Frequently Asked Questions

Our team of physiotherapists can assist you and your family with a wide range of problems including postural issues, sports injuries and rehabilitation support.

At Paddington Physiotherapy we see a lot of lower limb injuries (hip, buttocks, hamstrings, quads, knee, calf, shin splints, heel pain and foot injuries). We can help to improve your function and strength in the lower limb. We endeavour to fit your exercise regime into your lifestyle as much as possible. If you don’t like Pilates we will not force you into Pilates classes – you can always get core stability in other ways. If you want to run, we will help you return to running. If walking is your chosen exercise regime we will assist you into a walking programme.

Paddington Physio provides HICAPS facilities to claim your private health insurance on the spot, so usually you will only need to pay the gap. We help family members of all ages, active weekend warriors, and athletes need serious sports physio to keep them at their peak. Please do not hesitate to contact us if you are unsure if physiotherapy is for you! You don’t need a referral to visit.

Your Physiotherapist will talk with you about your symptoms (pain, pins and needles, numbness, weakness, giving way, locking, dizziness, headaches, stiffness etc.), how they affect you, what activities make them worse, when they first occurred, what (if any) treatment you have had prior to your appointment here. They will also discuss your goals and expectations, your normal leisure activities, sports and the physical demands of your occupation, your workstation/desk setup. You will also be asked about your general health and any medication you are taking.

Your Physiotherapist will then examine your movements and do some physical tests to see what aggravates your symptoms. They may look at your scans or reports from your scans if you have any.

After determining what is causing your symptoms and the contributing factors, your Physiotherapist will treat the main areas of concern. Your Physiotherapist will work with you to determine whether there are some changes that you can make to reduce the pain. Your Physio will have a discussion with you about what habits need to be changed or techniques or movement patterns need to change, your workplace changes of habits and the work environment and your posture. Sometimes just a small tweak to your daily routine can make a huge difference. Something as simple as using a lumbar support to help your back while sitting at a desk or adjusting the height of the computer screen might stop you from aggravating your condition.

While you are getting better it can be beneficial to reduce the movements that are causing the pain. The Physiotherapist can help you with some practical guidance on ways to prevent further injury. For example if you are the parent of a small child and have developed back pain, it is unlikely that you will be able to just stop lifting your child altogether, but the Physiotherapist will work with you to determine ways that you can reduce the strain on your back when lifting the child. The lifestyle changes might be simple, for example by using a small step when getting your child out of the cot.

If you are having difficulty lifting, we can teach you better ways to lift which will mean that you will be less likely to do further damage.

You will be given some exercises to do at home to maintain changes and make further improvements to range of movement, strength and balance. Our Physios don’t just do quick fixes – we are dedicated to assisting you to achieve long-term solutions. We work with you to help you regain your normal lifestyle as soon as possible.

We work with our patients to help them achieve the best possible outcome and therefore follow up with our patients to ensure they are maintaining improvements and continuing the necessary exercises. We are able to help you with decisions surrounding any required surgery and help you understand other choices and your likely recovery process after surgery.

At Paddington Physiotherapy, our fees reflect the experience and expertise of our clinicians, ensuring you receive the highest standard of care. Initial consultations for physiotherapy are more in-depth to allow for a thorough assessment and treatment plan. These longer sessions are priced accordingly, with reduced rates for all follow-up appointments.

To help minimise your out-of-pocket expenses, we can process eligible rebates at the time of payment.

• Medicare: If you’ve been referred by your GP under a GPCCMP Care Plan, you’ll receive a Medicare rebate for eligible services.

• Private Health: Bring your health fund card to claim a rebate on the spot (rebate amounts vary depending on your provider and level of cover).

• WorkCover: If your claim has been approved, you’ll only be required to pay a small co-contribution fee, with the remaining cost covered by WorkCover.

• DVA: Department of Veterans’ Affairs (DVA) patients are fully bulk billed—no out-of-pocket expenses apply.

If you’re considering a physiotherapy appointment but would like more information about pricing, our friendly reception team is always happy to assist.

Joint replacements are generally thought to last about ten years prior to needing revision surgery. You cannot have multiple joint replacements on the same joint so it is most often beneficial to delay surgery. If you have a hip replacement you need to allow an extended period of time off work and spend time doing your rehabilitation, so sometimes one of the benefits of delaying surgery is to fit it in when it is most convenient with your lifestyle and work commitments. Our physios can help you manage pain, regain some range of movement and strengthen up your hip area. Many of our patients have been able to put off having a hip replacement for over ten years without any increased levels of pain and with much better function.

It is a difficult position to be in when you need to exercise to help with weight maintenance or loss but cannot because of knee osteoarthritis or degeneration, especially if a joint replacement is required but the risks are too high when overweight or obese. Our physios have helped many patients manage their knee condition so that they can return to exercise. Sometimes in losing the weight and doing the prehabilitation they have found that they no longer need the joint replacement. A programme of treatment with our physios can make your joint replacement surgery safer and sometimes gives you the choice to delay it indefinitely.

The current research suggests that degenerative knees and degenerative cartilage symptoms in the knee do not benefit substantially from arthroscopic surgery but are more likely to benefit from physio management. Acute locking episodes and traumatic tears of the meniscus, however especially in younger patients, do still get better outcomes with surgery. Your physio can help you with the diagnosis of your knee injury and discussing your prognosis.

There are a number of headache types that physio can assist in resolving which include;

• Cervicogenic headaches, which are caused by the joints and muscles of the neck. These headaches will regularly refer to the eye socket and can often feel like someone is poking a pencil in your eye.
• Tension headaches, which are caused by the muscles of the neck pulling on the muscles of the scalp.
• Pre Migraine. A neck headache can be a trigger for developing into a true Migraine yet often times if you manage the neck headache early, you can prevent it from progressing. Improvements in neck range and function may be able to help you reduce the number of migraine episodes you experience.
• Post Migraine, many people experience a residual neck headache and restriction of neck range of movement after a migraine. This will respond quite well to physio management and can aid faster recovery and help reduce further episodes of migraines.

It has been fairly difficult for researchers to definitively prove that posture has an effect on the development of injury, this is likely to be because some people just manage to get away with bad posture without injury and thus skew the research results. However, there have been plenty of studies that suggest that posture can affect mood and can affect the way other people perceive you. You can also easily demonstrate that your posture affects the amount of range that you have available for certain joints to work in e.g.: sit in a very slumped, C-curve position and try lifting both your arms straight up in front of you, you come to a stop. Then try sitting up tall with your head on top of your neck and lift both arms and you will find that you can easily make full shoulder range.

Clinically, we find that patients get much better, much more quickly if they are able to spend more time in a good position than in a bad position. Our spines have curves in them to increase the structural strength if we maintain those curves well we take the weight of our very heavy heads more easily.

Another obvious example of posture affecting your movement is at the shoulder. The scapula or shoulder blade is mainly held in place by muscles, which essentially means that you decide where you are going to put your shoulder blade. If you elevate it as you slump, it will not be able to move as well as you lift your shoulder and it will block the movement.

If you have had a gradual build-up of symptoms it is often most convenient to see the physio as a private patient. If you have had an incident where you have injured yourself at work (or on the way to or from work) you should report it to your employer, see your GP for a medical certificate and a referral to physio and then lodge a claim with Workcover. We are able to assist most workers back to work having missed very few days. You may be able to go back to restricted duties, shorter hours or modified duties. If you seek physio treatment early you can usually resume your normal lifestyle faster.

There’s a lot of evidence emerging that prehabilitation, which is rehabilitation before surgery rather than afterwards, is beneficial in better, faster outcomes following surgery for a lot of different conditions. Some of the surgeries where it can be useful to see a physio beforehand include anterior cruciate reconstruction, total knee replacement, total hip replacement, rotator cuff surgery and ankle reconstruction.

Our Physios adapt their management according to your abilities, general health and your goals of treatment. Your age is taken into consideration but the abilities and goals of people the same age are vastly different. We have clients whose physical activity matches that of people 20 years younger than their chronological age so we match their capabilities. You are given exercises that you are capable of getting done without much hassle. Irrespective of your age, your range of movement and pain is likely to be improved with physiotherapy and just a small amount of targeted intervention could have a huge impact on your quality of life.

You do not need a referral to see a physio as a private patient. Your physio can refer you for most investigations you might need and can write you a medical certificate for the workplace or school. If required, we also liaise with your regular GP. You might need a referral if you are under DVA, Workcover or if you are covered under the Medicare GPCCMP with a Careplan in place, or after a motor vehicle accident (although your referral might also come from your lawyer).

The rotator cuff is a group of four muscles that stabilise the shoulder and help keep the ball in the socket joint. They are prone to injury when you lift a weight out to the side like lifting your handbag off the passenger seat or when you reach behind you to put the seatbelt on or put on a heavy coat. Often you will do these movements and not really notice that you have injured yourself until the pain appears later. This is quite a common presentation. Your Physio will test the rotator cuff and other structures around the shoulder to determine what you have done and help you treat the pain, strengthen up and avoid aggravating movements in the future.

A break or a fracture means the same thing and there is no difference in severity. If you have broken a bone it will be managed according to which bone it is and the severity and position of the fracture. The primary management may be a cast, a bandage, a brace, crutches, a sling or surgery. In the early stages a physio appointment may help you learn how to manage the fracture during the period of immobilisation. Some examples might be;

• If you have fractured your shoulder you may need physio treatment of your neck for pain from the fall or from being in a sling. You will also need to be given exercises to prevent a frozen shoulder and to prevent wrist and elbow complications, as well as taught positions of comfort and what to do with the sling.
• If you have fractured your ankle you may need to be taught how to use your crutches, what other muscles you can exercise during your time in a cast and you may need treatment for other areas that might have been injured at the same time for example your low back.
• Some fractures you won’t be immobilised for and should commence Physio treatment for immediately, such as some avulsion fractures where a chip of bone is pulled off by a muscle.
• After you come out of immobilisation you are very likely to require physio treatment to regain your range of movement and strengthen up. Stiffness and weakness after immobilisation need to be addressed.

Low back pain can respond really well to Physio treatment. Your Physio will help you settle the immediate pain and give you exercises for pain relief and to help you strengthen up. When you get low back pain, even for a short period of time, some of your core muscles can get inhibited. Your physio can help you to activate them properly and teach you positions of comfort and ways of avoiding back pain. Low back pain is common but it is not normal. It may have a recurrence rate of over 90% but the trick is to reduce recurrences and make future episodes less debilitating.

The word chronic is used as a measure of time not severity. Chronic means that the condition has been present for a period of greater than three months. Having chronic pain does not mean that you cannot get rid of it and resume your normal lifestyle. We see lots of patients with chronic pain, sometimes it is simply because they have not previously sought treatment. One of our patients was 21 years old and had an eight-year history of low back pain. She presented to Paddington Physiotherapy after going to a party where the conversation led to her finding out that not all people had back pain. She had thought that it was normal and there was nothing she could do about it. She responded well to treatment and was able to get rid of her back pain.

People will often say they are waiting for the swelling to go down before I see the physio or that they prefer to wait for the pain to settle before seeing the physio. The injury needs to be diagnosed as you may be doing the wrong thing for the injury. Physio treatment can help from the beginning in reducing swelling and reducing pain and making it so you don’t end up with more problems from compensatory movements or slowing down your recovery due to not addressing the muscles that get inhibited right from when the injury occurs.

There are some injuries that put you at risk if they are not diagnosed early, some examples being if you have calf pain that is caused by a clot (DVT), or a calf injury which is actually ruptured and needs immediate attention, or a cartilage injury that needs appropriate time non-weight bearing. So the answer to when should I see a physio is ASAP. If you ring up, our receptionists will endeavour to book you in with a physio as soon as possible.

When you sprain your ankle. you usually lose range in a movement called dorsiflexion. This will not spontaneously correct itself, it is best regained through Physio treatment. A loss of dorsiflexion has been shown to contribute to the onset of many other problems including shin splints, hamstring strains, hip/groin pain, knee injury, foot injuries, stress fractures, Achilles tendinopathy, recurrent ankle sprains, arch pain, heel pain…. So it is very important to get your ankle back to full range. You also need to strengthen your ankle correctly and learn how to improve your proprioception or balance.

Tendinitis means inflammation of the tendon and whilst there are conditions that have inflammation, research has found that many painful tendons do not have any inflammation present so we generally call tendon injuries Tendinopathy, although it may be called Tendinosis on your Ultrasound or MRI. Often there is delayed pain after exercise that can warmup but as the condition worsens it starts to affect normal lifestyle activities and becomes present at rest.

Tendinopathies can often be quite troublesome to patients and difficult to resolve. Common tendinopathies include:

• The lateral hip (and Trochanteric bursa) – responsible for extreme tenderness on the outside of the hip making it difficult to sleep on your side
• Achilles tendon or plantar fascia – producing heel pain
• Hamstring – at the back of the knee or up at the buttock
• Patellar tendinopathy – below the kneecap
• Tennis elbow (although there are other cause of tennis elbow as well)
• Rotator cuff in the shoulder

Our physios help you determine how the tendinopathy has developed and what lifestyle factors you need to change as well as treating the contributing risk factors and assisting you with your strengthening programme to resolve the condition.

Our physios can get you ready to use a personal trainer if you have not exercised much in the past – we can get you fit to Get Fit! We are always happy to work in collaboration with other medical, health and exercise practitioners to ensure the best results for our clients.

It is common for people to blame a lack of flexibility for injuries however research shows that flexibility is rarely a cause of injuries. Maintaining adequate strength, control and proprioception, which is like balance, have been found to be the most effective ways of preventing injury. Stretching immediately before running can impair performance. Read more about this in our client information.

Running has not been found to cause knee degeneration, studies have shown that runners who are consistent in their training loads are less likely to have hip and knee problems than non-runners. It has also been shown that people with degenerative knees do not get worse if they take up running.