Shoulder Impingement

Posted on August 11th, 2016

Do you get pain when lifting your arm above your head or to the side? Is it uncomfortable to reach behind your back? Are you unable to lie on your affected shoulder when sleeping? These are signs that you may have impingement of your shoulder!

Shoulder and upper arm pain is one of the most common presentations we see as physiotherapists. This is due to the shoulder being one of the most moveable joints in the body.

A quick bit of shoulder anatomy!
The shoulder is made up of the head of the humerus (i.e. the top of the upper arm bone) and a shallow groove on the outside of the shoulder blade. This is what makes up the shoulder joint. Above the shoulder joint there is another bone which comes off the shoulder blade called the acromion. The area between the shoulder joint and the acromion is called the subacromial space, and there are various structures which run through this space including one of the rotator cuff tendons (the group of muscles that hold the shoulder in its socket) and a bursa (a small fluid sac which cushions the rotator cuff tendon). When we raise our arm up or to the side, the subacromial space narrows, however there is still room for the tendons and bursa. This is not the case with shoulder impingement.

What is shoulder impingement?
Shoulder impingement is where there is pinching of the rotator cuff tendon or bursa between the shoulder joint and the acromion. This is what causes your pain when lifting your arm up. Shoulder impingement is not a condition, rather a consequence of another underlying problem.

Things that can cause shoulder impingement include:
– Problems with your rotator cuff muscles, such as weakness, a tear or general overuse
– Weakness of the muscles that control your shoulder blade, which can alter how your shoulder works
– Tightness of the muscles around your shoulder and shoulder blade
– Instability of your shoulder (i.e. the ligaments around your shoulder are stretched which results in you having more movement than normal)
– Poor posture (i.e. having a slouched upper back or your chin poking forward)

Things you can do to help:
– Try to limit the stress on the rotator cuff tendons. You can do this by avoiding any activities or movements which cause your shoulder pain. This will allow the tendons to heal.
– See your physiotherapist! Because there are various factors which can cause impingement, it is important to identify the exact cause which is resulting in your pain. A physiotherapist will be able to do a thorough assessment to identify these dysfunctions, and will then be able to treat the cause of the impingement.

Image result for rotator cuff

Postural Syndromes

Posted on May 31st, 2016

Posture is something that a lot of health professionals address with patients who come in for neck pain. Those of you who have been to a physiotherapist, would have a bit more knowledge about posture and biomechanics of the back and neck. However, the way our society is progressing, with the development of technology and the resultant jobs that are produced from technology, our occupations are becoming more sedentary. I believe the result of this is that physiotherapists are now dealing with a lot more postural issues throughout the age spectrum.

Children have access to iPads and computers from an early age, at school and at home. Prolonged periods of sitting at computers, using iPads/iPhones and other iGadgets can cause a great strain on the neck and back (especially if slouching), muscles and spine. Not only is it the use of these technologies, and our sedentary occupations, it is also a lack of awareness/knowledge about posture and the correct way to be sitting and standing. Many companies now have policies in the workplace to address these issues. However, I feel there is still a huge percentage of our population who do not know the basics of correct posture.


Poor neck posture can be characterised by:
• Slouched upper back (thoracic kyphosis)
• The chin sticking out (chin protrusion)
• Increased curvature/extension of the neck (increased cervical lordosis)
• Rounded shoulders (protracted shoulders)

Symptoms include but not limited to:
• Burning/aching pain on the musculature of the neck base of the skull, across the shoulders, and in the upper back
• Worsening pain with sustaining a position for a period of time (sitting, standing, driving, cycling, etc.)
• Pain can be alleviated with movement or changing position
• Stiffness in the neck and upper back
• Tightness with shoulder movements
• Headaches

There are many different approaches that are used to treat pain caused by poor posture. Preventative measures also can be put into place to avoid the production of pain. Your Physiotherapist will conduct a subjective and objective assessment to confirm the diagnosis and provide treatment and advice relevant to your individual needs.

Treatment can consist of, but not limited to:
• Education on posture and how to correct/retrain
• Prescribe exercises to improve strength, flexibility and stability
• Manual therapy in the form of massage, mobilisations, manipulations, etc.
• Electrotherapy (ultrasound for example)
• Dry needling
• Taping or bracing
• Ergonomic assessment and/or advice
• Activity modification
• Biomechanical correction
• Lumbar rolls, air cushions, (and other aides depending on your individual needs)
• Clinical Pilates

The prognosis for pain caused by poor posture is great (depending on patient compliance, as well). So if you feel you have poor posture that you would like to get help with, please contact our clinic on 47 233 552.

Brukner, Peter., & Khan, Karim. (2012). Clinical Sports Medicine. NSW, Australia: McGraw –Hill Australia

Ouch! Why does my foot hurt in the morning?

Posted on May 17th, 2016

It could be because you have plantar fasciitis – an inflammatory condition of the foot. Plantar fasciitis is a very common condition that affects many people yearly. Generally only one foot is affected, however it can affect both. Research has shown that approximately 1 in 10 people will develop plantar fasciitis in their life. Plantar fasciitis is more common in young male athletes and middle aged obese females. It can be a very painful condition, however your physiotherapist will provide you with advice and education on how to manage and treat your condition.

The plantar fascia is a band of connective tissue that originates from the bottom of your heel and extends out towards your toes. The plantar fascia is made up of three segments and plays an important role in foot biomechanics. It provides support for the arch and also assists in shock absorption. It also helps to stabilise the foot and to reduce the tension on the ligaments and the neural structures of the foot.

• Gradual onset of pain
• Generally worse in the morning and decreases with movement
• Can ache after weight bearing activities e.g. walking
• Can become present during weight bearing if the condition has worsened

Your physiotherapist will assess your gait pattern, palpate the joints and muscles of the foot, and will assess your ability to control the muscles of the lower limb with a biomechanical assessment. This will enable us to determine if there is a weakness in any of the supporting muscles of the foot and ankle. From your assessment, your physiotherapist will be able to provide treatment and recommend a home exercise program tailored specifically for you.

Brukner, Peter., & Khan, Karim. (2012). Clinical Sports Medicine. NSW, Australia: McGraw –Hill Australia

New Physiotherapist!

Posted on February 16th, 2016

We have kicked off the new year by welcoming a new physiotherapist to the PhysioCare Townsville team. Dean was born and bred in the Hunter Valley of NSW. He made the move to Townsville to undertake a degree in Physiotherapy at James Cook University. Dean graduated with honours in 2015!

Dean has a keen interest in all musculoskeletal conditions. He has completed further professional courses in sports training, taping and Clinical Pilates. Dean plans to attend further courses over the coming year. He believes strongly in implementing the latest evidence-based techniques to help patients achieve their goals.

Outside of work, Dean enjoys a game of cricket, a hit of golf and hanging out with his dog Titan.

New Opening Hours

Posted on January 12th, 2016

PhysioCare Townsville’s trading hours have now been extended. We will be open 7am-6pm Monday to Thursday, and 8am-5pm on Fridays. For an appointment, please call (07) 4723 3552 or book online through this website. We look forward to seeing you soon.

Exciting News!

Posted on November 10th, 2015

After some very busy months, we have exciting news to share here at PhysioCare Townsville! Emma, who has been with us for over four years, has now become a shareholder of PhysioCare Townsville. Now both Katharina and Emma share the duties and the joys of directing PhysioCare Townsville!

We also welcome two new faces to the team. Danielle is our new occupational therapist AND physiotherapist, and Monica is our new physiotherapist. Both Danielle and Monica completed their degrees at James Cook University and are excited to be working for us. They have been taught the most up to date, evidence based practice and have gained a wide variety of skills across all areas of physiotherapy. For more information on our new team members, check out the “About Us” tab on the website. We look forward to having them on board!

Professional Development News

Posted on April 2nd, 2015

The staff at PhysioCare Townsville are committed to ensuring they assess and treat patients using the latest evidence-based procedures and techniques. To ensure we remain up to date with the latest Evidence-Based Practice, PhysioCare Townsville will be closing at 1pm on the second Friday of every month to allow for Professional Development. Whilst in training, our staff will be unable to attend to phone calls, however if you need to talk to us urgently, please ensure you leave a message and we will return your call before the close of business that day.

In other Professional Development news, Katharina recently attended a 3 day Musculoskeletal Specialist Course – The Complete Upper Quadrant. During the course, Katharina learnt to differentially diagnose contributing mechanisms and impairments in patients presenting with pain in the upper quadrant, with consideration of cervical, neural and shoulder structures. She found the course very interesting and is keen to pass on her new knowledge to the rest of our team during this month’s Professional Development In-service.

Staff news

Posted on March 20th, 2015

Yesterday was a sad day for us here at PhysioCare as we said our goodbyes to Melissa, who will be realising her dream of becoming a paediatric physiotherapist by working with special needs kids at Education Queensland. We have thoroughly enjoyed working with Melissa and watching her develop from a budding new graduate to the fantastic physiotherapist she is today. She will be sorely missed by staff and clients alike and leaves behind big shoes to fill. We wish you the very best of luck in your future journey Mel!

Staff Update

Posted on January 13th, 2015

Welcome to PhysioCare in 2015! We hope you have all had a very happy a safe festive season.

PhysioCare are very pleased to welcome back Lauren from Maternity Leave in 2015. With a full team, PhysioCare will be extending our opening hours to include Saturday mornings.

Our 2015 team is as follows:
Katharina Dallmeyer
Lauren Stock
Emma Reid
Melissa Rowbotham-Spampinato
Claire Bugeja
Danielle Dury

Wibke Rettberg
Teri Thorne

Christmas Opening Hours

Posted on December 3rd, 2014

PhysioCare would like to thank each and every one of you for your continued support in 2014. We wish everyone a very Merry Christmas and a Happy and Prosperous 2015.

Below are our opening hours for the festive season. To make an appointment, please call us on 4723 3552 or alternatively, book online through our website.

Wednesday 24th December: 8am – 12pm
Thursday 25th December: CLOSED
Friday 26th December: CLOSED
Saturday 27th December: CLOSED
Sunday 28th December: CLOSED
Monday 29th December: 9am – 3pm
Tuesday 30th December: 8am – 4pm
Wednesday 31st December: 9am – 3pm
Thursday 1st January: CLOSED
Friday 2nd January: 9am – 5pm
Saturday 3rd January: CLOSED
Saturday 3rd January: CLOSED
Sunday 4th January: CLOSED
Monday 5th January: CLOSED
Tuesday 6th January: CLOSED
Wednesday 7th January: CLOSED
Thursday 8th January: CLOSED
Friday 9th January: CLOSED
Saturday 10th January: CLOSED
Sunday 11th January: CLOSED
Monday 12th January: Normal opening hours resume.