What we treat

• Most common complaint in patients with associated neck pain
• Other common headaches include migraines, tension headaches and sinus headaches
• Caused by incorrect work postures and poor ergonomics, trauma to the neck from whiplash and poor neck support whilst sleeping
• Presents with pain in the neck, back or side of head, restricted neck mobility and tightness or overactivity in the muscles of the neck (cervical spine)
• Myotherapy and Remedial Massage treatment aims to reduce pain and improve posture
• Treatment will focus on mobilising the upper cervical spine to reduce the severity and frequency of the headaches while reducing stiffness of the upper cervical spine

• Often referred to as TMJ syndrome
• Caused by muscle tension or spasm from clenching teeth, prolonged dental procedures or trauma, postural factors, neck problems, incorrect sleeping position, stress, trauma to the head, neck or jaw, headaches, referred pain eg. heart attack
• Can have clicking, grinding or locking of the jaw
• Pain and stiffness can be present in the jaw, neck or shoulders, you could experience ear pain or pressure and have limited movement of the jaw, with a bite that feels off
• Often related to impairment of function of the muscles of mastication
• Treatment will focus on releasing surrounding soft tissue of the neck and jaw, mobilising the jaw and possibly some dry needling to increase movement of the jaw

Postural Pain

• Most common neck complaint typically involving tightness of neck muscles and restricted neck movement
• Widespread aching pain in the neck
• Often a result of repeated or sustained poor posture
• Pain increases as the day progresses
• Treatment will focus on soft tissue manual therapy, joint mobilisations and postural modifications to reduce pain and increase movement

Nerve Root Compression

• When a nerve exiting from the spinal cord becomes compressed by a structure in the neck
• Normally occurs at the levels of C5/6 and C6/7
• With or without neck pain, often associated with pain around the shoulder blade
• Usually a result of a disc bulge, prolapsed or herniated disc and or osteophytic spurs
• May be associated with numbness, pins and needles, and loss of strength/movement in the arm
• Generally worse with looking up and or with sustained postures such as sitting
• Myotherapy and Remedial Massage aims to educate patients on correct posture, pain management and provide advice on positions that will best ease pain and stay active especially if at a desk job

Whiplash

• Common result of a car accident or sporting trauma due to impact forces causing sudden acceleration and deceleration of the head beyond its normal limits
• Muscles go into spasm to protect the neck
• Treatment will educate patients on optimal relieving positions, reduce pain and increase neck movement, increase quality of life and return to work/ sport
• Myotherapy will also help identify whether nerves may be compressed as a result of the accident and treatment provided accordingly

Wry Neck

• Common neck spasm which results in acute neck pain and stiffness, typically caused by sleeping in a poor posture or using an inappropriate pillow.
• Strong or sharp pain in one side of the neck resulting in difficulty moving the head.
• Most often preventing full neck rotation to one side
• Best to rest, keep the neck warm and it tends to resolve over the course of 3-5 days
• Myotherapy will advise appropriate sleeping posture, restore movement and provide neck exercises

Rotator Cuff Injury / Tendinopathy

• Rotator cuff muscles become inflamed and often lead to impingement resulting from poor shoulder biomechanics
• Common in tennis players, swimmers, weight lifters and anyone who uses the shoulder repetitively
• Pain is often felt with over the lateral deltoid region and exacerbated by overhead lifting, hand behind back movements, difficulty driving and when rolling over onto the affected side while sleeping
• With impingement, there can be a catching or pinching sensation
• Treatment will concentrate on soft tissue massage and improving shoulder biomechanics

Subacromial Bursitis

• Shoulder pain is often vague and occurs at end of range overhead lifting
• The shoulder has three bursa, these can become inflamed and cause shoulder impingement
• Caused by incorrect shoulder biomechanics
• Treatment will concentrate on improving shoulder biomechanics and improving rotator cuff strength

Frozen Shoulder

• Also referred to as adhesive capsulitis, results in the glenohumeral joint becoming inflamed with the development of adhesions
• This is a self- limiting condition that can last up to 2 years
• Pain in normally located in the upper lateral arm, with stiffness and severe restriction in the shoulder
• Pain is especially noticeable at night and while lying on the side
• Difficulty with putting on a jacket or scratching back
• Myotherapy aims to educate the patient on the phases that you can expect to go through throughout the condition as well as relieve secondary complications from the condition

Long Head Biceps Tendinopathy

• Common condition with people who do a lot of lifting or pulling
• Pain is usually felt at the front of the shoulder in the bicipital groove
• May note a lump or bulge in the bicep in case of tendon rupture
• Treatment will involve rotator cuff strengthening, improving scapular stabilisation and eccentric biceps exercises

Nonspecific

• Most low back pain is nonspecific, and can be caused by lifting, sitting or standing for too long
• Pain can be due to mechanical problems such as muscle or joint strain
• May be further classified as mechanical, non-mechanical, or referred pain
• Myotherapy and Remedial Massage will help release any muscle spasm and mobilise joints to improve movement and return the patient back to sport/work

Spinal Disc Problems

• A pinched nerve is typically a result of a disc bulge, prolapsed or herniated disc, or osteophytic spurs
• The disc itself is not painful, but rather the leaking disc which is pinching a nerve
• Commonly occur at the levels of L3/4 and L4/5
• Pain is often radicular, meaning nerve root pain. Commonly referred to the low back and down the leg
• Leg pain from a pinched nerve is usually described as sciatica
• Disc pain or disc degeneration is typically caused by a degenerative disc
• One that causes low back pain and/or leg pain
• The disc itself is painful and the source of pain
• Often associated with numbness, pins and needles, and leg symptoms
• Myotherapy and Remedial Massage aims to educate patients on positions that ease pain as well as improve posture and symptom management

Spondylosis / Spondylolithesis

• Spondylosis is a form of degeneration of the spine
• Spondylolithesis is forward displacement of one vertebra on another, usually occurring in the lumber spine
• Most common at L4-L5-S1
• Commonly causes referred pain through the lumbar region into the buttocks or lower leg
• Often occurs in adolescence and is an accidental finding on imaging later on in life

Sacroiliac Joint Pain

• Likely to occur due to hypermobility of pelvic joints
• This may result during pregnancy or after having a fall
• Myotherapy and Remedial Massage treatment will release soft tissue in the lumber and hip region while educating the patient on stretching strengthening exercise

Scoliosis

• Condition in which a person’s spine is curved from side to side
• Sometimes resembles an ‘s’ or ‘c’ shape in spine
• Scoliosis can be functional or structural
• Functional scoliosis may be corrected with myotherapy treatment educating the patient of habits that cause an imbalance, it can also help strengthen weak muscles and loosen tighter muscles

Lumbar Stenosis

• This is a degenerative condition which involves the narrowing of the spinal canal
• This condition may cause lower limb symptoms such as varying back pain, referred pain to one or both legs, tingling and numbness
• Treatment will involve educating patients on relieving positions and discuss management strategies

Tennis Elbow

• Often due to tears of inflammation at the tendinous attachment
• Common injury in tennis players but also everyday workers
• Pain is commonly felt on the outside of the elbow which may extend to muscle of the forearm
• This is an overuse condition which can occur and aggravate pain from using a screwdriver, turning on a tap and playing tennis
• Can become difficult to treat when it becomes chronic
• Myotherapy aims to reduce pain and increase strength through soft tissue, dry needling and modification of aggravating activities, with an eccentric elbow strengthening program

Golfers Elbow

• This is the opposite to tennis elbow, it occurs on the inside of the elbow
• It is also an overuse condition from wrist flexor muscles as in playing the piano, golf or typing
• Myotherapy aims to reduce pain and increase strength through soft tissue, dry needling and modification of aggravating activities

Carpal Tunnel Syndrome

• Located in the wrist among several tendons and vessels
• Inflammation can build up in the carpal tunnel which may cause impingement of the median nerve
• The main symptoms are pain, numbness, burning or tingling in the hand, wrist, palm, thumb or first three fingers, especially at night. Diffuse numbness can occur in the forearm, upper arm and shoulder
• Shaking the hand or running it under water can sometimes aid in relief
• Treatment will help offload the nerve through stretches and bracing
• Long term pathology may cause atrophy of hand muscles so strengthening exercises are beneficial

Repetitive Strain Injury (RSI) / De Quervains Tenosynovitis

• The tendons of the thumb can become inflamed due to overuse such as repetitive writing, typing, carrying and lifting of a baby
• Pain and weakness may occur in hands causing difficulty in gripping, and there may also be tingling into the fingers and swelling in the hand and fingers
• Myotherapy and Remedial Massage aims to release tight muscles and advise strengthening exercises

Trochanteric Bursitis

• A bursa is a sac of fluid which is located behind the greater trochanter (most prominent bony spot on the thigh bone)
• A lot of muscles connect into the greater trochanter and the job of the bursa is to reduce friction during movement
• Tight muscles and a lack of motor control and stabilisation, can cause the bursa to become irritated and inflamed
• Repetitious bending and lifting may also aggravate this condition
• Myotherapy will help improve hip biomechanics and reduce muscular tightness by utilising friction massage

Hip Labral Tear

• The labrum is a lip around the socket of the hip
• It is sometimes torn as a result of femoro- acetabular impingement or due to high impact forces such as during a car accident, or playing golf, hockey, soccer and doing ballet
• Pain or ache in the groin, is normally prominent over the lateral hip, or deep in the buttock region
• Tears often cause a feeling of the leg “catching” or “clicking” in the hip socket. It may also feel like the hip is locking up or giving way within the hip
• Treatment will help strengthen the hip, if surgery is required myotherapy can help provide post- operative care

Osteoarthritis

• Degenerative condition of wear and tear due to the demands placed on the joint over time
• Primary inflammation is rare and pain is worse at the end of the day
• Morning stiffness, aches gradually develop but develop into low grade inflammation
• Pain may be referred to the outer thigh medial knee or the groin
• Sleep disturbance is common as the problem develops
• Myotherapy and Remedial Massage can help strengthen muscles around the joint to help support the joint or help improve range of motion during times of flare up
• Myotherapy can also help with post- operative management

Adductor Strain / Tendinopathy

• A muscle strain is the most common cause of groin pain
• Occurs when a muscle is stretched beyond its normal capacity or encounters an unexpected opposing force
• Pain can be acute over the muscle belly, with swelling, and occasional bruising
• Common injury in soccer players
• It can be quite a difficult condition to manage if not treated timely as there is a risk that it may become chronic
• Treatment aims to reduce pain and improve strength

ACL and PCL Ligament Tear / Injury

• Occurs in sporting injuries and causes instability and discomfort within the knee joint
• Commonly injured ligaments include Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL)
• ACL tear is very common injury that requires surgery if you want to continue with most sports
• Posterior Cruciate Ligament (PCL) tear is not common, usually occurs as a dashboard injury during car accidents or when the leg is pushed back on the thigh
• Myotherapy aims to provide pre- operative strengthening as well as post- operative rehabilitation including improving range, strength and proprioception to return to sport as safely as possible

Medial and Lateral Collateral Ligament Tear

• Medial collateral knee ligaments are commonly injured when the knee is forced inwards
• Pain occurs on the inside of the knee
• Lateral collateral ligaments are not as commonly injured and often results from contact or a blow to the inside of the knee
• Pain occurs on the outside of the knee
• Treatment will concentrate on improving range and knee strength as well as agility

Patellofemoral Pain Syndrome (PFPS)

• This is the most common knee injury which often results from poor tracking of the knee cap due to incorrect hip and knee biomechanics
• Pain felt behind the kneecap
• Treatment will aim to balance the tracking of the knee during knee flexion as well as correct biomechanical errors

Iliotibial Band Friction Syndrome (ITBFS)

• This is a common injury among runners who train with downhill running
• The ITB is a taut band on the outside of the knee and is irritated with slight knee flexion
• Treatment will consist of soft tissue manual therapy as well as strengthening exercises to correct any biomechanical and running techniques

Meniscal Tear

• The menisci are the knee’s cushion, they help to absorb forces and improve congruency of the knee
• If they are torn on the outer third, there is good capacity to heal as there is adequate blood supply. If they are torn in the middle 2/3, you are likely to require surgery
• Myotherapy will advise knee stretches and strengthening exercises

Patella Dislocation

• Can occur in twisting movements of the knee or due to a direct blow
• Myotherapy aims to stabilise the knee cap by strengthening the quadriceps muscles
• If a second bout of dislocation occurs, surgical opinion is required
• Treatment will be required for strengthening the knee pre and post- op

Hamstring / Quadriceps Strain or Tear

• Muscle strains usually happen when a muscle is stretched beyond its limit, tearing the muscle fibres
• A similar injury occurs if there is a direct blow to the muscle. Muscle strains in the thigh can be quite painful
• A popping or snapping sensation may be heard as the muscle tears. Pain is sudden and may be severe, the injury may be tender to the touch, with visible bruising
• Muscle tears primarily occur during lengthening contraction of the muscle
• 3 grades of tears with different prognosis
• Treatment will aim to minimise scar tissue build up, improve range and strength in the muscle and return the patient back to sport and functional capacity as soon as possible

Hamstring / Quadriceps Muscle Contusion

• Known as a corked thigh and predominately occurs in contact sports
• There will be pain at the time of injury and the athlete is likely to have restricted movement in the muscle. Swelling and bruising may appear over time
• Thigh contusions are also graded 1, 2 or 3 depending on the severity
• It is essentially a bruising in the muscle and return to sport timelines depend on the severity
• Treatment will involve soft tissue manual therapy to increase the blood flow in the muscle as well as stretching and strengthening exercises

Calf Muscle Injury

• Pain that occurs in the calf muscle on the lower part of the leg often is the result of a pulled or torn calf muscle
• A calf strain is similar to an achilles tendon tear or rupture, but occurs higher up in the back of the leg
• You may hear a “pop” often described as a gun shot
• Sudden pain at the back of the calf, with swelling or bruising in the calf and difficulty walking properly or standing on your toes
• Calf injuries usually occur during acceleration or changes in direction
• Tears are graded into 3 grades with different prognosis for each
• Treatment will aim to minimise scar tissue build up, improve range and strength in the muscle and return the patient back to sport and functional capacity as soon as possible

Ankle Sprain

• The lateral ankle ligament is most commonly injured as the foot rolls inwards
• Pain can be local and is present at rest and especially with weight bearing
• Swelling, heat and bruising may be noticeable immediately
• Graded 1-3 from mild, moderate or severe
• Rest, ice, compression and elevation of the leg should be applied immediately
• Treatment will consist of soft tissue manual therapy, joint mobilisation, ankle strengthening and proprioceptive work

Shin Splints

• Form of tendonitis that effects the lower leg
• Two types of shin splints, anterior and posterior
• Anterior shin splints affect the anterior shin and are most known to athletes
• Posterior shin splints affect the medial ankle. Posterior shin splints are also known as posterior tibial tendonitis
• Pain is usually felt in the middle part of the tibia
• Ice helps alleviate pain and inflammation
• Shin splints effect men and women equally. The onset of shin splints is insidious and may vary with levels of activity
• Myotherapy and Remedial Massage aims to release tight muscles in the lower legs through cupping, dry needling and muscle manipulation

Achilles Tendinopathy

• Tendinopathy occurs when there is an inability for the tendon to cope with the load placed upon it. It is characterised by micro tearing of the tendon and a failed healing response
• Due to overload, return to activity after a period of inactivity and age related degeneration
• Pain and/or stiffness with activity which improves and then worsens at the end of the day or after activity
• Pain and/or stiffness in the morning, especially the day after activity, tenderness with touching the tendon and symptoms that do not improve with rest
• Treatment will constitute an eccentric ankle program

Plantar Fasciitis

• Commonly occurs in middle aged people or those who are involved in running sports like tennis, basketball and netball
• Pain is located in the sole of foot and can spread down towards the toes, its worse in the morning and eases with movement
• The foot results in a repetitive strain of the fascia due to overstretching
• Due to poor foot biomechanics and is often associated with excessively high arches or flat feet
• Treatment will help improve length of the plantar fascia and pain management strategies