How to fix tennis elbow!

2021-07-15Physio Tips No Comments


What is tennis elbow? (It’s not just for tennis players)

The condition commonly called tennis elbow has many other names such as lateral epicondylagia, lateral elbow pain , lateral epicondilitis etc.

It describes an issue with the tendons located on the outside of your elbow. The tendons attach the muscles that extend your wrist and fingers to the bone on the outer elbow. You use these muscles when you grip, lift or carry something.

Tendon pain occurs when they are overloaded with repetitive activities and is unable to cope with the workload. This results in changes to the cells and matrix of the tendon and this can cause pain, loss of strength and stiffness in the tendon.

What are the symptoms?

Symptoms include:

– Dull aching pain on the side of the elbow after activity
– Tends to warm up a little with activity
– Tenderness on the side of the elbow

Pain or loss of strength with activities such as:

– holding a cup
– opening a door handle or
– gripping the bar at the gym


The aim of physiotherapy is to get you back to doing the things you love so your treatment we make sure your treatment is specific to your goals.

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


Written by Brianna Downward


Calf injuries in runners!

2021-07-02Physio Tips No Comments

Running related calf injuries!


Dreaded calf (or baby cow) muscle strains are a common running injury, and often leave you going crazy with the next running event getting closer and closer! Greater than 50% of running power is generated from the calf muscles, so it’s understandable that the calf can be a potential site of muscular injury for a runner.


Types of calf injuries: 


The calf is made up of 2 main muscles – the Gastrocnemius and Soleus. It’s important to understand which part of the calf is injured when designing a rehab plan and preventing recurrences.

  1. Soleus strain – In most cases, runners don‘t feel a sudden twinge – but feel a tightening sensation in the calf that develops slowly during a run. This type of strain often involves injury to the soleus muscle and may occur with fatigue, overtraining or a change in running surface / hills. The Soleus muscle works harder during distance running and where the knee is in a bent position.

  2. Gastrocnemius strain – These trigger sudden onset of pain in the region of the calf, often caused by faster intervals, sprinting, or high-speed tempo runs. The gastroc muscle crosses over the knee joint and works harder where the knee is in a straight position, and explosive sprinting/jumping activities.


What causes calf strains when running?


  • Getting too keen! We’ve all been there, and we know how exciting training for your next event can be. Quickly Increasing training loads, speed or hill work most often overloads the calf.
  • Poor strength and endurance of the calf!
    Clinically I like to see all runners be able to complete 25 single leg calf raises repetitions with good form, and arbitrarily use the following assessment criteria:
    < 15 reps (poor)

    15-30reps (satisfactory)
    > 30reps (good)
  • Change in footwear – A change in heel to toe drop/angle with your shoes will change the amount of stretch and load on the calf muscle.
  • Hip/knee weakness: Your glutes and quads work with your calf to push you forward. If muscle groups higher up the kinetic chain aren’t doing they’re job it’s going to increase load on the calf. 
  • Running technique – A conscious change in running technique to mid-forefoot running


Can I still run with a calf strain?


Continuing to train in some form is important for a speedy recovery, whether it is a light running/walking program or cross-training program to keep you moving!

Severity of muscle strain can be assesed by your physio and will determine recovery timelines and structure of rehab. 

  • Grade 1: 1-2 weeks to return to some running
  • Grade 2: 2 weeks+ to return to some running
  • Grade 3: 3-6 weeks to return to some running
  • Grade 4: 3 months+ to return to some running

How do you treat a calf strain?


Accurate diagnosis of the type of calf injury, and early appropriate treatment can significantly affect duration of your recovery. 

Phase 1: Acute treatment is aimed at limiting pain and limiting further muscle damage.

  • No stretching
  • Ice and compression to limit muscle bleeding 
  • Normal walking pattern: Heel wedges or a crutch are often helpful in the first couple of days
  • Early calf loading exercises

Phase 2: Aimed at re-building calf load tolerance 

  • Progress calf strengthening exercises targeting both muscles!
  • Hip strength exercises

Phase 3: Building a resilient calf and a safe return to running 🙂

  • Plyometric and calf endurance exercises 
  • Return to running program!

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 Kieran Fercher 


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