5 tips to help your shoulder pain get better.. fast!

2021-05-21Physio Tips No Comments


The Physio Depot’s 5 Top tips for managing shoulder pain!


Let’s face it shoulder pain is the worst. Not being able to get dressed without making loud grunting noises, difficulty reaching the top cupboard to get the wine glasses and spending weeks doing painful bench press in the gym hoping it will get better.


Shoulder pain affects EVERYONE – No matter gender, age, activity levels, sporty people or sedentary people.


shoulder physio blue mountains

Typically there is a trigger for that painful shoulder it could vary from an accident or fall, a change in activity load, a big day in the garden or lots smaller repetitive stress on the shoulder.


The Depot’s top tips for managing a painful shoulder!


1. Avoid pushing & pressing exercises at the gym!

  • Bench press and shoulder press are the two most aggravating exercises for a painful shoulder.
  • Substitute these for bench press off the floor and work on those shoulders below shoulder height (think: bent over lateral raise!)

2. Rest does not help shoulders get better!

  • Shoulders are not very good at getting better by themselves. The majority of shoulder stability arises from the muscles surrounding the shoulder girdle, prolonged rest weakens this system and in return your shoulder may worsen over time not improve.
  • If we don’t fix the parts of your shoulder which help it move optimally then the painful cycle will start all over again.

3. Pulling exercises ONLY!

  • Work that upper back and postural muscles by adding more pulling work at the gym. (Think seated row, lat pull down etc).
  • We love exercises that promote healthy shoulder blade conditioning and movement. The shoulder generally does not hurt with these movements, we can keep you in the gym and you’re on your way to improving your shoulder pain for good.

4. Don’t forget thoracic mobility!

  • Limitations in thoracic mobility especially thoracic extension (arching your upper back backwards) will have huge effects on shoulder movement and function.
  • General postures, thoracic stiffness and tight muscles at the front can lead to ongoing shoulder issues.
  • So… sit up straight, get those back muscles working and pec muscles stretched out.

5. It’s a marathon not a sprint – Shoulders take time to rehabilitate!

  • Most painful shoulders should improve with treatment over a 3-6 week period. Full shoulder rehabilitation generally takes 12 weeks with ongoing exercises for long term management.
  • Remember pain free shoulders are generally robust and strong shoulders.
  • Shoulders sacrifice stability for large amounts mobility. All that mobility needs to be controlled by a very smooth series of coordinated muscle firing for it to perform optimally, when a shoulder gets injured this system malfunctions and it takes specific exercises to restore it.


If you have any questions shoot us a message or book an appointment online!

Any questions about an  injury shoot us a message, give us a call on (02) 4751 9127

or book a session online here.

Written by Patrick Lincoln


Ankle Syndesmosis Injuries

2021-04-08Physio Tips No Comments

Ankle Syndesmosis Injuries 


The ‘high ankle sprain’ AKA ‘Syndesmosis injuries’ 

Everyone has known someone to ‘roll’ their ankle. Generally this is a twisting motion of the foot and damages the structures to the outer ankle, known as the lateral ligament complex. Ankle injuries involving excessive external rotation and/or dorsiflexion (toes up to shin and ankle twisting inwards) can disrupt the syndesmosis complex (pictured below). The syndesmosis is a fibrous tissue joining the shin bone with the fibular its primary role is to aid stability around the distal part of the ankle, as well as providing shock absorption when we run and jump. The syndesmosis is made up of 4 ligaments and is fundamental for good ankle function.






Tell tale signs you have a syndesmosis injury not a ‘lateral ligament’ injury!

It’s important you do not miss or confuse a syndesmosis injury with a normal ankle sprain. Early rehabilitation differs greatly and can lead to chronic issues if not managed appropriately.

The key things to remember if questioning a syndesmosis:

  1. The mechanism of injury: Hyper-dorsiflexion or forceful external rotation.
  2. The swelling pattern is above the ankle joint not laterally and below.
  3. Pain increases with walking or weight-bearing that can be reduced by squeezing the lower leg bones together.
  4. Pain increases with dorsiflexion, but can be eased with compression of the tibia and fibular junction


Got a question about an injury, shoot us a message or book a session online here.


Written by Patrick Lincoln



Shoulder Dislocations Made Simple.

2021-02-10Physio Tips No Comments

Shoulder Dislocations Made Simple .


What is a shoulder dislocation?

A shoulder dislocation is when the top of our arm bone slips out of the cup like socket that contains our shoulder joint. Unfortunately, our shoulders are built for mobility not stability making it a very common injury.

How does a shoulder dislocate happen?

Shoulders can dislocate in a number of positions. Most commonly the shoulder pops out in a forward direction due to a force on the shoulder with our shoulder out to the side and above shoulder height or a blunt force to the back of the shoulder. Occasionally shoulders will dislocate backwards, this can happen due to a fall on an elbow or onto your hands in front of the body causing the arm bone to move backwards through the joint.

How painful is a dislocated shoulder and what should I do immediately afterwards?

Dislocated shoulders are generally very painful at the time. You will feel an immense pain, muscular spasm and inability to move the arm. The good news, once your shoulder is relocated the initial pain calms down instantaneously. The following 1-2 weeks your shoulder will be quite tender and may need the use of a sling.

How long does it take to recover?

General timeframes very depending on the type of dislocation and the mechanism of injury.

A rough time period of 6-12 weeks for return of normal function is a good starting point. More traumatic dislocations which cause extensive damage to the structural integrity of the shoulder can take upwards of 3 months for full recovery.

Is my shoulder going to permanently damaged after a dislocation?

Following a dislocation your rehabilitation is extremely important. Once the shoulder is dislocated you damage the structures that hold your shoulder in place on a day to day basis. In order for you to return to sport, overhead activity or gym training it’s imperative you follow a strict rehabilitation plan. Unfortunately the re-occurrence rate is quite high, especially in the adolescent patient group. In summary, your shoulder is not permanently damaged but you have to work hard strengthening and stabilising the muscles surrounding the shoulder.

How can Physio help?

  • Restore shoulder range of motion.
  • Immobilisation strategies to settle the shoulder down in first 10 days.
  • Guided rehabilitation program to strengthen shoulder stabilisers.
  • Return to sport/activity guidelines and testing.

Do I need surgery?

A first time dislocation does not generally need surgery unless you have a traumatic/unstable fracture. After your first dislocation you will generally start a rehabilitation program with your Physio over a 12 week period.

If you make dislocating your shoulder a habit despite your best efforts of Physio and exercise. Then you may be on your way to the surgeon to get your shoulder stabilised with an operation.

What does the first 6 weeks of Physio look like after a dislocation?

    10-14 days of using a sling to support the injured arm. This is useful for pain, but also stops the shoulder popping out again in the first 5-7 days.
    Start muscle activation in supporting muscles at the back of the shoulder.
    Begin light resistance training focusing on shoulder stabilisers, trunk muscles and rotator cuff.
    With your shoulders supported start weight bearing shoulder exercises.
    Build strength in zones above head and focus on stability exercises.
    -Build functional exercise program targeting demands of your sport.


Got a question about an injury, shoot us a message or book a session online here.


Written by Patrick Lincoln



5 Tips for runners to avoid a trip to the Physio!

2021-01-12Physio Tips, Uncategorized No Comments

5 tips for runners to avoid another visit to the Physio!


Runners accumulate an amazing amount of distance over a 12-month period. The gradual load this has on joints, ligaments, muscles and bones can inevitably lead to injuries. A whopping 82% of all runners will get injured throughout their running career.


Our goal at The Physio Depot is to give you strategies and training tips that educate you on how to lower your risk of injury, therefore keeping you running all year round. We all know what runners are like when they don’t run… If you don’t know what I mean, ask your friends or partners (Yes, we are talking about you Mr/Mrs Grouchy!).

Here are our 5 top tips for a happy and injury free running season in 2021!


  1. Slow & steady wins the race:

    Build your training kilometres up slowly. We often see people jumping up to 40-60km per week after only training for 4-6 months and they wonder why their body is hating it.
  2. Strength wins over stretching:

    Most runners gravitate to stretching or foam rolling for managing their injuries. What we see is a neglect of strength work when runners are pain free. Our view is that strength training should be a consistent theme throughout the whole training year. All running injuries are treated with an element of strengthening exercises, so why not do it before an injury occurs.

  3. Footwear that suits your feet:

    Not all feet and shoes are created equal. The main message here is that you need to purchase the right shoe for your foot. Not everyone has to be running in a whizz bang zero-drop shoe! People have different foot shapes, which may require different levels of support. Think about this:- Does the shoe match your foot?
    A flat weak foot may need more support than a strong foot with a higher arch.

    Is the toe box to small?
    The area where your toes sit provide all the shock absorption for your running. If your toes can’t spread, you are increasing the ground reaction forces throughout the whole body chain.

    What is the ‘drop’ of the shoe?
    The drop of the shoe is the amount of change in height from the heel to the toe in the sole of the shoe. Think of it as the ‘heel’ of the running shoe. This height change effects the amount of load transmitted through the foot, calf and lower limb. Typically a ‘Zero’ drop versus ‘10mm’ drop will increase the amount of calf/lower limb strength needed to tolerate your training load.

    Talk to a professional and seek good advice from people that run themselves
    We love the guys at Blue Mountains Running Co. in Glenbrook. Click HERE to visit website 

  4. Recovery, Hydration & Nutrition:

    Everyone knows the power of sleep. New research suggests if you’re getting less than 7 hours sleep per night, you’re putting yourself at risk of injury. So.. put the phone down, turn off Netflix and get some sleep!Adequate nutrition and hydration is imperative for good performance, lowering injury risk and aiding in tissue recovery. This is especially important for bone health and reducing stress related injuries.


  1. 80:20 – Training variability and terrain:

    Training variability is important, but can lead to injury. The 80:20 rule means that 80% of your total training time should be completed at an easy to moderate effort, 20% should be completed at a more intense level. Runners often fall into the trap of running the easy runs too fast, adding hills repeats and sprints to their training sessions. This causes the pendulum to swing and all of a sudden 60-70% of their training is now in the hard intensity zone, thus increasing their injury risk.



Got a question about an injury, shoot us a message or book a session online here.


Written by Patrick Lincoln



ACL Rehabilitation & Recovery

2020-10-07Physio Tips No Comments

ACL Injury & Rehabilitation Explained

Firstly what is an ACL and why is it important?

The anterior cruciate ligament aka ACL is one the main ligaments joining your thigh bone to your shin bone. This inherently keeps the knee very stable so we can jump, run and change direction in a sporting context. The ACL’s job is to stop the knee hyperextending, rotational control and a degree of proprioception for our knee.

What causes an ACL injury?

  • A twisting movement of the knee on a stationary foot is very common.
  • Knee hyperextension can cause injury.
  • Non contact causes account for the majority of ACL ruptures.
  • Females are at greater risk.
  • Higher prevalence in sports requiring sprinting, pivoting, decelerating and jumping.

What are the symptoms of an ACL rupture?

  • A audible pop is present in some cases (not always).
  • Immediate joint effusion and swelling.
  • Sudden onset of pain that eases afterwards. Most people can walk on a ruptured ACL with little to no pain.
  • Night time symptoms in the first 24 hours.
  • Knee joint stiffness due to swelling and pain.

How do you Diagnose an ACL rupture?

A Physio will listen to your story and then assess your knee with series of tests. Imparticular the Lachmans test, the pivot shift test or the lelli’s test will be used to clinical diagnose the ACL rupture.

If the Physio feels the ACL is ruptured an MRI will be performed to confirm the diagnosis and assess any other structures that are injured for example: Medial meniscus, medial ligament and any cartilage or bone involvement.

Does every ACL injury need Surgery?

This space is ever evolving in modern sports medicine. Generally conservative management was only used in the older population who had retired from their sporting days. Surgery was the once the only option for younger people wanting to play sport again. Yet, there is a growing body of evidence that rehab based management of an ACL may have the same benefits of the surgery itself.

What does the ACL rehab process involve if I have surgery?

An approximation of the rehabilitation process involves:

  1. Day 0-14
    – Manage the knee swelling.
    – Restore knee extension range of motion.
    – Ensure good quadriceps activation.
    – Normalise the walking gait cycle.
  2. Week 2-6
    – Ensure the above is completed diligently.
    – Quadricep strengthening in various positions.
    – Restore basic movement patterns: Squat, quadricep squeezes in standing and walking practice.
    – Begin hamstring strengthening. Being mindful if you have had a hamstring graft for your ACL.
    – Stationary Bike if pain, range and swelling allows.
  3.  Week 6-12
    – Start further strengthening work.
    – Loaded Strength Exercises: Calf raises, hamstring work, squats, leg presses, modified step up work.
    – Ensure Knee range is perfect and knee is not swelling.
  4. 12-16 weeks
    – If KNEE has good quads, no swelling, terminal knee extension and single leg controls is adequate we can start a return to straight line running plan.
    – Strength work continues throughout the whole process.
  5. 4 months to 6 months
    – Be nice to your ACL this is where people get cocky.
    – Slowly building running load into your legs and keep it to straight lines.
    – Advance single leg drills and stability work.
  6. 6-9 Months
    – Learn to get your springs back.– Learn to land, hop and get really good dynamic control.
    – Start testing muscle groups with specific measures to see right and left differences.
  7. 9-12 months
    – Cutting and directional running changes.
    – Add external distractions with sport specific rehabilitation.
    – Ensure a very thorough return to sport testing protocol.



Recovering from an ACL injury takes time and a lot of hard work. You as the patient are doing all the work with this recovery and it takes discipline and patience to do it well. New research suggests the longer we stay out of sport the lower the likelihood of re-injuring the ACL again. A minimum of 12 months is recommended by most Surgeons.


Any questions about an injury shoot us a message or book a session online here.


Written by Patrick Lincoln



Top 10 ways to finish the Ultra-Australia injury FREE!

2020-07-15Physio Tips No Comments

The Physio Depot’s top 10 ways to finish the UTA injury FREE!



     – ‘If you fail to plan, you are planning to fail’
    – Get to know what training volumes and duration your body can handle. Some people can pump out 100km weeks all year round without a niggle, others will run a 50km per week and be broken for months.
    – Get to know YOUR body’s capabilities and training schedule not someone elses.
    – Plan what you can actually achieve and be realistic with your lifestyle.

    – Try make your training specific by getting on the course if you have that luxury.
    – Breakdown the sections as this helps mentally on the day of knowing what’s to come.
    – If you can’t run the course try and find places where you can get some vertical elevation. It will be hard to find similar elevation profiles hence why the event is held in the Blue Mountains. 

    – Be consistent with strength training each week.
    – Focusing on all the big engines of the body: Quadriceps, calf, hamstring, gluteals and core muscles.
    – Don’t be afraid adding a little weight. Adding stress to your system is great cross training tool that will really help with all those stair and hill climbs. 

    – Be on your legs consistently. All your runs do not have to be long and arduous, but you do have to be consistent with your training.
    – An injury is calling with inconsistent weeks of training and then trying to ‘catch up’ on training.
    – This does not work. It will cause overuse injuries.
    – Sleep and recovery is paramount to quality training. Schedule it like your training runs.
    – It’s helpful to recover from long runs with cross training like swimming or bike riding.

    – Nutrition is key to keeping your body nourished for all your training. Careful not to overeat now you’re running like Forest Gump as some people actually gain weight.
    – Replenishing nutrition stores after your long runs is important.
    – Don’t forget water – Keep a water bottle with you all day everyday.

    – The 100km UTA event as 4,400m of climb and 4,400m of descent. That’s a lot!
    – The only way to get through this is to start loving hill work, stair climbs and more hill work.
    – A common misconception is that you need to train hard all the time. Yes – parts of your training can be hard but only 15-20%. This may include hill repeats, speed work or fartlek runs.
    – To avoid injury make 80% of your training easy to moderate. 

    – The quadricep complex work extremely hard as your brake when running down hill and are prone to exploding if you have not trained running downhill enough prior to this event.
    – Be sure to add down hill running and downstair work in your training program.
    – If you’re a local – Kedumba will do the trick!

    – What comes up must go down so get training.
    – This one is pretty straight forward – To finish this event you must learn to love stairs.




Any questions about an injury shoot us a message or book a session online here.

For more information regarding the Ultra-Australia Click Here

Written by Patrick Lincoln



What are the ways to prevent injury when returning to sport?

2020-06-25Physio Tips No Comments

What are the ways to prevent injury when returning to sport? 


As sport returns and lockdown rules are starting to ease, sportspeople and weekend warriors are chomping to get out there again!



  • There is always a risk of injury in returning to the sport after an extended period of time off. This is particularly relevant with the additional closure of gyms, and for those who have been moving less than ever by working /studying from home over this period.
  • With decreased activity or training, it’s not just our fitness or muscles that deconditions… The bones, tendons, and joint surfaces also lose strength, which puts you at a higher risk of injury.
  • These changes are exaggerated for children who continued to grow during the lockdown period, there can be dramatic changes in body mass, since they last played a sport, especially in adolescents.


Here are our tips for returning to sport/training WITHOUT getting injured!



Increase your training volume steadily and slower than you think. Your body takes time to adapt to certain training load. It’s tempting to go back into our old routines straight away, but

start at about 75% of your training load and intensity, and gradually increase this slowly week by week.



Chances are over the last few months the muscles that support and protect your joints aren’t as strong as they were pre-lockdown.

Targeted preventative strengthening programs to supplement your training will help reduce the likelihood of overuse and non-contact/contact sporting injuries, and it is a great way to improve your performance!

For sports that involve sudden changes of direction (soccer, football, netball) prioritizing single-leg strength and control plays a huge part in injury prevention.


Recovery is as important as the training itself, the time spent recovering is when your muscles are rebuilding, your tissues are getting stronger and tendons becoming robust to sustain more training. Start with a rest day between every training session. Initially, you will feel like your body can keep training, but it may catch up with after a few weeks of consistent training.



Like anything using a Personal Trainer or Physio to help guide your return to exercise can be important to returning without getting injured and performing better! Aside from providing structure and direction to your training program, it will provide accountability to your training and goals.


Any questions about an  injury shoot us a message, give us a call on (02) 4751 9127

or book a session online here.

Written by Kieran Fercher


Help – I’ve got shoulder bursitis!

2020-06-02Physio Tips No Comments



Shoulder Bursitis

What is Shoulder Bursitis?

The bursa of the shoulder is a fluid filled sac that exists to reduce joint friction between the shoulder blade and the top of the arm bone. With good shoulder mechanics the bursa slides and glides within the shoulder and creates a perfect synergy.


In the diagram above we can see the bursa is enlarged due to swelling which can happen gradually over time or if the shoulder sustains a specific trauma. The problem now is the shoulder starts to wedge up against the inflamed bursa causing further pain, poor movement and bursitis.


The cycle begins….



How do I know if I have shoulder bursitis?

  • Pain in the shoulder, upper aspect of arm or bicep region.
  • Pain with lifting arm above shoulder height.
  • Pain reaching behind your back eg. Doing up belt, tucking shirt in or doing up a bra.
  • Pain sleeping on that shoulder.
  • Difficulty getting dressed or arm into a jacket.
  • Pain that is sore through movement but disappears once you reach the top of the movement.
    This is referred to as a painful arc.


How long does it take go away?

  • There is no quick fix for shoulder bursitis.
  • Clinically it can take up for 4-6 weeks for an initial improvement of inflammatory symptoms,
  • Full recovery will take up 12 weeks.
  • To treat this condition well you need to re-train how the shoulder is behaving which causes the ‘bursitis’ in the first place.
  • We look at the bursitis not as the condition but the symptom of a grumpy shoulder.


Will a cortisone injection help shoulder bursitis?

  • In SOME cases a cortisone injection is necessary to provide a rapid change to one’s symptoms in order for them to do the rehab well.
  • Without some form of active rehabilitation a cortisone injection can be a short lived exercise, with pain often returning upon the resumption of normal activity.


How can Physio help shoulder pain?

  • You need to settle down the initial inflammation using a variety of methods.
    – Massage & release work
    – Dry needling
    – Taping
    – Anti-inflammatory medication
    – Education regarding: Ergonomics, sleep position, postures and exercise modification
  • Exercise therapy is key to a long term solution.
    – Organising shoulder mechanics and re-training muscle function.
    – Mobility exercises targeting muscle tightness and imbalance around the shoulder girdle.
    – Gradual overload of muscle system back into a regular strengthening routine.
  • Designing a shoulder friendly gym or home program to work on


We love treating all types of shoulder injuries at The Depot and you are in good hands with all our experienced staff members!


Any questions about an  injury shoot us an email or give us a call on (02) 4751 9127

Need an appointment –> BOOK HERE! 

Written by Patrick Lincoln


Physio Depot’s top tips to help acute neck pain!

2020-04-28Physio Tips No Comments





I just woke up…
Now I cannot turn my head at all..
and it hurts like hell… HELP!
Sounds like a Wry Neck!


A wry neck is one of the most common neck issues we see in our community. It’s characterised by severe limitation in neck movement and excessive muscular spasm. And it hurts…. A LOT!

What causes this reaction is trivial movement or a sustained position of your neck eg. sleeping in a car or twisting your neck quickly for something. The facet joints of your neck lock up due  excessive spasm in the surrounding muscles causing pain and loss of movement.

Good thing is they don’t last long with proper management and the quicker you restore that movement the quicker the pain dissipates.

Our top tips to you fix your wry neck?

1. Get moving as soon as possible!

  • The longer we wait to start moving the longer it generally takes to resolve.
  • It will be sore but trying to move the neck in the directions that are less painful is a good start.
  • It’s very rare for all directions of movement to be severely limited.

2. Heat packs will be your best friend 

  • Keeping heat packs applied regular or hot showers is a very effective way to limit the amount of muscular spasm.
  • Ensure you don’t burn yourself but there is no limit to how much you can do this.
  • The quicker the muscle spasm settles down the quicker the neck movement will be restore.

3. Gentle PNF Stretches (We will explain what that is!)

  • Gentle muscle contractions and movement will help this resolve quickly.
  • Find a spot on the floor.
  • Use your hand to create a pressure against your hand – Do a little contraction.
  • Let your head fully relax.
  • Then try and turn your head a little bit. Repeat this process as far as you can. (You can see a video on our insta or facebook page)

4. Seek treatment as soon as possible

  • The quicker you restore your movement the better and Physio can help with this immediately.
  • Massage treatment to settle muscular spasm.
  • Joint mobilisation to restore joint movement.
  • Advice, education and reassurance surrounding your condition.
  • Exercises to help you manage this at home so you get better faster.



If you have any questions shoot us a message or book an appointment online!

Any questions about an  injury shoot us a message, give us a call on (02) 4751 9127

or book a session online here.

Written by Patrick Lincoln


Helpful tips for working at home!

2020-04-08Physio Tips No Comments


Rather than our usual ergonomic office set-up, working from home during self-isolation means many of us are spending our days slouched in bed with our laptops or working from the kitchen table, and are moving less than ever throughout the day.

These prolonged hours of these often slouched, and static postures can result in significant discomfort.
Setting up a work space at home that considers your posture and incorporates some simple exercises throughout the day is extremely simple, and will have positive effects on your health, movement and productivity.


Keep your monitor at eye height

The most important aspect of your desk set-up is getting the screen at eye height. Often in the office, people use monitors or stands for their laptops. Though, at home you can use some stacked books to raise the laptop to eye height, then connect a keyboard and use a mouse. This set-up will assist in maintaining your upper back, head and neck in a neutral position, minimising muscle fatigue.


Think about your desk set-up

Though it might be comfortable initially, always avoid slouching on the sofa or lying in bed to do your work. You should always use a solid desk or kitchen table to work from. The height of your chair should be adjusted so your feet sit flat on the floor and your thighs parallel to the floor – you can always use a small step to raise your feet. Your elbows should be able to rest comfortably at a 90-degree angle on the table. If you don’t have lumber support, place a pillow behind your back to support your natural lumbar curvature.

Alternate between sitting and standing

If you can, it’s always best to alternate between working from a sitting and standing position. For those that do not have a standing desk, use your kitchen bench, and again, stack some books to ensure that the laptop is at eye height. Working from a standing position will reduce hip flexor tightness and lumbar spine compression associated with sitting for extended periods of time.

Keep moving

Our bodies are made to move, so our number one tip – keep moving and take regular breaks every 30-60 minutes. Working in any position for an extended period of time will cause muscle fatigue and discomfort, so go for a walk, get some fresh air and reset. We also recommend incorporating some stretches at your desk to decrease joint stiffness, muscle tightness and improve postural awareness.

Try some simple chin tucks, shoulder rolling and seated rotations that can all be done from your desk.


If you have any questions shoot us a message or book an appointment online!

Any questions about an  injury shoot us a message, give us a call on (02) 4751 9127

or book a session online here.

Written by Patrick Lincoln