. Leave your ego at the door.
  • Do go in with a plan (a proper program and diet)
  • Don’t have unrealistic expectations (you will not be an ADONIS in 2 weeks) good things take time.
  • Do return your weights once you have finished
  • Don’t drop your weights
  • Do wear deoderant (no one likes a smelly person working out next to them)
  • And finally enjoy yourself you are embarking on a life changing journey.

If you would like a consult with one of our physiotherapists give us a call or use the online booking service.