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Frailty Frailty is a clinical state that is associated with an increased risk of harm, admission to hospital, disability, and poorer quality of life. Frailty refers to a loss of physical strength and physiological reserve, means that an individual living with frailty is more vulnerable to the physically stressing effects of diseases, infections, and injuries. Because of this increased vulnerability, individuals who are frail sometimes require increased care support and monitoring, from medical and allied health, social supports, and personal care. While there is no absolute standard for frailty, the commonly accepted characteristics of present and increasing frailty include unintentional weightloss, an increasing sense of difficulty in performing reglar tasks like self-care, decreasing engagement with physical activity, slow walking speed, and physical weakness. Not all of these factors need to be present in an individual to classify them as medically frail. The effect of these factors can be amplified by other issues such as disabilities, diseases, physical and cognitive impairments and other risk factors. Frailty is most commonly seen in the elderly, though any individual can experience frailty as a consequence of illness, injury, or some other factor that depletes the body's ability to maintain itself. For this reason, while frailty is associated with ageing, frailty is a problem separate to ageing and increasing geriatry. Because of this, anyone who experiences a chronic illness, who spends a long time in hospital, or who becomes injured runs the risk of frailty. Management of frailty through engagement with physiotherapy depends on the degree of impairment and physical change that the individual has experienced as a consequence of their frailty. If someone at risk of developing frailty is attended to rapidly, they stand a greater chance of avoiding more serious effects of weakness and poor energy. For those individuals whose frailty has progressed to the extent that they experience difficulty walking, moving, and engaging with structured exercise, physiotherapy focuses on basic reconditioning with a view to minimising future risk. Regardless of the factors contributing to frailty or the aims of the treatment, management of the frail individual is always multi-disciplinary, requiring oversight from a medical practitioner like a physician or specialist in addition to one or a few allied health professionals. 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.

Foot Pain and Ankle Pain Foot Pain and Ankle Pain refer to pain felt below the middle of the calf, and which may involve structures in the foot like the heel, the sole of the foot, and the toes. Foot and Ankle Pain can be caused to muscular, bony, ligamentous or nervous factors. ​ Common bony problems in the foot include arthritis of the ankle, bones in the foot, and the toes. The human foot is composed of more than twenty bones, held together by a complex scaffold of ligaments, connective tissue, and layers of muscle. All of these bones need to work in concert during movement of the feet, as well as bear the weight of the human body throughout the day. For this reason, Foot Pain and Ankle Pain due to bony causes may occur later in life, due to weardown of bones and joints. ​ Patients with Diabetes commonly experience Diabetic Neuropathy, a condition in which the high blood sugar can damage nerves throughout the body. Most commonly, this occurs in the legs and feet, which can cause Nervous Foot Pain. In severe cases, there may be weakening of the muscles that supply power to the foot and the lower limb, accompanied by numbness. ​ Most commonly, Foot Pain and Ankle Pain are caused by mechanical and physical factors. Active sportspeople may roll, twist, or otherwise impact their ankles and feet during sports matches or training. Sometimes, people experience Foot Pain and Ankle Pain due to stepping on uneven ground, slipping on wet surfaces, or just as a consequence of walking. ​ Management of Foot and Ankle Pain 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 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.

Medicare and Bulk Billing Physio Atlas Physio is happy to provide bulk billed service to clients under the Chronic Disease Management program, formerly known as Enhanced Primary Care. CDM and EPC referrals for physiotherapy are written by your doctor, and entitle you to a number of medicare-subsidised appointments every year. You have five medicare-subsidised appointments that you may bulk bill in a calendar year, and these appointments may be distributed between different allied health professions, or all used for one specialty like Physiotherapy, Podiatry, or Speech Pathology. CDM / EPC plans enable GPs to plan and coordinate the health care of patients with chronic medical conditions, including patients who require team-based care from a GP and other healthcare providers. Receiving EPC physio treatment as a bulk billing client is different to receiving treatment as a private client, so take note of the following: 1. You will need a referral. To receive medicare subsidy for your appointment, you will need a medical referral. Your GP is responsible for writing and planning your referral. It is important to have this ready when you meet your therapist - it's how we bill for our services. If you do not have a referral, you have two options: - You can reschedule your appointment until such time as you or your doctor can provide a current referral for physio treatment. - You can access physiotherapy at standard rate. You will then receive a receipt for your appointment, which may be used to claim a reimbursement. A sample EPC referral form is available here - feel free to present this to your GP for review and completion. 2. Medicare referrals require assessment and reporting. As part of receiving subsidised physiotherapy treatment, Atlas Physio is obliged to conduct ongoing reassessment of your progress, and provide reports of your progress to the relevant authorities and individuals when requested as well as at regular intervals. This means that details of your treatment and your response to it will need to be submitted. Atlas Physio will take every measure to respect your privacy and minimise exposure of your information. For more information, you can refer to our consent and privacy documentation. 3. Subsidised treatment rates are different to standard rates. The schedule of fees published by Medicare specifies the maximum amount paid for in an appointment. 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. If you are a new patient, your first appointment will be an initial assessment at normal duration and cost. For more information on appointments and appointment fees, you can refer to our fees and charges.

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.

Sacroiliac Pain Sacroiliac Joint Pain refers to pain and discomfort felt within or around the Sacroiliac Joint of the pelvis, where the bones of the lower back meet the bones of the pelvis. Sacroiliac Joint Pain is a common problem, and has the potential to affect one in five people over the course of their lifetimes. The Sacroiliac Joint transfers the weight of the torso and the lower back into the bones of the pelvis. The joint is reinforced with strong ligaments and overlaid with a muscular mesh that keeps the joint strong and stable. Because of the nature of the joint, Sacroiliac Pain can be felt in a broad band across the tops of the hips, as well as in the lower back or even in the legs. Sacroiliac Pain is most commonly experienced in prolonged sitting, and may become worse when bending forward. For this reason, both technical and manual professionals are at a risk of experiencing this discomfort, and this risk is increased again if a person has recently experienced pain, discomfort, or injury of the lower back, the hips, the hamstrings, or the knees. Sacroiliac Joint irritation can also result in referred symptoms being felt in one or both of the legs due to the irritation of the nerves that pass through this region, as well as pain when performing otherwise unremarkable activities such as sitting down or rolling in bed. Management of Sacroiliac Pain 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 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 and out of the clinic. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

DVA and Veteran's Physio Atlas Physio is happy to provide services to clients who are DVA White Card, DVA Gold Card, or DVA Gold-TPI Card holders. Receiving treatment as a DVA client is different to receiving treatment as a private client, so take note of the following: 1. You will need a doctor's referral. To receive DVA subsidised services, you will require a referral from your GP stating how many sessions you need and what your assessed problems and goals are. A DVA client is eligible for 12 sessions of physiotherapy per referral before a new referral needs to be written. It is important to have this ready when you meet your therapist - it's how we bill for our services. If you do not have a referral, you will not be able to access DVA-subsidised physiotherapy. DVA clients must also present: - A valid (non-expired) white or gold card. - I.D. containing date of birth, and your full name. If you cannot provide these details, you will not be eligible for subsidised rates at the time of your appointment. You will still be able to access physiotherapy services at standard rates, and you will still be provided with receipts. 2. DVA treatment will require reassessment and reporting. As part of receiving subsidised physiotherapy treatment, Atlas Physio is obliged to conduct ongoing reassessment of your progress, and provide reports of your progress to the relevant authorities and individuals when requested as well as at regular intervals. This means that details of your treatment and your response to it will need to be submitted. Atlas Physio will take every measure to respect your privacy and minimise exposure of your information. For more information, you can ask your clinician any questions you may have regarding DVA procedures. 3. Subsidised treatment rates are different to standard rates. The schedule of fees published by the Department of Veteran's Affairs specifies the maximum amount that will be paid for in an appointment. 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.

Headache Headaches are pain experienced in any part of the head, on both sides of the head, or in just one location. Half of all adults will experience a Headache in any given year, and the severity of this headache can vary. Headaches are the result of a complex collection of factors that all combine together to produce pain. Because of this, headaches are classified by their causative factors. Primary Headaches refer to Migraines, Tension Headaches, Cluster Headaches, and Other Kinds of Primary Headache. Primary Headaches tend to be longstanding, episodic, and are believed to be due to factors related to the blood vessels and nerves within the brain and spinal cord. For this reason, assessment of Headache Pain believed to be due to a Primary Headache will involve an assessment of the neck. Secondary Headaches are Headaches that arise from a separate injury or incident. Trauma from a whiplash injury, blunt-force to the head, or trauma to the neck can cause Headache Pain. Disruption of cervical spine and cranial bloodflow due to a stroke, artery pain or vascular disorder can also cause Headache Pain. Headaches can also be caused by infection, damage to or irritation of the facial nerves, or by blood pressure changes. Headache assessment and treatment is complex because of the number of anatomical, neurological and personal factors that contribute to Headache Pain. Headaches are the result of lifespan, lifestyle, occupational and physical characteristics combining to produce discomfort. Additionally, stress has been proven to be a major contributing factor in Headache Pain. With this in mind, your treating Physio may discuss psychologist referral if appropriate. Management and assessment of Headache Pain 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 Headache 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.

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.

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.

Your NDIS Plan NDIS Plans are the backbone and basis of all treatment you receive as an NDIS client. An NDIS plan outlines a client's goals, and how the NDIS, community and private services, and the government all work together to achieve those goals. In order to do this, the NDIS plan considers a client's individual life circumstances: information about a client like disability, living situation, family and social networks, and other factors related to their lives and their unique situations. By considering these factors, the NDIA makes sure that the services they provide are reasonable and necessary: that those services will improve the quality of life and participation of the person for whom they are approved. The NDIS plan is a comprehensive assessment that states what you want to achieve, how you want to achieve it, what resources the NDIA are providing to assist in that process, and how those resources are allocated among multiple categories of potential spending. NDIS plans are developed in consultation with the NDIA through one or more meetings in which all of these factors are considered. Having a developed and authorised NDIS plan is essential to receiving physiotherapy support as an NDIS client. Having an NDIS plan in place means that your goals have been accepted by the NDIA and can be used to determine what therapy you receive as well as guide its input, and that funding can be allocated to things like sessions of treatment, purchasing equipment, and working with other services as needed. An NDIS plan is designed to provide clarity to you as the client and to the professionals and services with whom you work, so that the money you spend is done so transparently and with accountability, and is spent in a way that supports the things that you want to achieve. When you receive physiotherapy services as an NDIS client, the treatment you receive will be reviewed against your goals, your plan, and your timelines to make sure that what is done is relevant to you. This may mean discussing the goals in the plan and how physiotherapy treatment can help achieve those goals. This is important because physiotherapy treatment and management is much more than exercise - your physio can add value to your life and help you achieve your goals by advocating for services, by referring you to other professionals who may be helpful, by ordering equipment and by preparing reports for the NDIA and for anyone involved in your care. The important thing behind all of this is that all of those activities are guided by and in service to your NDIS plan. Having an NDIS plan means that you have been approved to receive funding from the NDIA to support the goals you want to achieve in your life. This opens the door for you to access services like physiotherapy in a supportive and flexible manner, and ensures that those services are effective within the context of your goals and the things you want to achieve. Your NDIS Plan is your plan for success, and by working with your physiotherapist in line with that plan, you can achieve your goals successfully and sustainably.