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Post Surgical Physiotherapy Post-Surgical Physiotherapy refers to any physiotherapy intervention undertaken following, and in the context of, surgical management of a problem. Timely physiotherapy intervention in the form of post-surgical rehab has been established as a highly effective means of ensuring a good outcome following surgery, minimising the risk of an adverse outcome, and best preparing someone to meet the demands of their lives. Post-Surgical Physiotherapy can be conducted as soon as less than twenty-four hours of an operation, depending on the surgeon's orders as well as the state of the patient following the procedure. This physiotherapy is routinely conducted within the hospital, on ward or in a specific rehabilitation gym designed to provide a safe and supportive environment in which exercise can be undertaken, and where patients can be monitored and cared for in the event of an issue. After leaving the surgical ward, patients may receive physiotherapy treatment in a rehabilitation ward where they stay for the duration of their treatment, via a home-visit service in their place of residence, in a hospital clinic during daytime appointments, or in a community rehabilitation center. There are many options for someone to receive physiotherapy treatment following surgery, some of which may be more or less favourable depending on the type of surgery that has been performed and the best management plan following the procedure. It is common for patients who are already seeing a private physiotherapist prior to their surgery to maintain contact with and involvement from that same clinician after their surgery. This ensures continuity of care, appropriate patient management, and minimises the likelihood of information loss or confusion due to multiple handovers between professionals and clinics. Your private practitioner will liaise with the surgical team and other staff as needed to ensure appropriate management. Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

Muscle Contractures Muscle contracture is a condition in which muscles tighten as a result of pathology or some outside injury, resulting in shortening of the muscle that is unable or difficult to be reversed. Normal function of muscles requires them to change their length to generate force and produce movement by pulling on bones. The classic double-bicep pose in bodybuilding is an example of muscular shortening as the result of movement, which in that case produces bunching of the bicep muscles. Muscular contractures occur when the shortening that is necessary to produce movement is maintained over time by neurological factors, is more difficult than normal to reverse, or which resists normal movement. Because muscles need to change their length in order to produce movement, the inability of a muscle to lengthen causes changes in function that can result in difficulty in balance, walking, or interacting with the outside environment. Severe cases of contracture can be extremely painful and can pull joints and bones out of position as the result of sustained and un-managed muscular action. Sustained muscular contracture can result in changes in or damage to the structure of joints, being either the bony or soft tissues, and can cause damage to the skin as well. Muscle contracture can be caused by a damaging event or other factor that causes change in way in which the brain and the nerves control the muscle. An example of this is a contracture that occurs following a stroke or spinal cord injury, which causes changes in the muscle tone as a result of damage to the parts of the nervous system responsible for the control and coordination of the muscles in a part of the limb. Another example of muscle contractures being caused by a neurological condition is the increased muscle tone common in cerebral palsy, wherein the increased tone or inappropriate contraction of a muscle can lead to abnormal positioning which, if sustained, may eventually cause shortening of the tissues. Muscle contractures can result from congenital or medical events that occur across the lifespan and which affect a person's neurology, but can also result from non-neurological factors as well. Muscle contracture can occur and develop following decreased or changed use of a muscle. The most common example of this is the development of muscular shortening in the splinted or protected limb. Following a fracture, dislocation, or other structural injury that requires immobilisation of a limb, muscles may be stiff and resistant to movement that is driven either by the patient or by their therapist. This is an example of muscular contracture that does not have a neurological cause. Another example of this kind of muscular contracture is the contractures and shortening which occurs in patients with arthritis and other bony conditions that develop with age. When bones and joints aren't moved through their regular ranges of motion for extended periods of time, the soft tissues that usually provide that flexibility become stiff and shortened, and attempting to move the limb beyond it's shortened range of flexibility can be painful and unpleasant. Physiotherapy management of muscular contractures differs based on the cause of the condition as well as the context of the person. Managing a muscular contracture that occurs in a young adult with cerebral palsy will require a different approach and progression compared with managing a muscular contracture that occurs in an older adult with other age-related conditions or other diagnosed issues. Regardless of the manner in which the condition is managed, physiotherapy intervention has been demonstrated to be effective in the management of the problem and in controlling the risks that may occur. Such treatment may include soft-tissue work like stretching, massage, and manipulation of stiff joints and muscles, movement re-training if the contracture is occurring within the context of stroke or brain damage, coordination with other management such as botox injection or surgery, and liaison with other clinicians as needed. Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

Reporting for the NDIS As a participant in physiotherapy funded by the NDIS, sometimes the NDIA will ask for progress reporting and reassessment. This is to make sure the therapy being provided and the funds being used are producing tangible and measurable progress towards your goals. Being asked for a progress report isn't a bad thing - it's an opportunity to review the progress that has been made, consider what is working and what isn't working, and use that to keep improving the plan in place to help you achieve your goals. The basis of a good report is thorough assessment and discussion, which is why your therapist will ask you questions and even potentially do assessments again a second time to chart your progress. Progress reporting for NDIS clients provides the NDIA with a summary of the supports provided to a partcipant, and how those supports are used. Specifically, reporting shows how the support, be that therapy, transport, modification or equipment, has helped you work toward your goal. This doesn't mean that you have to have achieved your goal entirely, just that you are making forward progress towards it in a consistent and sustainable way. Progress reporting is also an opportunity to discuss barriers encountered during the course of the plan, and discuss strategies implemented to resolve these. If you're having any specific difficulty with the plan as it is, this is a good time to discuss that too. Beyond these basic facts, progress reporting also gives participants the opportunity to request and justify any additional supports or resources, by discussing how proposed outcomes and plans may have changed since the time they started therapy. This is an opportunity to advocate to the NDIA for continued input based on sustainable and demonstrated progress. Remember, progress reporting isn't a bad thing - it's an opportunity to talk about how things are going, and what can be changed to make things better or more supportive in the future. Your physiotherapist will work with you through any reporting or review that is requested by the NDIA. It's important to remember that any report on your progress also needs to capture an accurate picture of you, including your situation, your desires, your goals, what you want to achieve and how you're finding the process. Reporting may also require discussion with other professionals or services providing you support, so as to present the NDIA with an accurate representation of your life and how you're engaging with NDIS funded services. Reporting may involve one person, or it may involve your plan manager or an advocate as well. Regardless of who is involved and how, you should remember that the most important person in the process is you, the participant. This is your opportunity to show how you've been doing, discuss your difficulties and advocate for change, and to put that in a formal document. Your clinicians and other professionals will be there to help you, and are happy to answer any questions you may have as part of this process or any other.

Work Injuries Many people who work experience injuries related to their obligations at work. Everyone is at risk of experiencing a Work Injury, regardless of the nature of their jobs. Injuries like sprains, Back Pain, Shoulder Pain and Knee Pain are highly represented in physical jobs such as Trades and Technical fields, while conditions like Carpal Tunnel, Neck Pain, Headache are commonly represented in Desk jobs. ​ If you experience a Work Injury, it is important to be assessed and treated quickly. This will minimise the time spent off work, improve the likelihood of returning to work at your previous duties, and will also ensure a productive relationship between yourself and your care provider. If you suspect you have experienced a Work Injury, you should speak to your treating clinician or doctor. ​ As part of treatment for your Work Injury, you may be eligible for subsidised treatment under WorkCover / WorkSafe. At Atlas Physio, we do NOT charge a gap fee in addition to any subsidised cost of treatment. However, the cost of gait aid prescription, gym or pool membership as part of rehab, as well as imaging or reporting may not be covered under the schedule of subsidised fees. Make sure to discuss this with your treating clinician. ​ Management of your Work Injury will depend on the nature of that injury, your physical obligations at work, the time you need to return to work, as well as your schedule. The treatment you receive will be tailored to address the specific cause of your pain, and will focus on minimising pain, maximising your ability to move pain free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, a structured Return to Work plan, and ongoing monitoring of your pain both in and out of the clinic. We will also be happy to liaise directly with your insurer, legal representatives, and employer if required. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

Telehealth Atlas Physio is happy to provide services to clients remotely via Telehealth. Atlas Physio has provided treatment remotely for those clients who have been unable to attend in clinic due to illness, transport issues, difficulties in mobilising, as well as other factors. Undertaking treatment remotely via Telehealth is different to receiving treatment in the clinic or in your home, so take note of the following: 1. You will need a calling link. As part of Telehealth Services you will have need a ZOOM calling link. It is important to have this ready in advance of your session - it's how we conduct treatment remotely. In addition to having the appointment-specific ZOOM calling link, also make sure of the following: - Your internet connection must be strong enough to maintain an audio and video call for the duration of the appointment. - Your device must be capable of undertaking videocalls and audiocalls, and have an adequate amount of charge. - You should participate in the telehealth appointment in an area that is open, clear of obstructions, and well-lit. 2. You do not need a medical referral to undertake treatment remotely via Telehealth. Physiotherapists are direct contact practitioners, so you do not need a medical referral to start physiotherapy treatment via Telehealth. All you will need is a confirmed ZOOM link and appointment time, and you will be eligible to begin treatment. 3. Telehealth treatment is only eligble for those clients who have already undertaken assessment and treatment in clinic, or under singular circumstances. Telehealth appointments are elibible for booking once a patient has been assessed in clinic. This is because initial assessment consists of physical assessment, observation of movement as well as physical testing. Without this information, appropriate treatment is difficult to conduct. For this reason, telehealth appointments are only available for those clients who are known to the clinic and those clients who have undertaken an assessment for their present problem. 4. Payment for Services is due on the day of the appointment. Given that treatments are conducted remotely, invoicing for private health via Telehealth as well as payment of clinic invoices will need to be done via bank transfer. YOu will be provided with a link and details to . Atlas Physio WILL NOT charge you more than this rate for a standard consultation. You will still be liable for gym memberships, equipment purchases, and any out-of-clinic expenses.

Manipulation Manipulation refers to movements in which the therapist applies an external force to a joint or a muscle in order to achieve a therapeutic aim. Manipulations are typically associated with the spine, in which physical force is used in combination with body and joint ergonomics to move the spine, and sometimes produce a "Cracking" sensation. ​ Manipulation is used to test, address and improve any issues with joint mobility and stiffness that may be encountered, and not all manipulation results in a cracking sensation or noise. Manipulation is used to move joints and limbs without the action of the patient's muscles. This allows the therapist to further investigate the nature, progression, and severity of any pain or discomfort that the patient may be experiencing. Manipulation is also used to assess the movement of joint articular surfaces relative to each other, and in this way can be used to investigate the nature of local tissues surrounding the joint, as well as any issues with associated joints nearby. ​ In clinic, manipulation will be performed alongside other treatments, to best address the problem and to increase the likelihood of longterm functional improvement. While manipulation alone can be useful for the treatment of individual problems, the application of manipulative forces with other treatments can boost the effectiveness of those treatments and can amplify their clinical effect. Not every patient will be appropriate for manipulation. Spinal and joint manipulation in the clinic will be used depending on the discretion of your treating clinician as well as the nature, history, and context of your presenting discomfort. Feel free to discuss this treatment with your clinician, either in appointment or during your initial consultation.

Muscular Weakness Muscular weakness refers to a situation in which a muscle or group of muscles cannot produce the strength needed for a task. Muscular weakness is always evaluated relative to a task - an average, untrained middle-aged individual with no underlying health conditions could reasonably be expected to be able to stand, walk, and maintain their posture. This same individual may not be able to execute a one-hundred kilogram clean with perfect technique. For this reason, whenever considering muscular weakness, it's important to think about the activity as well - does the effort need to be exerted over a short or long period of time? Is the movement repetitive, held, or awkward? Is muscular effort needed in combination with some other effort, like endurance, balance, or fine coordination? These questions make the evaluation and management of muscular weakness a nuanced process. Muscular weakness can happen after periods of intense exercise or effort. This is muscular fatigue and is a normal part of living. The harder muscle groups will need to work, the longer they will need to rest. Even if the effort isn't intense but sustained, muscle groups can become fatigued with time. Anyone who's started slouching after a long period of sitting down at a desk can attest to that. Muscular fatigue can become a problem if the fatigue occurs earlier than expected or takes a longer time than usual to recover. Muscular weakness can be one cause of this - the muscle groups don't have enough strength or capacity to work in the way that they are needed. In this case, treatment for muscular weakness involved strengthening and conditioning of the muscle groups - exposing them to controlled and escalated loading in such a manner that they become capable of efforts that are stronger, more sustained, and more repeatable. This conditioning is typically done as part of a broader treatment regimen, and can be done in clinic, in a gym, or in the privacy of someone's own home. There are other causes for muscular weakness in addition to this, such as illnesses, injuries, changes in the connection between the muscle and the brain, and changes in the physiology of the muscle itself. In these cases, weakness is the result of a process that needs to be addressed alongside strengthening the muscles themselves. Common causes of muscular weakness in this way include decreased endurance because of changes to the heart and lungs, decreased strength due to a stroke, decreased coordination and sustainability of movements because of Parkinson's disease, and many other factors. Normal function of the human body requires strength, endurance, coordination, balance, and reflex, and any program of rehabilitation needs to take all of those factors into account. Muscular weakness is usually addressed by strengthening. Strengthening the muscles is accomplished by exposing muscles and muscle groups to controlled loading, which causes muscular adaptation and improvements in power, endurance, and working capacity over time. By strengthening your muscles and improving your overall physical capacity, you improve the quality your balance, the resistivity of your bones, the efficiency of your heart and lungs, alongside other benefits that are too numerous to list. Muscular strengthening and conditioning is the basis of all physiotherapy intervention, and every individual treatment has a strengthening component within it, to best address the issue at hand and to prepare the body for what may be ahead. Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

Cartilage Injuries Cartilage Injuries refer to a broad range of traumatic, age-related, autoimmune and disease-related conditions in which the cartilage in joints is worn down, degraded or damaged. Cartilage is an essential component of nearly all the moving joints in your body, from the small bones in your toes to the long bones in your arms and thighs, the working surfaces of the joints have a coating of cartilage to minimise shock to the bone, aid in weightbearing, improve the mechanical advantage of the limbs and make movements easier. Cartilage-covered surfaces are involved in almost all major and minor movement of the body, so they are constantly under strain during daily life. Cartilage is also present in the body in structures like the labrum of the shoulder, the acetabulum of the hip, and the meniscus of the knee. These cartilage structures are reinforcers of their joints; they change the way the bones work together to increase stability, smoothen movement, hold the joint together, and help it last longer. With so many places in the body being made up of cartilage, there are many common cartilaginous injuries that can occur. Two common ones are explored below. Meniscus Injuries: The meniscus is a structure inside the knee that attaches to the top of the tibia, which you may know as your shinbone. The knee is made up of the articulation between the thigh, the kneecap, and the shinbone. The end of the thighbone is rounded, and the top of the tibia is flat. Because it's difficult to stabilise a round object on a flat plane, the knee joint is well-reinforced by ligaments, the tendons of muscles crossing over the joint, the joint capsule itself, and the meniscus. The meniscus is a double-crescent shaped cartilaginous structure that is thicker at the front of the knee and thinner towards the middle. It is attached to the top of the shinbone and acts to center and seat the rounded end of the thighbone while the knee is being used for standing, bending, and weightbearing. The rounded heads of the thighbone are kept in place regardless of light or heavy movement, and so the meniscus is usually under continuous strain. The meniscus can be injured in the same way the ligaments of the knee can be injured. During twisting, shock loading, awkward landing or external trauma, the thin cartilage of the meniscus can become torn and begin flapping about inside the knee joint itself. Excessive loading of the knee can also result in the degradation of the meniscus and separation of the structure without a traumatic cause. The meniscus is also degraded over time as a result of ageing, and in severe cases of arthritis, its loss can result in bone-on-bone contact of the thigh on the top of the shinbone which can be quite painful. Meniscus injuries can be managed with exercise and manual therapy, as well as with surgery. Regardless of the course of management, if you currently suffer from or have experienced a meniscus injury in the past, you will be encouraged to seek input from a physiotherapist. The work you do will focus on building muscular strength and stabilising the joint through basic and then complex movements, as well as planning a return to sport if that is something important to you. Labral Tears: Your arms and your legs attach to your body at the shoulderblades and the hips, respectively. At the shoulder, the rounded head of the humerus interacts with the shallow cup of the shoulderblade to seat the arm, and the shoulder joint is then stabilised by the capsule of that joint as well as the complex mesh of muscles that flow over, under, in front of and behind the joint. The hip has a deeper cup to accommodate the head of the femur, and so relies less on supporting muscles and more on the actual shape of the bones comprising those joints. Both the arm and the hip are made up of rounded bone heads fitting into socket-like spaces, so they are called ball-and-socket joints. The fit of a bone into a joint is called its congruence, and like fitting jigsaw pieces together, a more congruent joint is a more stable joint. Both the hip and the shoulder have a cartilaginous labrum. A labrum is a cup-shaped rim of cartilage that reinforces a ball-and-socket joint by increasing its depth and increasing the amount of surface area that the rounded bone head can interact with. This is particularly important in the case of the shoulder, whose range of motion is so significant that it is highly prone to dislocation if jarred or struck in the wrong way. The labrum of the shoulder joint acts to minimise the likelihood that the joint will be dislocated, but in the case of traumatic injury, the labrum may be torn. The labrum of the hip can also be worn down over time due to occupational, recreational, or anatomical factors such as hip dysplasia, and the result can be quite painful and debilitating. Labral Tears can be managed with exercise and manual therapy, as well as with surgery. Regardless of the course of management, if you currently suffer from or have experienced a labral tear in the past, you will be encouraged to seek input from a physiotherapist. The work you do will focus on building muscular strength and stabilising the joint through basic and then complex movements, as well as planning a return to sport if that is something important to you. Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

Carpal Tunnel Carpal Tunnel Pain refers to pain experienced due to inflammation, wear-down or irritation of the structures in the Carpal Tunnel of the Wrist. Carpal Tunnel can be felt as pain in the wrist accompanied by numbness of the fingers and palm of the affected hand, which may also be accompanied by weakness, loss of dexterity, and pain that moves up the arm. ​ Carpal Tunnel Pain is caused by compression of the Median Nerve in the Carpal Tunnel of the Wrist. The Carpal Tunnel is an anatomical structure, bounded by bones and ligaments. The Carpal Tunnel allows tendons, blood vessels, and nerves to pass from the forearm to act on and supply structures inside the hand. Muscles that pass through the Carpal Tunnel allow the fingers to move, and nerves that pass through the Carpal Tunnel provide sensation to the hand. One such nerve in the Carpal Tunnel is the Median Nerve. ​ The Median Nerve provides sensation to the palm and fingers, as well as allowing some small muscles in the palm to be controlled. Compression of the Median Nerve results in pain felt in the areas of skin supplied by this nerve, as well as weakness in the muscles that this nerve controls. The Median Nerve is most commonly compressed by inflammation of the Tendons that run through the Carpal Tunnel, alongside this nerve. ​ Tendons in the Carpal Tunnel can become inflamed for many reasons. Most commonly, inflammation is caused by repetitive movement of the hand in the use of machinery or fine tools like a stylus or a pen. Carpal Tunnel Tendons can also become inflamed due to a cyst or tumour in the Carpal Tunnel, due to trauma to the wrist, or by infection. Management of Carpal Tunnel is a process that involves addressing physical, occupational, personal, and lifestyle risk factors to minimise pain and maximise function. The treatment you receive will be tailored to address the specific cause of your Carpal Tunnel Pain, and will focus on minimising pain, maximising your ability to move pain free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in and out of the clinic. Contact us to arrange an assessment, and to take the first step on a course of corrective care today

Plantar Fasciitis Plantar Fasciitis refers to inflammation within and irritation to the Plantar Fascia. The Plantar Fascia is a band of connective tissue that supports the arch of the foot. Plantar Fasciitis is a common problem that people experience, and may affect three in five people over the course of their lives. Plantar Fasciitis is felt in one or both of the feet, though you may feel the pain in the calf, the front of the lower leg, or in the toes if there is inflammation or involvement of the nerves of the foot. Plantar Fasciitis may last from weeks to months depending on the nature of the pain, the cause, the progression, and the speed with which treatment is sought. Planar Fasciitis is caused by irritation of the Plantar Fascia. The plantar fascia is a thick fibrous band of connective tissue that extends along the sole of the foot before inserting at the base of the toes, and supports the arch of the foot The specific cause of the pain depends on many factors like the age of the person experiencing the pain, their occupation, whether the pain was caused by an accident or started rapidly, as well as other variables. Management of Plantar Fasciitis depends on the cause of the pain, how it feels and changes over the day, what makes it better or worse, and the length of time you have been experiencing the pain. All of these factors will be addressed in your initial assessment, which is the first step towards minimising and managing any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your Plantar Fasciitis, and will focus on minimising pain, maximising your ability to move pain free, and developing a plan to minimise the risk of a flare-up in the future. At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in and out of the clinic. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.