Andrew Firth’s view on Pilates

Andrew has a long association with disciplined movement. His early sporting exploits are across the board and cover tennis, basketball, cricket, golf and perhaps most successfully athletics, until he became a competitive ballroom dancer in his early adult years which he continues to this day. His focus as a teacher is on rehabilitation through movement and he enjoys challenging his healthier clients with a range of exercises designed to both stretch and strengthen their bodies to their pinnacle. Learning from Andrew will mean a tailored, traditional approach to the Pilates method that will educate your mind and body, allowing you to achieve your personal best. Here Andrew talks about the importance of the body system…

How does one build a strong, flexible and highly functional body? How do we eradicate pain, remove dysfunction, and manage our body in such a way that we remain pain-free?

It’s the system that counts.

The single best thing we can do for our body is to move. Move regularly. Move lots. Move in such a way that each of our joints (and all the muscles in between) receives tender loving care. Yes, going for a walk on a regular basis is good. It’s great in fact, but walking alone isn’t enough. What about our thoracic mobility, our scapula stability, or any other number of undervalued movements that it fails to address?

Again, it’s the system that counts. How well-educated is your system of movement? How varied is it? Does your system account for all of the body’s needs?

Cultivating a healthy body is like planting a crop. Sowing the seeds is only a small part of the job – after that you’ve got to tend to the seeds regularly (and with some degree of know-how), even if you can’t see the sprouts of green poking up through the dirt yet. Sow, cultivate, and then you shall reap…but that doesn’t mean you have to flog yourself. An apple a day keeps the doctor away, and by the same token, a daily dose of educated movement goes a long way to building a healthy body. Regular, well-informed workouts beat the hell out of one massive workout done whenever the blue moon is up.

It’s the system that counts. Pilates has proven time and again to be a valuable addition to many a person’s movement philosophy. Just remember that execution is power – not knowledge. The most intellectual system in the world is useless if never put into action.

Andrew Firth
Pilates instructor


As a physiotherapist I am always assessing and considering the biomechanics and anatomy of various body parts and their relevance to pain and stiffness. I recently attended an interesting and informative lecture run by the Australian Physiotherapy Association on breasts, bras and biomechanics. Breasts have been linked to upper back, neck pain or headaches and should be taken into consideration like any other body parts! Breast hypertrophy has been associated with chronic headaches and musculoskeletal pain is one of the leading reasons women seek reduction mammoplasty.  Furthermore, 17% of women reported breast pain as a barrier to exercise participation, the 4th highest reason. If you have ever experienced exercise induced breast pain you certainly are not alone.

Advances in motion technology have allowed us to study breast movement during various forms of exercise and use this information to improve sports bra technology.  The breast displaces in three dimensions and varies with breast size and intensity or type of exercise.   Biomechanical studies have concluded that breasts should move in a butterfly pattern to reduce strain on supporting structures and technical sports bras have been developed in line with this.  Reduced breast support has also been shown to have an adverse effect on gait or walking pattern.  The effects can include reduced arm swing, altered stride length and foot strike pattern, and increased use of chest muscles to improve support for breast tissue.  These things in combination can lead to further musculoskeletal issues.  Technical sports bras need to be seen as an essential part of exercise equipment.

A technical sports bra can only be defined as such if it has undergone biomechanical testing and is based on current evidence. Technical fabrics may include moisture wicking and heat dissipation properties. Unfortunately, many advertised sports bras are not a technical product and are not readily available on the retail market. She Science in Kew is one of the only stores in Australia stocking technical sports bras who can assist you with specialised fittings using motion technology.  They provide a number of brands and options for breastfeeding mums, post mastectomy populations and active women of all shapes and sizes.

So ladies, if you think lack of breast support may be contributing to your musculoskeletal issues or preventing you from participating in exercise, speak to your physiotherapist and consider having a specialised sports bra fitting today!


Ali Harding


Jess Kostos joins the team

We are excited to announce Jess Kostos has joined our Physiotherapy and Pilates clinics. Jess is an experienced clinician in Private Practice, treating general sporting and musculoskeletal conditions as well as pelvic health for men and women.

Jess completed her degree with Honours at The University of Melbourne, and has since completed post graduate studies in continence and pelvic floor rehabilitation at The University of Melbourne. This enables her to assess and treat any dysfunction of the pelvic floor.

Jess has experience working in both the private and public health sectors, treating a wide range of clientele; however she has a particular interest in the health and wellbeing of women. She has lots of experience teaching clinical Pilates, especially to those in the pre and post-natal period. We are excited to announce that Jess is running a Mums and Bubs Pilates class at our Pilates studio on Wednesdays and Fridays. Get in fast as we expect these to be very popular.

Jess maintains an interest in general sports, musculoskeletal and spinal physiotherapy, and is passionate about helping people of all ages achieve their optimal physical health and well-being.


  • Bachelor of Physiotherapy (Honours) (The University of Melbourne)
  • Graduate Certificate in Continence and Pelvic Floor Physiotherapy (The University of Melbourne)
  • Level 1 – 3 and certified APPI Matwork Pilates instructor
  • Level 1 -4 APPI Equipment Pilates series
  • APA Level 1 Dry Needling

Professional Memberships

  • Australian Physiotherapy Association (APA)
  • Continence and Women’s Health Interest Group (APA)
  • Continence Foundation of Australia
  • Continence Foundation of Australia – Physiotherapy Group


We warmly welcome Jess to our team.

Cam Walker Fittings

A cam walker is an adjustable orthopaedic device that looks like a boot. “Cam” is an acronym meaning “controlled ankle motion.” Its main purpose is to prevent or limit ankle and foot movement after a serious sprain, surgery or removal of a cast.CamWalker

The boot is commonly used in the treatment of lower limb injuries which require non or partial weight bearing, or a period of complete immobilisation. Physiotherapists use cam boots in the management of a range of orthopaedic conditions, including moderate to severe ankle sprains, fractures of the ankle, foot or lower leg.

A key feature of the cam walker is the joint mechanism. This allows the cam to be adjusted so it can completely immobilise the ankle, or set using small increments to allow the ankle only a specified range of motion. This allows therapy to be very gradual and controlled.

Cam walkers come in several styles to suit a range of needs. Some offer adjustable uprights (the vertical aluminium bars attached to the joints) and the addition of a metal “rocker” to the sole of the plastic form. The boot height can vary, depending on how much of the leg needs to be stabilised.

All Clifton Hill Physiotherapists are trained in the correct fitting technique for cam walkers. Please contact us should you or someone you know need assistance with correct fitting or access to a cam walker.

Welcome Billy Williams

We warmly welcome our newest Physiotherapist and Pilates instructor, Billy Williams.

Billy has recently joined the team at Clifton Hill Physiotherapy and Clifton Hill Pilates and Rehab after spending the last two years working in Victoria’s Northeast in Myrtleford, Bright and at Mt Hotham Village during the ski season.

Billy has worked in private practice and clinical pilates, as well as being the club physiotherapist for the Myrtleford Alpine Saints in the Ovens and Murray Football League. He has a keen interest in working with sporting people and is currently undertaking Post-Graduate studies in Sports Physiotherapy.
With a particular interest in shoulder instability, he is passionate about combining graduated exercise prescription with physiotherapeutic techniques to return an individual to their professional and recreational activities in a safe and timely manner. Billy also enjoys participating in his own competitive football and following sport of all kinds.

What is ‘I love my physio’ all about?

Many people think physiotherapy is limited to helping those with sporting injuries. But each year physiotherapists keep people healthy, mobile and independent through the prevention, maintenance and treatment of a wide variety of injuries and chronic health conditions.

The ‘I Love My Physio’ campaign is designed to spread the word about how physiotherapy can help treat, manage and improve everything from neck and back pain, to soft tissue injuries, to pelvic floor issues and even recovery from accidents that affect the brain, balance and coordination.

So if you have a story about how physiotherapy has helped you, a loved one or a friend, feel free to share your story online at

You can win some great prizes and help to spread the positive word about physiotherapy in the community.

For details go to:

Femoracetabular Impingement

Like all things in life there are trends and fads.  The world of sports medicine is not averse to such things either, with some classic examples being the LARS graft for ACL reconstructions and PRP injections for so many musculoskeletal conditions.  The ‘’fashionable’’ condition in recent years has been Femoroacetabular impingement or FAI.  One of our physiotherapists, Josh Heerey, has recently started a PhD looking into FAI and he took some time to out to talk about his project, and what it will mean for patients who have FAI.

FAI is a bony condition found within the hip joint of both males and females.  It commonly presents as hip or groin pain that occurs during or after exercise or vigorous activity.  Most commonly it is seen in people who put the hip joint in positions that require greater amounts of flexibility that is normally associated with everyday activities like walking, standing or sitting.  To be diagnosed with FAI you need to have two things:

  1. Symptoms reproduction with clinical testing used by physiotherapists
  2. MRI/Xray confirmation of the bony changes commonly seen in FAI

In the last 10 years there has been an exponential increase in the rate of arthroscopic surgery for this condition without a real understanding as to whether conservative management (physiotherapy and exercise) can be used instead to manage FAI.

I am currently undertaking my PhD looking at the natural disease course of FAI.  We are following a group of male and female soccer players for two years who have FAI which is diagnosed with clinical and radiological assessment.  We are interested in seeing what factors such as strength, flexibility and/or movement patterns result in people improving or developing worsening symptoms during the two year period.  As part of this project I will also be looking at the ways that the muscles around the hip joint function in people with FAI.

The project will provide us an understanding about the factors that lead to disease improvement or progression and also give us a better understanding about how to use rehabilitation to improve hip muscle function in people with FAI.

Joshua (Josh) Heerey

B Physio, PhD candidate, La Trobe university

Josh graduated from physiotherapy in 2008.  He completed his Post Graduate Certificate in Sports Physiotherapy in 2013 and has started a PhD in 2015 looking at Femoroacetabular impingement (FAI).  His project is looking at the risks factors associated with progression of FAI, as well as the effectiveness of exercise for FAI.


He has developed clinical expertise in managing hip and groin pain in athletes from his time working in both soccer and VFL.  He also has an interest in acute and chronic shoulder conditions.


Plagiocephaly Update

Recent research investigating plagiocephaly (1) has received significant media attention as it found that children treated with helmet therapy did no better than a control group that received education regarding counter-positioning. However closer inspection of this study indicates a number of flaws which may indeed compromise their results. These flaws included the possibility that the helmets being prescribed were not appropriately fitted, as the study does note that 73% of children experienced issues with the helmet not fitting, and 96% had skin irritation whilst wearing the helmet. This is not the norm for children who receive a helmet in Melbourne.

In contrast Jordan Steinberg and colleagues (2) from the Lurie Childrens Hospital in Chicago followed over 4000 children over a seven year period using a standard treatment algorithm. The children were placed into a conservative group who received education and training regarding positioning and tummy time (RT) +/- biweekly physiotherapy (PT), or a Helmet therapy group, who received a cranial remoulding orthoses (helmet), plus RT +/- PT. Some children in the conservative group who were deemed to not be improving were shifted across to the helmet group.

Complete correction was achieved in 77.1 percent of conservative treatment patients; 15.8 percent required transition to helmet therapy and 7.1 percent ultimately had incomplete correction. Risk factors for failure included poor compliance, advanced age, prolonged torticollis, developmental delay and severity of the head asymmetry at initial examination. Complete correction was achieved in 94.4 percent of patients treated with helmet therapy as first-line therapy and in 96.1 percent of infants who received helmets after failed conservative therapy. Risk factors for helmet failure included poor compliance and advanced age.

At Clifton Hill Physiotherapy we follow a similar treatment programme. Families are educated on the importance of positioning and tummy time, and may also be shown stretches if the child has neck stiffness. Additional developmental sessions may also be required for those children whose development is delayed. We monitor the child until approximately six months of age, when a decision regarding helmet therapy is made. We aim for complete correction using both conservative and orthotic/helmet interventions.



  1. Van Wijk, R., van Vlimmeren, L., Groothius-Oudshorn C., Van der Ploeg, C., Ijzerman, M., Boere-Boonekamp, M. (2014) Helmet therapy in infants with positional skull deformation: randomised co
    xntrolled trial. British Medical Journal, 348:g2741 doi:
  2. Steinberg, J., Rawlani, R., Humphries, L., Rawlani, V., Vicari, F. (2015) Effectiveness of Conservative Therapy and Helmet Therapy for Positional Cranial Deformation. Reconstr. Surg. 135: 833-842, doi: 10.1097/PRS.0000000000000955


Brendon Egan, Physiotherapist

Brendan is an experienced paediatric Physiotherapist having spent over sixteen years working at the Royal Children’s Hospital treating children and adolescents with a range of conditions. He has presented at national and international conferences and is co-author and editor of a book on sporting choices for boys with Haemophilia.


Brendan’s particular expertise is paediatric musculoskeletal issues with many years of experience treating children with persistent pain, haemophilia, juvenile arthritis, scoliosis and burns management. Other interests include advising families on developmental issues such as flat feet, knock knees and torticollis/wry neck. Children and adolescents requiring rehabilitation following trauma, fractures and surgery would also benefit from Brendan’s expertise. Dora Konya and Brendan Egan our Paediatric Physios, can address any concerns regarding your child and Plagiocephaly. Call 94861918 for any enquiries.

pilates 1

Introducing Clifton Hill Pilates and Rehab

We have some exciting news to share –  Clifton Hill Physiotherapy is proud to announce we have a new Clinical Pilates and Rehabilitation gym, conveniently located just 3 doors down next to Bendigo Bank.  

We have joined forces with Bodylogic Pilates (a longstanding leader and provider of excellence in pilates in the Clifton Hill area) to create Clifton Hill Pilates and Rehab.

With this new facility we will offer a full range of Clinical Pilates, mat based pilates, specialised classes (for example – pre and post natal pilates, strength training for women), comprehensive rehabilitation post injury/surgery and Podiatry services.

Please contact us for more information or ask your physiotherapist for further details about how you can participate. We plan to renovate this new space during the  September school holidays and launch to market soon after.


Help for sufferers of mastitis

Clifton Hill Physiotherapy offers help for mastitis sufferers

Earlier in the year Cathy Derham and Alison Harding attended professional development on “The lactating breast for physiotherapists” run by The Continence and Women’s Health Physiotherapy Australia Group.

Cathy and Ali reviewed the most recent research and current best practice in the management of conditions of the lactating breast. The most common of these is mastitis. Mastitis is defined as “inflammation of the breast” resulting in a blockage of the ducts that transport milk to the nipple for the baby to feed.

Mastitis occurs in as many as 1 in 3 women during the post partum period, with the highest incidence occurring 2-3 weeks post partum. Mastitis is the most common reason to wean in the first 12 weeks post partum.

Some common risk factors for mastitis include: previous episode; a sudden change in number of feeds; incomplete breast emptying; suckling replaced by pacifiers or bottles; finger/ pump/tight bra compression; positioning and attachment problems or direct blow to the breast.

Breastfeeding is considered the biological norm, and the World Health Organisation (WHO) recommends breastfeeding for the first two years of a baby’s life due to the enormous health benefits for both baby and mother. Therefore, best practice in the management of mastitis is directed towards resolution of the inflammation and unblocking any blocked ducts while supporting continuance of breastfeeding.

Cathy and Ali have recently conducted Mastitis update inservice to staff at Clifton Hill Physiotherapy, ensuring that your Physiotherapist at Clifton Hill Physiotherapy is delivering best practice for management of these conditions.


Cathy Derham

B Physio (Hons) M Physio (Sports Physio)