News & Advice Archives - West Lakes Physio

April 1, 2026April 1, 2026

The anterior cruciate ligament (ACL) is one of the main supporting ligaments in our knee. Not so long ago, a rupture to the ACL was an injury that we believed required surgical repair to return to a sport that involved twisting and turning. However, there is now considerable evidence that this is not necessarily the case.

Stephanie Filbay ( Physiotherapist and research fellow at the University of Melbourne) recently reviewed the literature to find the best evidence to support ACL injury management. She found that a lot of the common beliefs we have about this injury are not supported by research findings.

Myth 1: You can’t return to sport without having surgery.

In the last decade, multiple studies have investigated the return to sports rates that involve pivoting and sharp direction changes following ACL rupture. Return to sport and physical activity rates are similar in those undergoing surgical repair and those opting to do rehabilitation alone (Smith et al. 2014, Grindem et al. 2012, Frobell et al. 2010, Frobell et al. 2013).

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Myth 2: Knee injury rates are higher if you don’t have an ACL reconstruction following rupture.

Studies have shown that ACL reconstructive surgery does not protect the knee from further injury. The re-rupture rate of the surgical graft is up to one in three young people. Repair of the second ruptured graft offers no additional protection, with up to 27 % of revised grafts failing.

Myth 3: Your knee will be unstable if you don’t have the ACL surgically repaired after the injury.

Several studies have shown that patients can achieve a functionally stable knee by completing high-quality rehabilitation following ACL rupture.

Myth 4: You are more likely to get osteoarthritis if you don’t have the ACL repaired following rupture.

Reports of osteoarthritis on X-Ray are similar in both non-surgical and surgical management of ACL rupture. It is thought that the bone bruising that occurs at the time of injury causes the changes that are seen on X-Ray, years down the track.

It is important to note that arthritis findings on X-Ray are poorly linked to symptoms, such as joint stiffness and pain. Only 50% of people that have injured their ACL report knee pain some 10 to 15 years after injury.

Myth 5: Patients report better outcomes following ACL surgery.

Studies investigating patient reports of knee pain, giving way, activity levels, and quality of life; found no difference in these long-term outcomes in early reconstruction or rehabilitation alone (Grindem et al. 2018).

So what does this mean for you if you have just ruptured your ACL?

The evidence is clear that you can take some time to consider your options. Consider the following to help guide your treatment choice.

Non-surgical management of ACL ruptures can result in a knee that copes with high-level sports involving pivoting and direction changes.
MRI findings do help guide treatment options. If the injury only involves the ACL, there is more chance of success with a non-surgical approach.
If you don’t want to return to sports that involve rapid direction changes and jumping, there is a higher chance that rehabilitation alone will provide good long term outcomes.
Seek an opinion from a sports doctor and physiotherapist with experience in this area. They will help provide a treatment plan that considers your age, long term goals, the extent of the injury and the life demands that can interfere with adequate rehabilitation.
A trial of intense and progressive rehabilitation for 6 to 8 weeks before surgery is the favoured approach to see how well the knee responds to exercise. If the athlete cannot function at a sufficient level to achieve their sporting or occupational goals, ACL reconstruction should be considered.
Outstanding knee function following ACL rupture is dependent on completing a high-quality exercise program that focuses on strength, landing patterns, balance and sport-specific agility training (Eriksson et al. 2013). Surgery alone is not sufficient to achieve this result. Many recreational athletes fail to complete the necessary rehabilitation. Approximately 45 % drop out of supervised rehabilitation after only three months (Ebert et al., 2018). The prehab phase of management exposes the injured athlete to the rehabilitation demands necessary to achieve a successful outcome.
Before returning to a specific sport, the athlete should pass a series of tests that indicate that rehabilitation has achieved the necessary strength, balance and agility required to participate. These tests look at strength, hop distance, landing technique and agility skills. The psychological readiness to return to sport is important to assess how confident or mentally prepared the athlete is to return to sport.

What about kids?

The dilemma with athletes that are still growing is that surgery may disrupt bone growth. The reality is that this is less than 2% of cases (Moksnes et al. 2012). The research on operative versus non-operative management in this age group is scant. One study followed a group of paediatric ACL injuries sustained before 13 years of age through to 18 years of age. Of 44 participants, approximately half managed well without surgery. One-third of these returned to pivoting sports, and the remaining two-thirds restricted returned to sports that required no pivoting. The other half had ongoing instability and required ACL reconstruction. One-third of this group also required meniscal surgery (Ekas et al. 2019).

Where to get more information?

If you are considering your options following ACL rupture, several Facebook groups allow you to ask questions and see how others are managing their recovery.

See:

Email admin@westlakephysio.com.au for references

Posted by Sandy Woolman (Physiotherapist) March 2021

January 31, 2024March 29, 2026

As many of you would know, your neck can be a source of headaches and migraine. Hands-on physio treatment can help ease the pain and help reduce the intensity and frequency of headaches but there is a lot you can do to keep on top of things.
If you suffer regular headaches or always feel tight at the top of your neck, just under the skull bone, then give these exercises for headache a try daily. They can stop a headache from progressing, reduce the amount of medication you need, and relieve tightness.

Our Physiotherapist Sandy demonstrates each of the exercises in the video here or paste https://www.youtube.com/watch?v=Ssb0ME2dr-U into your browser.

1. Chin Tucks/ Cervical Retraction

These exercises are very useful in gently stretching the muscles between the skull and the upper neck. They also help improve posture and move the joints throughout the neck.

2. Shoulder Blade Setting.

The position of our shoulder blades rest plays a crucial role in what happens in our neck. Many muscles attach to the neck and then into the shoulder blade or rib cage area. The shoulder blade setting exercises help to lengthen these muscles and reduce tension. They also improve neck posture as you will sit or stand taller when the shoulder blades rest in the correct position.

3. Neck Rotation

This exercise will get the entire neck moving to maintain enough range to cope with daily tasks such as driving.

4. Head Nods: yes and no.

Nodding our head mostly involves the upper part of our neck and is a great way to get the joints moving and gliding to relieve stiffness and pain. The nodding action also uses the deep muscles at the front of the neck which are important to strengthen to hold the weight of your head. You can do this exercise in different positions depending on how sore your neck is.

5. Mid-back stretch.

By improving the flexibility in the middle of your back and opening up through the front of your chest, your posture improves, and you break out of the regular positions we spend large parts of the day in. There are several ways to do this stretch so choose the one that feels most comfortable for you.

As with any exercises, they need to be done correctly and should feel comfortable. It is common to hear “gravel” type noises when you do the Yes/ No exercises. This usually improves over time but go slowly to allow the stiff joints to adapt to being moved. Sharp pain and an increase in headache symptoms should not happen. Stop if you experience this and ask your physio for assistance on what other alternative exercises to assist with headaches would suit you.

Download a PDF summary of the exercises here or paste https://westlakesphysiosportsandrehab.com.au/wp-content/uploads/2024/02/5-EXERCISES-FOR-HEADACHES-AND-UPPER-NECK-PAIN.pdf into your browser.

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December 14, 2023March 29, 2026

The Amazing Hero Supplement- Magnesium!

I’m sure you may have heard a little about this humble mineral-but I bet you did not know these amazing facts and the real importance of it being a vital mineral in your everyday life!
Magnesium is predominantly found in nuts, seeds, legumes, whole grains, and green leafy vegetables such as kale and spinach, However, the soil quality in which these are grown has been declining since the 1950s, due to the use of pesticides. Western diet also is not high in these food sources so supplements can be a good way of boosting Magnesium levels.

Why is Magnesium so Important?

Here are some benefits: –
• Promotes healthy blood regulation.
• May reduce Stress and Anxiety symptoms
• Maintain Healthy Bones (protect against Osteoporosis)
• Improves Headaches/Migraines
• Supports healthy blood Pressure levels
• Improves Sleep
• Supports Healthy Nerve Function
• Regulates healthy Hormone Function
• Anti-inflammatory effects in Muscles/Tissues
• Alleviates PMS symptoms when combined with B6
Plus, so much more!

So, what has this got to do with Massage?

When combined with your treatment, it will aid in relieving any soreness and inflammation you are experiencing. The most effective way of taking this supplement is directly through the skin which will go to the targeted area of discomfort and straight to the bloodstream and this is with MAGNESIUM OIL SPRAY!

August 17, 2023March 29, 2026

Gluteal tendinopathy is literally one big pain in the BUTT that can have a big impact on mobility and quality of life.

What is it?

Gluteal tendinopathy is a painful condition that affects the tendons that join the big glute muscles in our butt to the outer or lateral part of our hip. Pain is felt on the outside of the hip, sometimes into the back of the hip and down the leg towards the knee, with activities such as walking, running, stair climbing and getting out of a chair. It is particularly painful at night to lie on as the bursa that lies deep to the tendon becomes inflamed and is painful when it is compressed. Gluteal tendinopathy can cause severe pain and limit your ability to walk, put weight on your leg, and sleep.

How Common is Gluteal tendinopathy and why does it happen?

It is the most common tendon issue in the lower limbs
It affects ONE IN FOUR women over 50 and is 4 more times common in women.
Gluteal tendinopathy is often associated with arthritic changes in the hip and knee.
The cause can normally relate to a recent increase in activity. It is commonly reported to start after a holiday where more walking is done or an increase in time walking up and down hills or stairs or on uneven terrain. A sharp increase in running distance or speed may be the culprit. Sometimes prolonged bed rest can irritate the glute tendons and underlying bursa due to sustained periods of compression.

Diagnosis

An examination of the hip will commonly find reduced pain with specific hip movements which stretch the muscle, pain on prolonged standing on the affected leg, weakness and pain when the muscle is tested and local tenderness. Diagnosis can be confirmed with ultrasound. An MRI will clearly show the condition. X-rays are useful to exclude hip joint disease.

Treatment

Physio

In a recent Queensland trial (LEAP trial), education and a progressive exercise program showed an 80% improvement in pain, improved ability to participate in activities that previously caused pain and a reduction in the frequency of the pain. This was shown to be better than wait and see or local cortisone injection. Learning how to reduce the load on the tendons early on, can make a big impact on how quickly you recover.

So physio is a great place to start to get the right advice and exercises.

Medicines

Paracetamol, analgesic rubs like Voltaren gel and anti-inflammatory tablets may provide relief.

Injections:

Cortisone Injections: These can be useful to settle the acute pain particularly of bursitis but do not provide long term pain relief. They are useful to settle symptoms so that you can start a specific exercise program

PRP (Platelet Rich Plasma) injections- these involve taking a sample of your own blood and spinning the sample to use the platelets. Recent studies show promising results but long term benefits are uncertain.

Surgery: Surgery is an option if all attempts at exercise have failed. The trochanteric bursa is removed and the glute tendon is repaired. However the results of surgery are variable. Pain is usually improved but muscle strength may not return.

Take home tips to manage Lateral Hip Pain

Avoid crossing your legs as this stretches the glute tendon and compresses the bursa.
Sleep on the unaffected side with a pillow between your knees to keep the top knee level with the hip. Or sleep on your back. This will avoid compression of the bursa.
Walk on flat surfaces rather than on slopes and inclines until the hip settles.
The use of a walking stick on the opposite side of your sore hip can make walking much more comfortable and is an easy way to unload the tendons whilst you work on your exercises.
Get help early to avoid long-term chronic problems.

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March 29, 2023March 29, 2026

If you are a 40 to 50-year-old female, you may wonder why everything suddenly seems to be aching. As a physio, a large part of my day is spent trying to help the 40+ age females cope with a multitude of muscle, tendon and bone issues that have crept upon them as they approach Menopause. So what’s going on?

For most females, oestrogen levels start to decline from about 40 with this phase known as perimenopause and females officially hit Menopause 12 months after their last period.

Oestrogen has widespread effects throughout the body and is particularly important for the structure, function and strength of our bones, muscles, tendons and ligaments.

Effects of Menopause on muscles:

Oestrogen has a direct impact on muscle mass and strength. Many women who have remained active, may start sustaining injuries despite not changing their activity level. The reduction in strength, unfortunately, includes pelvic floor muscles. Urinary and or faecal incontinence can become an issue despite years of being symptom-free following childbirth. Core muscles that support the spine are also impacted, and posture can deteriorate. (1)

Impact of Oestrogen levels on tendons and ligaments.

Oestrogen affects the collagen or elastic component of our ligaments and tendons. Our ligaments join bone to bone, and our tendons join muscles to bone. Both structures become stiffer as oestrogen levels drop. Stiffer ligaments can benefit those extra stretchy people with too much joint mobility. Stiffer tendons, however, have less capacity to cope with compression and high load and become vulnerable to injury. Tendinopathy is very common after Menopause, particularly in the glutes, hamstrings and Achilles and shoulder rotator cuff tendons. Pain will be felt in the outer hip, sit bones, back of ankle and shoulder (1).

Migraines and Headaches

High levels of estrogen can trigger headaches and migraines in some women. The good news is that declining levels of oestrogen post-menopause can reduce headache frequency overall. However, as your hormone levels fluctuate during Menopause, your headaches may be triggered more often in the short term.

What about our Bones?

Our bones are living, adaptable structures with new bone being made and old bone is broken down continuously. During our younger years, new bone is made faster than old bone is broken down, and our bone mass or bone density increases, reaching a peak at around 30. After 30, the balance starts to swing the opposite way. The most rapid bone density loss occurs in the five years after Menopause, and a loss in bone density leaves the bone vulnerable to fracture (2).

How to Minimise the impact of Menopause on muscles, tendons, ligaments and bones.

Exercise is the most important lifestyle choice to maintain healthy bones, muscles and tendons. However, you may need some help to gradually increase the load and intensity of your exercise to prevent injury. If you already have pain, seeing your physio is particularly important. Resting and waiting for these issues to improve can cause further weakness and injuries when you try to get moving again.

A combination of progressive resistance training and moderate-impact weight-bearing exercises can assist in improving and maintaining bone density and increasing muscle mass and strength.

Current World Health Organisation Guidelines recommend that adults complete 150 minutes of moderate-intensity exercise each week in addition to 2-3 resistance strength sessions. That’s about 30 minutes each day.

Adequate calcium intake and vitamin D levels are important to give your bones the essential nutrients for bone health.

What about Menopausal Hormonal Therapy (MHT)?

MHT (formally known as hormone replacement therapy) uses hormones to treat the symptoms of Menopause. The treatment commonly involves a combination of oestrogen, progesterone and testosterone hormones.

What are the benefits of MHT?

MHT helps combat symptoms such as hot flashes and night sweats. Mood, sleep and sex drive can also improve, and some find relief in joint aches and incontinence. It can prevent osteoporosis, fractures, diabetes and some types of cancer.

What are the risks?

Some types of MHT can lead to a slightly higher risk of developing breast cancer and blood clots in the legs or lungs. The risks depend on your age, type and dose of hormone therapy, how long you take it, and your medical history. If you are having significant menopausal symptoms, you should speak to your doctor to determine whether this is the right option for you. For further information on MHT see:

https://www.healthdirect.gov.au/hormone-replacement-therapy

So for women, body aches are common as hormone levels decline through our 40s and 50s. For Men, the decline in Testosterone levels is much slower, and the musculoskeletal effects are normally not as pronounced. Seeking help from your Physiotherapist to develop a tailored exercise management plan can help reduce the overall impact on your muscles, tendons, bones and joints during this rapid change in hormonal levels.

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December 7, 2022March 29, 2026

Plantar Fasciitis is the most common cause of heel pain and can be very painful, limiting most weight-bearing activities. The plantar fascia is a band of connective tissue that runs from the heel bone and attaches to the ball of the foot. The function of the plantar fascia is to transfer forces from the heel to the ball of the foot without the bones of the midfoot collapsing. Unfortunately, the plantar fascia is prone to overload and damage, causing pain and inflammation.

How is it Diagnosed?

The patient with plantar fasciitis will have typical signs and symptoms, which will lead to a diagnosis of plantar fasciitis. The heel pain usually is worse in the morning when you first get up and then eases a little as you get going. It will return after a period of rest during the day. Pain is commonly worse after but not during activity in the early stages. There is frequently local tenderness through the arch of the foot, with a focal area of pain on the heel.
X-rays will often show a heel spur, but this is not a cause of pain. Commonly, only one foot is symptomatic despite a heel spur being present on both sides. Ultrasound is the most revealing test and will show swelling of the facia and thickening.

Causes of Plantar Fasciitis:

High-impact sports such as running, dancing, and aerobics.
Flat feet will place more load on the plantar fascia. Flat feet are not just something we are born with or without. As we age, the foot muscles can become weaker, which can lead to the development of a flatter foot arch. Unsupportive footwear over long periods can also contribute to flat feet developing in later years.
High arches can also contribute to the development of plantar fasciitis as the fascia usually is tight, which makes it vulnerable to overload.
Occupations that involve long periods of standing or walking on hard floors can cause symptoms.
Changing floor surfaces in your home from carpet to a tiled floor can also be enough to load the plantar fascia beyond what it can tolerate.
Being overweight or pregnant
A stiff ankle can also contribute to plantar fasciitis
The change of season from winter to summer also shows an increase in the number of cases seen as people move from more supportive shoes to bare feet.

Treatment

Treatment options for plantar fasciitis are extensive and varied mainly because the condition can be challenging to settle down. The evidence supporting many of the treatments is limited, so beware of investing money in procedures that are not proven (Schwartz & John, 2014). We believe that following some basic guidelines can help you navigate the treatment options.

Initial 6 weeks.

In the early phase, self-treatment techniques may resolve symptoms.

You can try:

Regular calf and plantar fascia stretches seem to offer the most benefit (Tatli & Kapasi 2009). Hold each stretch for 30 seconds and repeat 3 times.
Manually stretch the big toe back and then massage the arch for 1 minute. Rest and repeat 3 times.
Self-massage with a golf ball for 1 minute. Rest for 30 seconds and repeat 3 times.
Strengthening the muscles of the foot and calf in conjunction with stretches have been shown to have good results. Using a tool such as the Fasciitis Fighter can specifically target the right area to improve results. A Physiotherapist can help guide you through an appropriate exercise regime. See here for suggested exerices using the Fascitis Fighter which is available for sale in the clinic.

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Wearing supportive shoes with arch support will usually help.
Silicon gel heel pads, heel cups or over the counter orthotics are often beneficial. Evidence suggests that custom orthotics do not offer superior results to the ready made orthotics (Landorf et al. 2006).
If your symptoms are worse in the morning after your regular exercise activity, consider reducing the amount you do initially.
Rolling your foot on a jar full of frozen water, especially after activity may help.
Weight loss

No Improvement with these simple measures?

If after 6 – 8 weeks there is no improvement, then you will need some extra help from a Physiotherapist, Podiatrist or General Practitioner. Recommended treatments at this stage include:

Deep myofascial release
Dry needling
Taping to unload the plantar fascia
Cortisone injections can offer short-term relief, but you need to consider the potential side effects of fat pad atrophy and plantar fascia rupture (Tatli & Kapasi, 2009). The reduction in symptoms can provide an opportunity to commence an exercise program to work towards long-term solutions for the pain.
Other injection options include Botox and platelet-rich plasma.
Night splints or socks (Strassburg Sock) to stretch the plantar fascia overnight may be worth trying and can help the morning pain. Sleeping in the brace may be challenging, so you have to way up the pros and cons.

Still NO Improvement?

If no improvement after a further period of 6 -8 weeks of assisted treatment, other options include:

Extracorporeal shockwave therapy. The evidence surrounding this treatment is mixed, but more recent studies suggest that it can be beneficial in this chronic phase, particularly in runners.
Referral to a foot and ankle specialist for consideration of surgical options.

In summary, plantar fasciitis can be a challenging problem to settle. We suggest seeking treatment within the first 12 weeks if your self-help strategies are not working.

Click here for Plantar Fasciitis Fact Sheet

Updated by Physiotherapist Sandy Woolman (March 2026)

October 30, 2022March 29, 2026

Spring has sprung and many of us head out into the garden. Gardening is a great form of exercise but unfortunately, it is a common cause of back pain. To enjoy pain-free gardening, consider the tips below from West Lakes Physio.

1. Stretching backward after you have been bending forward and stretching out your legs after squatting and kneeling, should help keep you moving during your gardening session. Stretch slowly until you feel a gentle pull and hold each stretch for 10 – 15 seconds. Repeat 2 times.
2. Work between waist and shoulder height as much as you can to protect your back. Use a table to re-pot plants whenever possible. When working at ground level for weeding and planting out, kneel on the ground rather than bend from your waist.
3. A “kneeler” is very useful if you have trouble getting back up or if you have sore knees.

4. Vary your activities so you are not in one position for more than 30 minutes.

5. If you move a pot regularly, put it on wheels. A sack trolley is useful to move pots a long way. Rolling the pot instead of dragging it, is better for your back. Use a wheelbarrow to transport heavy objects. Don’t overfill and keep the weight over the wheel.

6. Planting your pot plants in garden beds means no need for re-potting and less hand watering.

7. Lifting Heavy Items

Remember the rules for lifting. Make sure the area you need to carry things over is clear of obstacles. Get some help if the object is heavy. You need to coordinate the lifting effort so that you both lift the object together (i.e. Count out loud “1…2…3…lift”).

Start with feet shoulder distance apart. Bend at the knees and hips with your bottom stuck out. Grip the object firmly and keep the load close to your body.

Brace your stomach muscles to protect your spine and keep your back as straight as possible throughout the lift.

Walk slowly and avoid twisting when lowering the object.

8. When sweeping, push the broom and work in front of you. A smaller broom may be easier to manage if you have back problems, or use a light blower vac.

9. Using a garden hose for hand watering is much kinder on the back than buckets and water cans.

10.When using buckets for fertilising, try using two buckets half filled with water and carry one in each hand to balance your load.

If it hurts—STOP. Listen to your body. Pain is often felt before major damage is caused when you are digging and bending forward. This is a warning that you need to change position. If the pain doesn’t subside with this, then it is time to stop for the day. If pain persists, consult your doctor or physiotherapist.

We hope these tips are useful so you can enjoy pain-free gardening this spring.

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October 26, 2022March 11, 2026

The weather is improving, the sun is finally starting to shine, and we are all eager to get outside and get the garden spruced up and looking good. Unfortunately, this can be a shock for some parts of our body and can result in injury or soreness. We have all been hibernating during the cold winter months and enjoying watching the footy on TV. The lower back and shoulders commonly take the brunt of the action. Bending over and pulling out weeds, hedging shrubs and bushes, and generally doing more than we are used to through winter are some of the common causes.

So what is the solution?

The best way to minimise flare-ups or issues is to ease into it and not do too much in one hit. Our bodies, like a gradual increase in activity and a full day in the garden, can be a big shock. Regular breaks to stretch and rest when doing a repetitive task can be useful. Warming up and getting our bodies ready for the day ahead are also recommended. An important point to remember is our age. As much as we all think we are 21 and bulletproof, most of us aren’t. Things we could easily do previously are sometimes no longer in our capabilities or are safe. Cleaning gutters, trimming high bushes, and reaching above our abilities on ladders can result in falls and painful injuries.

The injuries that occur from falling off a ladder can be serious and are known to be life-changing for seniors. In 2017-2018 more than 5,600 Australians were hospitalised following falls off domestic ladders. In 2020, 36 people died from falls off ladders in Australia, the most at-risk group being males between 75 and 80. Broken bones, spinal cord injuries, head injuries, and open wounds are the most common reasons for hospital admission.

Sometimes the smart thing is to pay someone to do some of the harder tasks rather than injure yourself doing things that are beyond us. That way, you may be able to stay away from injury, the hospital and the Physio!

For more information on the safe use of ladders see: Ladder Safety Matters

August 24, 2022March 29, 2026

What is Cortisone?

Cortisone is a synthetic version of the Corticosteroid hormone group known as Cortisol which is produced by the adrenal glands in our body. Cortisol has many functions in our body. It is increased in stressful situations and helps our body be ready to respond to danger and repair tissue. It is a potent anti-inflammatory.

What is the purpose of injecting cortisone?

There are three main reasons your health practitioner may ask you to consider a cortisone injection.

To help treat chronic inflammation that is not settling with standard measures such as adjusting what you do, strengthening exercises and non-steroidal anti-inflammatory medication such as Voltaren and Nurofen. Cortisone acts on different cellular pathways than the non-steroidal anti-inflammatories and can be very effective even when other drugs have not helped.
To relieve or eliminate pain that is associated with inflammation. Pain associated with conditions such as bursitis, tendinitis and arthritis can be helped by cortisone injections. However, it is only part of the long-term management of these conditions.
To confirm or exclude a specific diagnosis. Often, scans show many things that could be potential causes of ongoing pain. A local anaesthetic is also injected with the cortisone. If pain is significantly improved immediately or shortly after the injection, it does indicate that the diagnosis is correct and can help guide treatment options.

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What are the potential benefits of Cortisone?

Studies show that significant pain relief occurs in about 70% of cases. For some, results are dramatic and long-lasting. For others, the result is mild and short-lived. The key to successful recovery is to use this period of less pain to normalise movement patterns and strengthen muscles around the site. Moving normally and getting stronger are the key elements to achieving long-term relief.

What is involved?

Ultrasound is used for most cortisone injections to ensure the cortisone is placed where it is needed to maximise results, confirm the diagnosis and minimise discomfort.

Local anaesthetic is commonly injected with the cortisone; nerve blocks are occasionally used to numb the area completely.

Are there any risks or side effects?

Significant complications are extremely rare. The most common side effect is a short-term increase in pain before the cortisone takes effect. This may be noticed between 4 – 48 hours post-injection. Ice and paracetamol can be used to settle discomfort.

Other side effects include:

Feeling flushed or red-faced, which may develop on days 2-3. It is normally mild and settles with antihistamines.
Sleep disturbances and hyperactivity for the first 24 hours are common
A transient increase in Blood sugar is commonly noted. You need to let your doctor know if you have diabetes so you can monitor and treat any changes to blood sugar levels following the injection.
Infection is extremely rare ( one in every 15,000 to 20,000 injections) but can be serious, particularly if injected into a joint. Signs of infection include fever, local heat at the injection site or increasing pain 48 hours following the injection. Consult your doctor if you notice any such symptoms.
Allergies, mild bruising, disruption of the normal menstrual cycle, nerve damage and hiccups are extremely rare side effects.
Superficial injections can cause the fat under the skin to dimple, and occasionally, the colour of the skin can change at the injection site.

What should you do or not do after having a cortisone injection?

We suggest you rest from exercise for 48 hours after the injection to optimise the chance for the cortisone to work. Driving and everyday activities can still be undertaken.
Use ice or paracetamol for any initial discomfort
three days post-injection, some modified exercises can resume
five days after the injection, you can resume normal training, running and jumping. However, you should be guided by your treating physio to ensure the load is appropriate to optimise long-term recovery.

Posted by Sandy Woolman – Physiotherapist September 2022

March 30, 2022March 29, 2026

What is Causing Symptoms?

The central part of our jobs as physios is to work out what is causing our patient’s symptoms. We need to determine if symptoms relate to an acute injury, or are they part of an aging process (wear and tear) that has now reached a stage where activity is challenging and pain is occurring?

Don’t Scans Show what the Problem is?

Clinicians can’t rely on scans alone as they don’t tell us what is causing pain. The whole patient picture must be considered, which includes an understanding of what is normal for age, what activities are affected and what the patient wants to return to. If a knee MRI shows a cartilage tear, it doesn’t mean that repairing or trimming the cartilage will allow the patient to return to pain-free running.

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Each day we get older, and regardless of how good we feel on the outside, our bodies are changing underneath. Many studies show that a high proportion of us have some form of pathology on X-ray, ultrasound, CT or MRI even though we don’t have symptoms. Almost 50 % of us have knee meniscal tears on scans at 50 years of age with no pain or issue. Low back disc bulges are prevalent in about 60% of us at 50 years of age.

This makes it all the trickier to determine when a patient presents to us if it is a pre-existing issue or whether it is something that they have recently done. This is important because it can influence how we approach the injury and treat it. Generally, our bodies have a remarkable ability to repair themselves, and many injuries will improve by themselves with time. Sometimes, intervention is required to assist the recovery process.

You Can Improve Symptoms arising from Wear and Tear.

One of my longer-term patients has major tears in 3 of the main tendons in her shoulder. Big tendon tears are problematic but common in the 60 plus age group. However, with careful strength training and high motivation, my patient’s shoulder improved significantly, and she was able to function and return to dragon boat racing without needing surgery. If we re-scanned her shoulder, the tears would still be there. However, we can improve, participate, and function well even when our bodies show significant wear and tear on scans.

Strength Training is the Key to Keeping Aging Bodies Active

We lose 8-10 % of our strength per decade after the age of 40.

One of the best things you can do to prevent or improve symptoms that arise from the normal aging process is to participate in regular muscle-strengthening exercise sessions at least twice a week. Even simple tasks like getting out of a chair become easier if our leg strength is maintained. It all takes effort. As the saying states, “Live stronger, live longer”.

Post by Physiotherapist Mark Nagel

Myth 1: You can’t return to sport without having surgery.

Myth 2: Knee injury rates are higher if you don’t have an ACL reconstruction following rupture.

Myth 3: Your knee will be unstable if you don’t have the ACL surgically repaired after the injury.

Myth 4: You are more likely to get osteoarthritis if you don’t have the ACL repaired following rupture.

Myth 5: Patients report better outcomes following ACL surgery.

So what does this mean for you if you have just ruptured your ACL?

What about kids?

Where to get more information?

1. Chin Tucks/ Cervical Retraction

2. Shoulder Blade Setting.

3. Neck Rotation

4. Head Nods: yes and no.

5. Mid-back stretch.

The Amazing Hero Supplement- Magnesium!

Why is Magnesium so Important?

So, what has this got to do with Massage?

What is it?

How Common is Gluteal tendinopathy and why does it happen?

Diagnosis

Treatment

Take home tips to manage Lateral Hip Pain

Effects of Menopause on muscles:

Impact of Oestrogen levels on tendons and ligaments.

Migraines and Headaches

What about our Bones?

How to Minimise the impact of Menopause on muscles, tendons, ligaments and bones.

What about Menopausal Hormonal Therapy (MHT)?

What are the benefits of MHT?

What are the risks?

How is it Diagnosed?

Causes of Plantar Fasciitis:

Treatment

Initial 6 weeks.

No Improvement with these simple measures?

Still NO Improvement?

So what is the solution?

What is Cortisone?

What is the purpose of injecting cortisone?

What are the potential benefits of Cortisone?

What is involved?

Are there any risks or side effects?

What should you do or not do after having a cortisone injection?

What is Causing Symptoms?

Don’t Scans Show what the Problem is?

You Can Improve Symptoms arising from Wear and Tear.

Strength Training is the Key to Keeping Aging Bodies Active

West Lakes Physio - Sports & Rehab

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