Whistler St Physio logo

Areas of special interest

Lumbopelvic Instability

Lumbopelvic instability is an overall term relating either to structural instability (e.g. spondylolythesis) or functional instability (e.g. poor core stability) of the low back and pelvis.  Either problem can result in repeated episodes of pain and dysfunction in the low back and pelvis with or without referred leg pain. 

Treatment involves correcting bony alignment, using braces to support the correction and muscle control and function exercises.  It normally requires an extended rehabilitation programme to achieve a good result (depending on the history of the condition) followed by an ongoing maintenance programme of exercises with occasional corrective treatment.  With dedication, good results can be achieved.       

Shoulder Injury and Rehabilitation

Shoulder injuries can be complicated and challenging and frequently involve an extended rehabilitation period.  This is due to the complex biomechanics of the shoulder girdle and it’s dependence on muscles for stability.  Unfortunately there are very few short cuts to recovery.  Even after ultrasound or MRI guided cortisone injections, which give great pain relief, the underlying dysfunction must be addressed or the pain will return.  

Early treatment for shoulder problems involves restoring good biomechanics and basic muscle stability and function to the shoulder girdle. Techniques such as joint mobilisation, capsular release, soft tissue release and very specific muscle work are used in conjunction with pain relief such as ice and your prescribed anti-inflammatory medication. 

Once the pain and dysfunction decreases and movement is restored to normal, technique analysis and treatment of any predisposing factors can be addressed. 

Exercise programmes must be performed religiously to gain a good, long-term result. 

Dance Injuries

Dance injuries most commonly occur due to the highly repetitive nature of rehearsing choreography.  This causes fatigue of the tissues and can result in stress reactions, stress fractures, tendon problems, hip pain, low back pain and a general feeling of being “twisted”. 

At Whistler St Physio, you will be thoroughly assessed both for the immediate problem (e.g. hip pain) and for more systemic problems through analysis of your movement and technique. 

Pre-pointe assessments are also available for those girls about to go “en-pointe”.  These are performed prior to buying your pointe shoes and involve an assessment of muscle function and biomechanics to determine whether you are physically ready to participate in pointe shoe classes.  As a result of the assessment, you will be given a tailored programme of exercises to prepare you for pointe work.

With your permission, I will communicate closely with your dance teacher/ dance school to maximise the effect of treatment and help integrate technical changes into class.

Women’s Health

The most common cause of incontinence is during or following pregnancy.  However, it is not the only cause.  Chronic coughs, heavy lifting and high impact activities such as running, netball and gymnastics can also lead to continence issues.   It has been shown that 28% of elite athletes in high impact sports suffer from varying degrees of incontinence (Nygaard 1990).

Incontinence can be separated into 2 basic categories:

  • stress incontinence (leakage of urine with coughing, running, sneezing, lifting etc)
  • urge incontinence (having to get to the toilet really quickly for fear of losing bladder control).

The great news is that these conditions are easily treatable, even in the older client.

Research has shown that there is a 73% “cure” and a 97% “cure/improvement” rate for women with stress incontinence who undergo a good pelvic floor muscle training programme alone or in combination with adjunctive therapies (e.g. cones) (Neumann et al 2006).

At Whistler St Physio you will undergo a thorough assessment.  This will include a verbal history, research validated questionnaires, a bladder diary (if indicated) and a detailed physical examination (including postural, movement and stability assessment of the pelvis and trunk, and an internal examination).

Internal examination is the most effective technique for assessing the function of the pelvic floor muscles and it is performed in a discrete, gentle and professional manner, however, if you are not comfortable with this form of examination, alternative techniques can be used to assess the basic function of the pelvic floor muscles.  It is always your choice.

A tailored treatment programme is formulated from the results of the assessment.  This may include pelvic floor exercises, bladder retraining, manual treatment of any pelvic or spinal dysfunctions, and core stability exercises.  

Adolescent Injuries

Major growth spurts occur when you are approximately 10-16 years old.

During these “spurts” the bones lengthen much more quickly then the soft tissues which can result in “growing pains”. These pains most commonly occur in the knees and ankles, but can affect any area of the body. 

Besides normal sporting injuries, the other most common adolescent problem is back pain and/or headaches.  These are exacerbated by poor posture, heavy school bags and extended periods spent studying.  

All these injuries are addressed with a detailed assessment and a tailored treatment and exercise programme.

Movement Analysis

Movement analysis can be used as a preventative measure when treating injuries, as well as a technique to improve performance, for example running efficiency or improving a golf swing.

The consultation involves the identification of muscle imbalance and areas of dysfunction in the body which are then addressed with a tailored treatment and exercise programme. 

Clinical Pilates

Clinical pilates was developed by physiotherapists to bridge the gap between inactivity or injury and the original Pilates method (created for professional dancers).  It is suitable for people who:

  • have not performed stability work before and want to progress into a standard pilates, yoga or exercise programme.
  • have sustained an injury or have pain or symptoms with normal movement.
  • are recovering from injury and are preparing for a return to high-level activity.
  • do not have an injury but are wanting to improve their performance with a good quality, individually tailored, core stability programme.  

Clinical pilates is based around movement biases and is specifically tailored to each individual.  This enables a fast, efficient progression without aggravation of symptoms.