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Get the latest and most reliable information on pain relief & physiotherapy treatments at Macquarie Street Physiotherapy Clinic blog.

Surf Ski Paddling on Sydney Harbour

Admini Si - Friday, March 15, 2019


Two years ago my personal trainer, Luke, decided to turn his own passion for surf ski paddling into a business, offering it as a new sport for his clients.  So with some trepidation, myself and some of my fellow training friends bit the bullet and found ourselves venturing onto the Harbour waters at Rose Bay.  Those first few sessions were hard, much of the time being spent in the water not on it!  Whilst sitting in the ski I often felt like jelly, but with practise and good instruction my stability improved.

I also had not appreciated as a sport you have to use every part of your body - arms for pulling the paddle, legs to drive against the foot plate, trunk to power the pull as you rotate, and of course the core for stability.

Luke has pushed me out of my comfort zone many times, from crossing the Harbour avoiding ferries and navy ships to paddling on the Hawkesbury to Palm Beach.  It is amazing what you can achieve with a positive mindset.

I now paddle at least twice a week.  Each session is always different and includes interval training.  Over time, my fitness and strength has improved.

I have to pinch myself sometimes realising how lucky I am to have a sport I love, on the most beautiful Harbour in the world and sharing it with some wonderful new friends.  A sport I can highly recommend to water loving people of all ages who love a bit of adventure and a challenge.

Posture Tips for Travel

Admini Si - Friday, March 15, 2019

Posture tips for travel

The adventure begins and finally you are heading off on your journey!  You can already sense the relaxation of having a break from work and a change of scenery…

The next step is one that physios often get involved in - treating the back strain from lifting the suitcase from the taxi or the rotator cuff tear from taking luggage from the carousel. It’s enough to ruin your holiday!

When you are going away there is often a lot going on, distractions and everything is rushed.  Your body is quite good lifting and carrying if you give it plenty of preparation and warning.  Of course, ideally, preparation started months before with some strength and conditioning at the gym or a sport.

Here are some tips to help avoid pain/injury whilst travelling:

  • Preferably start with a wheelie suitcase.
  • Have your suitcase up off the floor for packing (and stand upright now and then whilst packing it).
  • Know the weight of any suitcase you are about to lift - injuries can occur even when lifting a suitcase lighter than expected!
  • Take a moment to prepare by engaging your core and shoulder muscles before lifting bags in and out of a taxi, onto weighing belt, and off a carousel. Particularly with taking a bag from a carousel, set your shoulder blades back.
  • When lifting try to keep the case close to you, and avoid your torso being in a side-bent or rotated position.
  • If you have shoulder or neck problems ask for help with overhead lockers
  • Whether you are in a plane, train or automobile take a moment to adjust the seat. A lumbar roll behind the small of your back, even one fashioned from a jumper or towel, can assist with lower back and neck pain.
  • Take breaks from sitting to move around, and do exercises such as calf raises, glute squeezes and shoulder rolling whenever possible.

Good luck and happy, pain free travels!

Hydrotherapy for Women

Admini Si - Friday, March 15, 2019

Hydrotherapy for Women

Macquarie Street Physiotherapy is pleased to announce we are commencing hydrotherapy classes for women. We have access to the women’s-only hydrotherapy pool at City Tattersalls Club in Pitt Street, just south of the Mall. We are offering small group classes with a maximum of 5 per class. Classes run for 45 mins. Additionally, 1:1 sessions which run for 30 mins are also available. If you have extras on your private health insurance, you may qualify for a rebate for hydrotherapy run by a physiotherapist. Alternatively, your GP may refer you through the EPC Medicare scheme, which partially funds 5 sessions of 1:1 Physiotherapy (land or pool based) per year.

Why Hydrotherapy?

Hydrotherapy provides an excellent medium to exercise in, for a variety of conditions that may be better suited to water than land. Warm water promotes joint fluid viscosity, muscle and ligament flexibility and pain relief. This can allow movement that might otherwise have been painful. Buoyancy reduces bone and joint stress, and provides resistance to facilitate strength. The compressive force of immersion aides in swelling reduction.

Hydrotherapy is particularly helpful for swollen sore joints, such as hips and knees.  It is the ideal exercise for pre-surgical and post-surgical total hip and knee joint replacement. Osteoarthritic joints will enjoy the heat, buoyancy and resistance of the water especially so for those with higher BMI’s, reducing the pressure on those sore joints.

Strengthening of balance muscles and postural muscles will also help those with osteoporosis.

The benefit of hydrotherapy over aqua aerobic classes is that you are individually assessed by a physiotherapist, and your exercises in class will focus on your specific needs. Once you are proficient and confident with your specific programme we may encourage you to do independent pool exercises and, if capable, progress to an aqua aerobic class.

If you would like any further information about hydrotherapy, feel free to contact Macquarie Street Physiotherapy on 9221 1604

Hamstring Strains Prevention and Rehabilitation

Admini Si - Friday, March 15, 2019

Hamstring Strains - Prevention and Rehabilitation

There is a variety of hamstring-related injuries that can occur in the athlete.  Of these, hamstring strains are the most prevalent. Approximately one-third of hamstring strains will recur, with the highest injury recurrence being within the first two weeks of return to sport.  This high recurrence rate is suggestive of an inadequate rehabilitation program, a premature return to sport of a combination of both.

There is an increased risk for acute hamstring strains in sports that involve sprinting, kicking or high-speed skilled movements such as football, soccer, rugby and track. These strains are more common in competition than in practice and more common in preseason than regular season and post season.

I have compiled some information to best assist in assessing the readiness of an athlete to return to sport after a hamstring strain and may also be helpful in hamstring injury prevention during preseason and throughout the season.

When should I start preseason training?

The literature suggests that preseason training should start 10 weeks prior to commencement of the sports season.

What should my training include?


First and foremost having enough strength in your hamstring is a priority. In a study by C.Askling et al., eccentric strengthening exercises have been shown to reduce hamstring strains among male soccer players.  Eccentric strengthening means that the muscle we are strengthening lengthens as it contracts. Here are two examples:

Single Leg Hamstring Curl on Exercise Ball                                      


Nordic Hamstring Curl

Both exercises work the hamstring eccentrically. As a guide, 10-12 repetitions by 3 sets of both 3-5 times/week is a good starting point.

Nordic hamstring curls are getting a lot of attention in the literature over the last couple of years.  The exercise has been added to the FIFA-11 warm-up protocol. This is a very popular protocol used by many amateur and youth soccer coaches throughout the world.


Flexibility is another important element to include in your training regime. Studies show that including 3 stretching sessions/day can significantly increase flexibility and in turn lower the risk of hamstring strain. One stretching session consists of 2-3 different hamstring stretches, each held for 30 seconds and repeated 5 times.  Here are two examples:

 Hamstring stretch in standing                                    


Hamstring stretch with strap


Agility training programs are designed to allow the athlete to adapt to quick changes in directions, acceleration and deceleration, and cutting activities.

Sport-specific activities can include running, lateral running and backward running, shuttle runs, explosive starts and agility drills (figure-of eight running, running with quick changes in directions, cutting activities, and ball catching, throwing, passing, and kicking)

Some research suggested improvements in lower extremity control following agility training and a potential contribution to injury prevention.

Progressive shuttle runs/sprints                                             


How do I know I’m fit for return to sport or fit for the season ahead?

An athlete’s ability to return to sport may also be predicted by certain functional testing, such as the ability to perform a single leg hamstring bridge.

In one study that was carried out, Australian Rules football players who demonstrated low hamstring strength, via a singe leg bridge hamstring test, were at increased risk for hamstring injury.

A score less than 20 repetitions is considered poor, 25 repetitions is considered average and greater than 30 repetitions is considered good.

Functional ability testing should also incorporate sport-related movements specific to the athlete, with intensity near maximum

Single leg hamstring bridge

If you suffer acute or chronic hamstring strains or just want some advice on avoiding injuries during the season come and see one of our Macquarie Street Physios in Sydney’s CBD.


  1. Darryl G. Thelan et al. (2006) ‘Neuromusculoskeletal Models Provide Insights into the Mechanisms and Rehabilitation of Hamstring Strains
  2. Carl M. Askling et al. (2014) ‘Acute Hamstring injuries in Swedish elite sprinters and jumpers: a prospective RCT comparing two rehabilitation protocols
  3. Carl M. Askling et al (2002) ‘Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload
  4. Lauren N.Erickson et al (2017) ‘ Rehabilitation and return to sport after hamstring strain’
  5. J Petersen, P Holmich (2005) ‘Evidence based prevention of hamstring injuries in sport’


Admini Si - Friday, March 08, 2019

Vertigo is the false sensation of motion causing you to experience the feeling of spinning , dizziness, light headedness and being unsteady. You may also feel nauseous. It is as a result of problems with the balance mechanisms in your inner ear known as the vestibular labyrinth.  Within this there are 3 semicircular canals at right angles to each other. As you move your head this causes fluid in the canals to move which in turn causes tiny hairs to move, triggering the firing off of nerve messages to the brain. This gives the brain information about what position the head is in and of movement. This is reinforced by nerve input from the eyes, joints and muscles of the body.

There are a number of different causes of vertigo one of the most common is Benign Paroxysmal Positional Vertigo [BPPV].



Minute calcium carbonate crystals can be dislodged from their normal location in the inner ear and either float in the semicircular canal or get stuck in the canal where they are not suppose to be. This causes the brain to think you are moving. However your eyes and body provide your brain with different information causing a mismatch of input resulting in the sensation of dizziness.


  • Sudden onset of spinning sensation.
  • May have woken up with it or noticed it when turned in bed
  • Can occur when bending forward or looking up
  • May feel nauseous
  • Terrible feeling whilst spinning occurs but settles within seconds
Stemetil and Sec settle nausea but do not change dizziness


A simple test called the Dix Hallpike is used to determine which ear and canal are affected.

If this is positive there is a sensation of dizziness with involuntary movement of the eyes called nystagmus.


The vertigo resulting from BPPV can be dramatically relieved by specialist techniques performed by physiotherapists skilled in this area. This involves moving the head through a series of positions in order to reposition the crystals back where they will no longer cause any problems. This is known as a canal repositioning manoeuvre or Epley.

80% of people will respond to one treatment. If symptoms persist a second treatment may be required one week later.

Some people may need to perform positioning exercises at home.


  • Cervical Vertigo – caused by change in input from the joints of the neck.
  • Menieres – episodes of vertigo with fullness of the ear, some hearing loss and tinnitus.
  • Vestibular neuritis – Viral infection causing inflammation of the vestibular nerve with sudden onset of severe dizziness, vomiting and tinnitus.
  • Vestibular labyrinthitis – Viral infection causing inflammation of the labyrinth with sudden onset of dizziness and unilateral hearing loss.
  • Acoustic neuroma – a slow growing tumour causing a feeling of imbalance, unilateral hearing loss and tinnitus.
  • Vestibular migraines - a feeling of motion sickness that can last a few hours to days with or without a headache and other migraine symptoms. Psycho Physiological Dizziness Syndrome – dizziness brought on by conditions such as anxiety, depression and panic attacks. 

Vestibular Rehabilitation can help with some but not all of these. It involves specific exercises of the head and body including the eyes to try to recalibrate the balance and reduce the dizziness.

If you are currently experiencing vertigo feel free to book an appointment to see our Specialist Physiotherapists at Macquarie Street Physiotherapy and they will assess you to see if they are able to help your particular type of vertigo.

Macquarie Street Physio