Advice From Your Physiotherapist – Get fit for winter sports!

6th August 2012

Get Fit for Winter Sports from Clifton Hill Physiotherapy!

With the arrival of August we find ourselves well and truly in the classic ‘peak’ of the Southern Hemisphere snow season. At Clifton Hill Physiotherapy some of us have been lucky to enjoy a ski already. For those of you planning on heading to the mountains, in particular those who are looking to participate in snow sports, it is worthwhile ensuring that you are well prepared in order maximise your enjoyment and appreciation of our beautiful alpine environment, as well minimise your risk of personal injury! So here are a few tips from us at Clifton Hill Physiotherapy to help you along.

The best way to avoid many injuries incurred through participation in winter snow sports is to maintain an adequate level of fitness year round. In addition to this, a conditioning program that specifically targets increasing the strength, endurance and coordination of muscles and movements for your chosen winter sports will be of further benefit and should ideally be undertaken at least three times a week for six weeks. Our Physios at Clifton Hill Physiotherapy can help with preparation or any skiing or snowboarding injuries. The following is a small sample of exercises that can be undertaken at home with minimal equipment to condition for alpine and cross country skiing, as well as snowboarding.

• Wall squats
• Stair Climbing
• Jumps (side to side)
• Box Jumps
• Calf raises
• Knee Tucks with fitball
• Ski Pole with Theraband

In addition to being physically prepared, consideration of the following will result in a superior alpine experience:

• Ensure that you bring plenty of layers of insulating clothing to trap more body heat than one bulky layer. This also allows you to add or subtract layers according to your comfort.
• Avoid getting wet. Wear outer layers that are waterproof and ‘breathable’ (i.e. allow moisture produced by sweating to escape).
• ‘Pit zips’ on jackets and zips on pants are useful to release heat when one is exerting oneself excessively and in dangers of overheating.
• ‘Powder skirts’ are a useful feature in jackets to ensure that snow does not go up your jacket on falling in loose snow as this would otherwise make you cold and wet when it is melted by your body heat.
• Take spare gloves, socks and hat in case the ones you are wearing get wet.
• Wear appropriate footwear (such as insulated and waterproof shoes) and wear a blend sock that ‘wicks’ sweat away from the skin.
• Make sure all footwear fits you properly.
• Additional equipment such as helmets, wrist and knee guards or ‘body armor’ padding may be useful to prevent serious injuries from falls. ‘Lids on kids’ is a program that has been developed to promote the use of helmets in winter sports to decrease the risk of head injuries.

For more information click here:

• Wear close-fitting sunglasses or goggles that meet the Australian Standard AS1067.

• Be aware that you are exposed to UV radiation even on cold and cloudy days. Apply broad spectrum 30+ sunscreen to all areas of exposed skin. Reapply regularly.
• Cold muscles, tendons and ligaments are vulnerable to injury. Warm up thoroughly before playing your chosen winter sport. Remember to take cold temperatures into account and spend more time warming up than usual.
• In downhill snow sports obey the alpine responsibility code and any rules of the mountain.
• Know your ability and always stay in control and be able to stop and avoid other people or objects. It is your responsibility to stay in control on the ground and in the air.
• Take lessons from qualified professional instructors to learn and progress.
• As you proceed downhill or overtake another person, you must avoid the people the people below and beside you.
• Do not stop where you obstruct a trail or run or are not visible from above.
• When entering a trail or run or starting off downhill, look uphill and give way to others.
• When riding chairlifts always use the restraining devices. Always use suitable restraints to avoid runaway ski/snowboard equipment. Ensure your equipment is in good condition.
• Observe and obey all signs and warnings. Keep off closed trails or runs and out of closed areas.
• Before using any lift, you must have the knowledge and ability to load, ride and unload safely.
• Do not ski, snowboard, ride a lift or undertake any other alpine activity if your ability is impaired by drugs or alcohol.
• If you are involved in, or witness an accident, alert Ski Patrol, remain at the scene and identify yourself to Ski Patrol.

• When using terrain parks demonstrate appropriate etiquette. ‘Smart Style’ is a set of guidelines for this that was designed in America by Burton Snowboards and the National Ski Areas Association. The simple messages of this are:
• Look before you leap – obey signs, scope around jumps first, use a spotter when necessary
• Easy style it – know your limits and stay in control
• Respect gets respect – wait your turn and call your start, only one person at a time on each feature, clear the landing quickly

For more information on for exercising in alpine environments visit:

For a program that is specific to your Winter Sport Goals make an appointment with Cathy, our Sports Physiotherapist at Clifton Hill Physiotherapy who is a Certified Alpine Skiing and Snowboarding Instructor.

Time to get up and get moving

With the increasing roles of computers and other technology in our life we are all spending too much time sitting. In fact among those with sedentary occupations it is not unusual to be seated for up to 8 hours per day. At Clifton Hill Physiotherapy we regularily encounter clients with back and neck pain directly related to prolonged sitting. Alarmingly two recent studies have also found that prolonged sitting times are  related to mortality and chronic disease. Dr. Van der Ploeg and colleagues from the Sydney School of Public Health, University of Sydney in a study of over 200,000 people found a strong relationship between long periods of sitting and death. Disturbingly, this relationship did not change for those who combined long periods of sitting and regular physical activity.  However Katzmarzyk and Lee recently published an article in the British Medical Journal demonstrating a 2 year increase in life expectancy in those who limited their sitting to less than three hours per day.

Do you feel like standing up yet?

Our experienced physiotherapists at Clifton Hill Physiotherapy  can help with a comprehensive assessment, sensible advice and an exercise program to get you moving !

Hidde P. van der Ploeg, Tien Chey,; Rosemary J. Korda, Emily Banks,; Adrian Bauman, MBBS, Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults Arch Intern Med. 2012;172(6):494-500.

 Peter T Katzmarzyk, I-Min Lee Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis BMJ Open 2012;

Winter Breakfast Dry Needling

Our Physiotherapists have just enjoyed an early breakfast at Caulfield Racecourse, updating our knowledge on Dry Needling. Dry Needling is the use of specific needles for treatment of muscle or nerve pain and myofascial trigger points. Dr Peter Selvaratnum gave an entertaining and insightful presentation discussing the increasing body of evidence for the different chemical effects of dry needling.
Our Physiotherapists are trained and accredited to safely provide dry needling as an adjunct to comprehensive patient management. The hot coffee and views of beautiful horses on the track topped a great morning.

Footy is back

Footy is back and Josh has resumed his post as Physiotherapist for the Fitzroy Football club. He is following up on our intensive  pre season  screening of the senior players. Liz has made an impressive start in the cut throat CHP footy tips, although Sarah is looking like another Dark Horse…..

Good luck to ‘ The Reds’ this year.

The 2012 CHP Cup

CHP staff have just blazed the gutters at the annual Ten Pin Bowling CHP Cup. Cathy was the surprise champ, not to be beaten with 2 early strikes in Round 2. If only her footy tipping was that good!
Liz continues to dominate the CHP tipping.
Footy matters at CHP. The tipping is cut throat and Josh is relishing in his busy role with the Fitzroy Football Club, screening and managing those winter injuries.

Good luck to The Reds for the second half of the season.

Physiotherapy and Cervicogenic Headaches

A cervicogenic headache is a syndrome characterised by one sided head pain, referred from either bony structures or soft tissues of the neck.

What are the features of cervicogenic headache?

Sufferers usually complain of single sided headache which is side locked (does not change position). It can extend from the neck to the base of the skull and around to the front of the head. The symptoms are generally provoked by neck movements and sustained postures, usually being described as dull or moderate in intensity and worse in the mornings.

On examination, sufferers tend to have reduced neck range of motion, sore and tender neck muscle, reduced joint mobility with poor motor control of the deep neck flexors (stabilising endurance muscles).

How can cervicogenic headache be treated?

Physiotherapy is very effective in managing cervicogenic headache.  At Clifton Hill Physiotherapy we regularily help people with cervicogenic headache,  by using a combination of manual techniques including mobilisiation and trigger point massage. We also address the cause of your headaches by thoroughly assessing all contributing factors and putting together a plan to treat your current pain but more importantly to prevent further episodes.


Abdominal Strength and Back Pain Physiotherapy

When you injure your back people will often tell you that you have to strengthen your abdominals. If this is not explained correctly one would take this statement that you need to strengthen your stomach muscles by performing sit-ups.

The statement is correct but doing a sit up while you have back pain will actually increase your pain considerably. What we mean is that you need to increase your Transverse Abdominus strength. This very deep muscle wraps around your spine like a brace and directly supports your spine. People with lower back pain often have a very weak (or inhibited) transverse abdominus and therefore have very little support for their lower back whilst completing their normal activities of daily living.

At Clifton Hill Physiotherapy we utilise the latest technology and research evidence to assess and treat your back pain. Our physiotherapists use Real Time Ultrasound to accurate assess your ability to active your Transverse abdominus and other spinal stabilising muscles. This set of muscles can be difficult to activate but our physiotherapists are trained in teaching you how to get these muscles working.

A strong and co-ordinated set of core/stabilising muscles  will:

  • Reducing the occurrence of pain
  • Improve the strength and tone of your abdomen
  • May improve incontinence – or post pregnancy issues
  • Prevention of back pain


Two of our physiotherapists at Clifton Hill Physiotherapy have recently returned from attending the “Neurodynamics and Neuromatrix” Scientific Conference and Master Classes in Adelaide.  This conference outlined recent research on pain sciences and advancements in treatment approaches.  A significant component of this was on the concept of Neurodynamics.

What is Neurodynamics?

Neurodynamics is the study of the mechanisms and physiology of the nervous system and how they relate to each other (Shacklock 1995).  This sounds a bit heavy, but basically it means going about the assessment and treatment of the physical health of the nervous system.  It involves specific testing of nerves, and developing physical treatments based on these findings.  These treatments usually involve gentle mobilisation techniques that can cause the nerve to “slide” in either direction (towards or away from the head).

Effectiveness of the neurodynamic approach has most recently been published in 2011 and 2012.  These studies showed:

  • Physiotherapy treatment using neurodynamic techniques was effective in providing immediate clinically relevant benefits for nerve related neck and arm pain (Nee et al 2012)
  • Physiotherapy treatment using neurodynamic techniques was a valid method of detection of cervical radiculopathy (Nee et al 2012)
  • Physiotherapy treatment using neurodynamic techniques was an effective, conservative method of treatment to reduce oedema in carpal tunnel syndrome (Nee et al 2011)

All physiotherapists at Clifton Hill Physiotherapy are trained in neurodynamic techniques.  As part of our commitment to ongoing improvement, all of our physiotherapists will be attending an evening education session on recent developments in the neurodynamic concept, to ensure we are all best able to treat our patients utilising the latest clinical evidence.

Professional Development at Clifton Hill Physiotherapy

Our directors Jenny Langford and Sallie Cowan have just completed their Physiotherapy lecturing commitments at Melbourne University for the semester. Josh Heerey is enjoying applying new techniques learned at a recent course in Sydney to help tackle the complex thoracic spine.

Pain Society Conference

Physiotherapists Jenny Langford and Brendon Haslam will be attending the Australian Pain Society Conference in Melbourne .

This years conference has a them of “Integrated Perspective of Pain” will be exploring evolving issues in pain management with the view to updating modern practice.

For further details visit