Ballet dancing shoes

Dance Physiotherapy

We have a great team of physios with many years of experience in dance to keep you on your toes.

While some dance injuries result from a single event like a poor jump landing many come about from mild technique and training errors that are repeated many times over.  Overloading intensity near exams and performances is a common factor in injury. We assess, treat, strengthen and evaluate the cause to get you back on your toes as soon as possible.

Dance Assessments

A detailed assessment at any age will identify strength and flexibility issues that could be contributing to poor performance or injury. After the assessment we design a home programme so you can strengthen specific weaknesses and elevate your performance. We can also design you a specific strengthening programme in our Clinical Pilates exercise studio on our Reformers, Trap tables and Wunda chairs where our instructors will help you focus on achieving your dance strength goals. If you are too busy to attend our studio we can develop a home programme of exercise.

 
Pre-pointe Assessments

Going en Pointé is a big step in a young dancer’s career. We assess young dancers proceeding to pointé to determine not only if their feet are strong enough for pointe but also if their bodies are strong and stable so the feet aren’t overloaded by weakness further up the chain, especially in the core and pelvis. A home programme will be prescribed so you can achieve the strength you need for the transition to pointe. We can provide a report both for you and your teacher so they assist with specific strengthening goals.

 
Dance Injury Treatment

Our experience gives us extra insight into dance injuries, their immediate treatment and the recovery pathway from injury back to full dance performance.

 
Dance Conditioning

Pilates has been the strengthening exercise of choice for dancers wanting to perform at their best for many years. The founder of Pilates was Joseph Pilates and he worked with the New York ballet dancers and famous choreographers of his time so dance technique was incorporated into his exercises. We have taken the principles of Pilates and merged it with the latest in sports physiotherapy and dance physiotherapy to bring you a client specific exercise system which we now call Clinical Pilates. We can design you an individualised programme for performance enhancement or to rehabilitate you fully from injury.

 

Our Dance Physiotherapy Team

Jenny Birckel - (APA Sports Physiotherapist) started working with QDSE in 1990 and has performed pre-entry assessments and treatments for over 30 years. She also had a clinic in the Australian Dance Performance Institute where assessments and treating dancers was a regular event. Jenny began her journey into Pilates in 1995 as she sought an exercise solution to dancers with weaknesses and injuries.

Jenny is the director of the Pilates Institute of Queensland and runs Pilates training courses for physiotherapists, exercise physiologists, dance teachers and Fitness professionals.  

Maria Yee specializes in dance & sports injuries and musculoskeletal conditions.

Maria trained in numerous dance styles herself, including classical ballet and Chinese dance. She presented her honours thesis on musculoskeletal profiles of pre-professional ballet dancers at the International Association for Dance Medicine & Science annual meeting in Switzerland in 2014, and at the World Congress of Physical Therapy the following year. 

Maria has since worked with established professional contemporary and ballet companies including Les Misérables (Australia), Singapore Dance Theatre, and T.H.E dance company, conducting functional assessments and dance specific screening on top of injury management. She works closely with a number of Brisbane’s dance schools, and regularly conducts pre-pointe assessments and dance screening for dance students. She also runs dance specific Pilates studio sessions at Agility to help dancers get the best from their bodies. 

Michael Post - Michael graduated from the University of Queensland with a Masters in Physiotherapy. He was the recipient of multiple Dean’s commendations of academic excellence throughout his studies and place in the top three for highest clinical placement grades in his year group. He also has a Bachelor’s of Sport and Exercise Science and three years’ experience teaching Matwork and Reformer Pilates. Michael has a keen interest in sports physiotherapy, specifically dance injury prevention and management after having trained in classical ballet and contemporary dance himself. 

Andrea Maude is an APA Sports Physiotherapist  and part of our dance injury team.

Jo Kaighin has many years of experience treating and assessing sports and dance injuries. While she is a generalist musculoskeletal physiotherapist she has seen many dancers in our clinic and is spot on with finding a diagnosis, treatment and working them hard to rehabilitate and return to dance. 

Bones and Balance Article

Bones & Balance Classes at Agility

Aged Care Royal Commission identifies need for falls prevention programs for older people.

With the recent press surrounding aged care in Australia, and the Royal Commission into Aged Care Quality and Safety, Agility Physiotherapy is proud to be delivering Bones and Balance classes. Our Bones and Balance classes are run by our highly experienced Physiotherapists and are designed to improve strength, stability and balance, reduce falls risk and improve bone density.

If you would like more information about our classes, or would like to book in, please call or email either our Ascot or Bulimba practice.

The article below is from the Australian Physiotherapy Association and highlights the essential nature of promoting and maintaining strength and mobility as we age.

The Australian Physiotherapy Association (APA) has welcomed the Final Report of the Royal Commission into Aged Care Quality and Safety, which identified promoting and maintaining mobility to reduce the risk of life-threatening falls in older people. It has called on the federal government to roll out a comprehensive plan for implementation of its recommendations that has person centred care, not cost centred, as its basis.

The APA made a total of six submissions to the Royal Commission and presented expert evidence on falls prevention programs for both physical and mental wellbeing.

Promoting and maintaining mobility and reducing the risk of life-threatening falls in older people was noted as critical in the final report, which found that access to physiotherapists, who are highly trained and skilled in strength, balance and mobility training, was often lacking in aged care.

The report recognised that “mobility was closely linked with people’s health and their quality of life [and that] poor mobility increased the risk of falls and fall-related injuries due to deconditioning and reduced muscle strength.”

APA National President Scott Willis said, “Falls are the number one cause of preventable death in residential aged care. The lack of investment in falls prevention programs over a long period of time, particularly when there is such strong evidence for their value, is an oversight that has had tragic consequences for too many families.”

“The Royal Commission has rightly identified the critical role that physiotherapists play in aged care. These are highly skilled mobility experts who are literally helping to save and improve lives by ensuring residents are active, mobile and ultimately confident in their movement.”

“We know that mobility programs led by physiotherapists can reduce the number of falls in residential aged care by 55 per cent – the government simply has no excuse not to fund this critical care for older Australians.”

The report also found that those living with incontinence and dementia often received substandard care, which the APA has called out many times.

Mr. Willis said, “Appropriately qualified and experienced health professionals must be employed to provide the complex care and support that these extremely vulnerable people need. We have talked about team-based, holistic care in all health settings for a long time. There’s no more critical place for this to start than in aged care.”

Shockwave Theraphy

Shockwave Therapy

Shockwave Therapy is a non-surgical and non-invasive method of pain relief and mobility improvement. Also called Extracorporeal Shock Wave Therapy or ESWT, Shockwave Therapy is used around the world in physiotherapy, sports medicine, orthopaedics, podiatry and urology.

Here at Agility we use shockwave therapy to treat chronic painful tendon conditions such as: Achilles tendonopathy, patellar tendonopathy, plantar fasciitis, gluteal tendonopathy (hip bursitis), rotator cuff pain, tennis elbow and golfer’s elbow.

Shockwave Therapy offers several key benefits:

  • Fast, effective treatment
  • Minimal side effects
  • Speedy recovery

How Exactly Does Shockwave Therapy Work?

Shockwave therapy sends high-energy radial pressure waves to the site of chronic pain. These acoustic waves increase blood flow, stimulate muscle repair and regeneration, and increase metabolization at the cellular level.

Shockwave therapy is a safe, effective, treatment recommended for people suffering chronic pain – even at the highest level of sport. Clinical studies and literature reviews continue to prove the effectiveness of ESWT as a treatment method for tendon complaints and a raft of musculoskeletal issues.

What does Shockwave Therapy involve?

During shockwave treatment you may experience a small amount of discomfort, but your response is measured by our experienced physiotherapists to ensure you are not in pain. Because shockwave therapy creates an analgesic effect, you should experience immediate acute pain relief. The treatments also stimulate collagen production so you will benefit from increased mobility after 1 or 2 sessions.

Fast treatment

Generally we need to see you 4-6 times, about a week apart, for effective long-term pain reduction. Each session lasts around 20 minutes and most patients report a drastic pain reduction after the first treatment. Shockwave therapy is used as part of a tailored therapy pathway designed to address underlying issues in your body.

Limited side effects

Shockwave therapy carries a much lower risk of side-effects than surgery. Depending on your level of pain and overall health there may – in very rare cases – be side effects to ESWT:

  • Tolerable pain 2-4 hours after initial treatments
  • Mild discomfort during treatment
  • Mild bruising, swelling and/or numbness
  • No response to treatment (extremely rare)

Fast recovery

Shockwave therapy starts to alleviate pain and restore mobility after the first session. At most you will be restricted from high-impact activity for 48 hours following each session. Your physiotherapist will give more tailored advice, but in general the recovery periods following shockwave treatment are substantially shorter than surgery.

What to expect after Shockwave Therapy?

After 1-2 days you should experience reduced pain and improved mobility. Here at Agility, we design shockwave therapy plans that specifically address your pain points, to provide safe and effective pain treatment without surgery.

Contact us to learn more about Shockwave Therapy, book a shockwave therapy treatment, or speak with our team about treatment options tailored for you.

Knee Pain – Is It “Just Growing Pains”?

Knee Pain – Is It “Just Growing Pains”?

Does your teenager complain about pain in the front of their knees? Have you been told they have “growing pains” and it’ll just go away?  Have you been told you have arthritis in your knee and you should stop exercise?

This is just not true!!  Inaccurate advice like this can cost years of healthy activity and needlessly keep you or your loved ones from doing the things you love.

In a recent research update, world leaders in knee pain combed thousands of research articles to come up with updated clinical guidelines for Patello-femoral pain (aka runners knee, jumpers knee, netball knee etc).

Patello-femoral pain is felt at the front of the knee and hurts with sport, stairs, squatting and even sitting.

 

Some of the statistics are alarming:

  • It affects people of all ages and is extremely common
  • 29% of adolescents will get this condition
  • Half of them will struggle for 2 years to do the sport they love
  • Many will have niggling pain into their 20’s

 

The good news is that there are treatment options that are proven to help reduce pain, improve activity levels and get you back to sport. The ones with the most research evidence behind them are:

  • Hip and knee muscle strengthening exercises
  • Patellar taping
  • Inexpensive, off the shelf foot orthotics if you have flat feet
  • Patellar mobilisation and
  • Lower limb muscle stretching

 

The combination of these treatments should be tailored to you by a Physio skilled in treating Patello-Femoral pain. Treatments with no evidence to support them are passive choices like laser, electrical stimulation, needling, ultrasound and definitely not waiting for growth spurts to finish before going back to sport!

If you, or a family member has had enough of putting up with pain in your knee give us a call or book online to get started on the road to recovery and get back to doing what you love.  We are here to help!

 

10 Things Not To Do If You Have Lower Limb Tendon Pain

10 Things Not To Do If You Have Lower Limb Tendon Pain

  1. Rest completely

The old adage of use it or lose it applies to tendons, resting just decreases the ability of the tendon to take load. It also affects the muscle attached to the tendon and the rest of the leg, leaving the person with less ability to load the tendon. Conversely you cannot ignore the pain (point 4), you have to reduce loads to the level that the tendon can tolerate and then slowly increase the tolerance of the tendon to load.
 

  1. Have passive treatments

Treatments that do not address the need to increase the ability of the tendon to take load are not usually helpful in the long term, although they might give short term pain relief. Treatments like electrotherapy and ice will only temporarily ameliorate pain only for it to return when the tendon is loaded.
 

  1. Have injection therapies

Injections of substances into a tendon have not been shown to be effective in good clinical trials. In fact many of them are based on the false premise that tendons heal like other tissues and that there is a capacity to return a pathological tendon to normal. Do not have injection in a tendon unless the tendon has not responded to a good exercise based program.
 

  1. Ignore your pain

Manage the load on your tendon, pain is a way of telling you that the load is too much. Reduce the aspects of training that are overloading your tendon (point 10).
 

  1. Stretch your tendon

Aside from the load on your tendon when you play sport, there are compressive loads on your tendon when it is at  its longest length, adding stretching to most tendons only serves to add compressive loads that we know are detrimental to the tendon. Stretching while you are standing can be especially provocative to your tendon. If your muscles are tight use massage to loosen them.
 

  1. Massage your tendon

A tendon that is painful is one that is telling you that it is overloaded and irritated, therefore adding further insult by massaging it can actually increase your pain. Sometimes tendons will feel better immediately after a massage but can then be worse when you load them.  As mentioned in point 5, massage of the attached muscle can be helpful.
 

  1. Be worried about the images of your tendon

The pictures of your tendon with ultrasound and MRI can frighten you, and the words used by doctors such as degeneration and tears can make you wonder if your tendon should be loaded. There is good evidence that the pathological tendon can tolerate loads, especially when you gradually increase the loads on them.
 

  1. Be worried about rupture

Pain is protective of your tendon, it makes you unload it, in fact most people who rupture a tendon have never had pain before, despite the tendon having substantial pathology in it (see point 7).
 

  1. Take short cuts with rehabilitation

Taking short cuts with rehabilitation do not work, you need to take the time that the tendon needs to build its strength and capacity. Although this can be a substantial period (up to 3 months or occasionally even more), the long term outcomes are good if you do the correct rehabilitation. Things that are promised as cures (see point 3) often give short term improvement but the pain recurs when the loads are resumed on the tendon.
 

  1. Not have an understanding of what loads are high for your tendon

The highest load on your tendon is when you use it like a spring, such as jumping, changing direction and sprinting. Any loads that do not use these movements are low load for a tendon, so exercise using weights and exercise that is slow will not place a high load on the tendon, although they can certainly have a beneficial effect on the muscles.
 

Summary

The take home message is that exercise-based rehabilitation is the best treatment for tendon pain. A progressive program that starts with a strength program and then progresses through to more spring like exercises and including endurance aspects will give the right loads on the tendon and the best long term results. Make sure you see a qualified health professional with expertise in this area to guide your rehabilitation.
 

Reference:

Jill Cook:  http://semrc.blogs.latrobe.edu.au/10-things-not-to-do-if-you-have-lower-limb-tendon-pain/

Men’s Health

Men’s Health

How healthy are you? Did you know that most men have a functional view of their health?
e.g. “If I can still do the things that are important to me, then I’m healthy”.

We tend to view our health in terms of:

  • Work
  • Sport
  • Play
  • Sex

Did you know that men tend to live an average of 5 years less than women and that men lead in adverse health
statistics globally? So… what does men’s health cover? How can a physio help me?

Men’s health is a broad area and consists of:

  • Physical health
  • Medical health
  • Mental health
  • Social health

These areas do not exist independently. They are linked.
Neglecting one area can lead to reduced health in another.

Most of us are familiar with physiotherapy. If we have aches and pains, we see a physio. But did you know that
physiotherapists can help with:

  • Incontinence
  • Prostate symptoms
  • Sexual dysfunction
  • Pelvic Pain

The common reasons that men don’t go for regular check-ups are:

  • Fear
  • Denial
  • Embarrassment
  • Threatened masculinity

By the time we decide to seek professional help things are really getting out of hand. Guys, these statistics are
terrible! We are at least 30 years behind women’s health!

If you have any men’s health concerns, please don’t leave it too late and become a statistic. We are here to
help you. We will work with you and become part of the larger multidisciplinary team to help you achieve your
health care goals.

Adolescent Growth Spurts

Adolescent Growth Spurts

Adolescence can be both a fun and challenging time for the individual and those around them. Changes which occur are not only physical but emotional, psychological and social. It is also around this time that many teenagers and pre-teens are participating or increasing their participation in their chosen sporting pursuits and more time may be being demanded from coaches and teachers.

Every individual will develop differently. Some will grow in a slow steady fashion over a couple of years where as other will experience rapid growth spurts over a period of months. IT is often these individuals who will suffer more from growth-related problems.

 

As we grow during adolescence the long bones of our arms and legs grow first, followed by our trunk and then the muscles, tendons, and nerves catch up. It is this latency of the muscles and nerves that can give rise to the lanky, uncoordinated teenager who now has difficulty not falling over!

During these periods of growth, it is important to remain active but the activity level may need to change to allow for pain-free sporting involvement. It is also important to remember that if an individual has had a sudden growth spurt and has lost some of their natural coordination, training may need to be adapted while their body catches up to avoid putting them at risk of injury.

Stretching can be helpful during growth spurts although this needs to be done carefully as the muscles and tendons are already on stretch trying to catch up with the bony growth which has taken place. Controlled stretches and strength work can really help during this time to regain strength in the muscles new elongated range. This, in turn, provides protection to the joints and can assist in improving balance and coordination. Your physiotherapist can help advise on which stretches or exercises may be best and can also assist in load modification. During growth spurts, an individual’s training load may need to be adjusted to allow time for their body to catch up and let them perform pain-free. The physiotherapist can assist with advising on appropriate loads and also the reintroduction of activity to allow a full return to sport/performance. Controlled exercises such as Pilates can also be a great way to work on stretching and strength in a safe environment for growing bodies.

Whiplash

Whiplash

What is Whiplash?

Whiplash is a traumatic injury to the neck or back usually caused by a car or motor vehicle accident. Some other causes include sporting injuries or falls.

The doctor has already X-rayed my neck and nothing is wrong! Where is the pain coming from?

X-rays will only show damage to bones, for example, a fracture. Your pain is likely coming from damage to joint surfaces, bones, muscles, nerves, tendons and ligaments in the neck region. It’s a bit like an ankle sprain involving the joints in your neck.

There are several vital structures existing in your neck, so thorough medical examination and physiotherapy assessment is very important.

Why did it happen to me?

Often, not every person involved in a car accident will experience symptoms. Women for example, tend to suffer whiplash injuries more frequently than men, because their muscles, joints and supporting ligaments are smaller and more fragile.

The speed and direction at which you were travelling, the size of the vehicle, whether you were a passenger or drive and what you were doing at the time (turning around to check on children, using a GPS, checking a blind spot) all influence the nature of the injury. Previous injuries to the neck can also influence recovery and pain levels.

What symptoms can I expect?

You may experience any of the following symptoms. Sometimes they are latent, meaning that they do not become apparent until a day or two after the incident. These are very typical whiplash symptoms. Don’t be alarmed by them. It is, however, important to let your Physiotherapist know about any of these:

  • Headaches
  • Dizziness
  • Neck, shoulder or arm pain
  • Altered sensation (pins and
    needles or numbness)
  • Weakness
  • Difficulty swallowing
  • Visual and auditory symptoms
  • Difficulty concentrating

These symptoms may change depending on the type of whiplash you have (acute or chronic).

What will your Physiotherapist do?

We know from research that using many different forms of treatment is the best way to treat many conditions, including whiplash. We might try a variety of the following:

  • The mobilisation of joints in your neck
  • Correct your posture
  • Massage
  • Adjunct treatments such as
    Western Acupuncture, laser, heat
    and cold therapy, ultrasound
  • Prescribe Pilates and/ or
    generalised exercise programs to
    improve strength, posture,
    mobility and manage pain
  • Talk about work or home
    environments and make
    ergonomic recommendations.

What should I do?

  1. Chat to your physio about pain and symptoms- at Agility, we know that keeping our patients well informed helps them make a speedy recovery
  2. Try to keep your movements and daily activities as normal as possible (within reasonable pain limits)
  3. Exercise- discuss with your Physiotherapist as to which type of exercise is best to manage your whiplash.

At Agility, many people will try Pilates (or many continue Pilates they were doing before the accident) to strengthen muscles around the neck and shoulders, retrain the vestibular (balance system in the inner ear) system, or work on specific exercise for return to work or sport after their accident.

We can also provide advice on trying or recommencing other forms of exercise to manage pain and increase mobility.

Be pro- active! Have a daily plan of attack for pain management and exercise. Even simple stretching can help. Have reminders on hand to help you be consistent. Some people find it helpful to talk about the accident or their injury with a psychologist. We can help you find a suitable practitioner to talk to.

Talk to your doctor about taking pain medication in acute situations. It is easier to move normally when you are not in pain.

Do I need a neck collar?

No. Unless you have a serious fracture or instability, they can slow down your recovery.

Do I need time off work?

Like any injury, relative rest is quite important after a whiplash injury. Discuss specifics with your physiotherapist and they can help you plan your return to work. As you start to feel better, maintaining your exercise program, ensuring good work ergonomics and having occasional maintenance treatment is recommended.

Information gathered from:

“Your guide to whiplash recovery in the first 12 weeks after the accident”, Motor Accidents Authority, 2nd Ed. 2007 the University of Queensland’s Online Evidence Based Resource, accessed March 2013.