Physio :: Christchurch :: Sports Injury :: Physiotherapy :: Massage

By: Riccarton Physio  06-Dec-2011
Keywords: Acupuncture, Exercise, Rehabilitation


What is it?

The ability for you and your physiotherapist to see the quantity and quality of muscle activity instantly in real time. This is fantastic and gives you instant feedback as to the state of your identified muscles and enables you to CORRECTLY recruit the right muscle.  Getting the right muscles working in your abdominal area is a key element to controlling your pain.  Whether you have back pain, lower limb or upper limb problems, improved core muscle stability will help greatly.

Why use Real Time Diagnostic Ultrasound?

  •   Increased accuracy of diagnosis of deep muscle activity (core).
  •   Helps in setting the right rehabilitation plan to relieve you of your pain and work towards prevention of further episodes.
  •   Allows instant feedback to the patient as to the quality of their muscle activity.
  •   Greatly speeds up the learning process by instant visual feedback.
  •   Pain free and non invasive
  •   Excellent objective measure than can be retested to gauge improvement.

Recent research (over the past 10 years) has found that the deep stabilising muscles of multifidis and Tranverse Abdominis have a significant influence on the lumbar spine. It was found that the Multifidis muscle ceased to function and wasted in size and quality after the onset of low back pain. Even when the low back pain settled the back muscles did not regain their function which then lead to a recurrence of pain in 80% of cases within 12 months. With the Diagnostic Ultrasound to diagnose deep muscle dysfunction and wasting, and then help in restoring function reduced the recurrence rate to 30% – a significant improvement.

Rehabilitation is about correctly selecting the dysfunctional muscles and restoring their stabilising role through low intensity retraining. This does require time, skill, passion and investment in the latest technology to provide a service to the patient that is cutting edge in rehabilitation.

Who should use it?

  •   Anyone with pain where we think that the core muscles are not functioning as well as they could.  This poor stability leads to overuse of other muscles that can then result in pain.
  •   If you are finding it difficult to isolate the core muscles.
  •   If you are unsure or want to know the state of your core muscles then ask your physiotherapist if the Diagnostic ultrasound would be suitable.


For the next three months (June, July and August) you can come and see us for a 15 minute appointment to have your abdominals/core muscles evaluated. An appropriate home exercise program will be given to you to improve the function of your core. By improving the function of your core muscles you will greatly reduce the risk of back pain and/or ease any current niggles. All of this with one of physiotherapists for only $15. There are limited spaces for this so please call reception (3485359) and ask for a CORE ASSESSMENT.


What is Physiotherapy?

Physiotherapy is a therapeutic health profession concerned with enhancing functional ability and quality of life by using clinical reasoning to deliver the most suitable treatment for an injury or condition. Physiotherapists help people gain as much movement and physical independence as possible so they can resume their normal job or lifestyle. Physiotherapists assess, diagnose and treat people with movement problems. They also deliver patient education and help people avoid injuries and maintain a fit, healthy body.

How does it work?

Physiotherapy is a tool for enhancing your body’s natural ability to heal and optimise movement. Physiotherapy integrates clinical expertise with evidence-based research. Physiotherapists are trained to assess the underlying causes of joint, muscle and nerve disorder, educate patients about managing their condition, and advise ways to prevent pain and injury. Often, a personal exercise or rehab program is prescribed.

Physiotherapists use a wide range of drug-free techniques to relieve pain, restore function and movement, and prevent further problems, including:

• Soft tissue massage and mobilisation techniques

• Joint mobilisation and manipulation

• Exercise prescription for rehabilitation and prevention of injury

• Taping to protect injured tissues and joints, prescribing supports splints and braces

• Biomechanical assessment of movement

• Assessment and treatment of postural and movement dysfunctions

• Electrotherapy (such as ultrasound or interfernetial)

• Acupuncture

• Clinical Pilates

As a profession, physiotherapists work within a framework of empowering the individual through education and the promotion of self-management of health and wellbeing.

How can physio help?

Physiotherapy is useful in the acute stages of soft tissue (muscle or ligament) or joint injury to relieve pain and promote the healing process. Physiotherapy enhances your body’s natural ability to heal and optimise movement. So whether it is a common sprain and strain, or a more complex condition like headaches, sciatica or an occupational injury, our physiotherpists are able to sucessfully manage and treat your condition in conjunction with you.

Our physiotherapists are highly qualified specialists in manual therapy, acupuncture, spinal therapy, sports medicine, manipulation and exercise rehabilitation including core stability, strength and flexibility.

At our clinics we can help you treat headaches, neck pain, OOS, tennis elbow, golfers elbow, wrist sprains, hand sprains, sports injuries, breathing problems, stress management, knee cartilage, back pain, postural problems, muscle imbalances, hip pain, arthritic joints, knee pain, sprained ankles, heavy bruising, growing pains, muscle strains, foot problems and many other conditions.

In the sub-acute stages we aim to optimise function and allow more activity without re-injury and in the chronic stages to retrain pain management mechanisms and improve physical fitness.

How many treatments will I need?

What to expect from your Physiotherapist

Our physiotherapists are registered health care professionals and have completed a university degree. Our staff are required to complete continuing professional development each year, which ensures that they are keeping up to date with evidence based practise and cutting edge physiotherapy techniques to optimise your recovery.

On your first visit a full history will be taken followed by a thorough examination and assessment of your problem. You will normally be asked to perform a simple series of movements and special tests, which stress the muscles, joints and nerves, which may be causing your condition.

Our physiotherapists may require you to remove the outer layer of your clothing as it is easier to see what is happening to the joints, muscles and overall posture as you move. It is a good idea to bring a pair of shorts with you to your physio appointment so you can be assessed in comfort.

Do I need a referral from my GP?

How long will it take?

The first physio session you have involves a thorough assessment and diagnosis of your injury/condition followed by some treatment. This is usually 30 minutes. We take a full history and perform a thorough examination. We find how the problem affects you and what you want the therapy to achieve. We give advice on how we can help, length of time of the management/process and costs involved.

Manual Therapy

This is the base of our approach. We use our hands for massage, muscle stretches and gentle joint manipulation and mobilisation.

These techniques are generally the basis of our treatment. They tend to be the cornerstone of physiotherapy in New Zealand.

Manual therapy is not often painful, although can sometimes produce a little discomfort.

Exercises are a large part of physiotherapy treatment. They are prescribed to your specific needs and are reviewed progressively as your body responds to the therapy with improving strength and flexibility. These are not hard exercises as given at gyms, rather, they are easy to perform, are specifically tailored to your individual injury, and wont interrupt your daily life.

This is the greatest tool we can give you, it allows you to manage your injury to a quick and full recovery and prevents recurrance.

Clinical Pilates adapts traditional Pilates principles to enhance understanding of alignment of the body, therefore maximising performance through focused control of specific muscles.

The precise movements of Pilates, led by a physiotherapist, can gently and safely help to re-pattern

and strengthen ineffective and dysfunctional movement patterns caused by injury.

Clinical Pilates is designed to strengthen weak muscles, elongate tight muscles and balance

asymmetries of the body.

Clinical Pilates begins in the treatment room under the guidance of our therapists, with a series of exercises that the client can practice at home to improve function. As the client’s ability and understanding of movement patterns improves, especially with recruitment of the correct muscles, progression is made to our Pilates equipment in the gym. The Trapeze Table and Reformer allow for control through range of movement and greater focus on the affected area.

Once instructed in the correct use of the equipment, clients may then purchase a gym concession card and come in to use the equipment independently.

Currently we have Sally leech who has trained in Clinical Pilates, and share the passion for this form of rehabiliation. Often clients are referred to Sally for focused one-to-one sessions as they come to the end of their recovery. This aids in the prevention of further injury through an effective and individually-tailored exercise program.

At Riccarton Physiotherapy Diana Connor and Nigel Roy will be implementing the Activity Based programs – Functional Reactivation Program (FRP) and Work Hardening Program. Both have vast musculoskeletal experience and enjoy the use of gym based rehabilatation. These two programs will run for 6 weeks and may be extended to 12 weeks if required and approval from ACC is granted.

The main difference between the two programs is the fact that the Work Hardening is for those clients who do NOT have pain as a major factor but need rehabilitation to restore strength and mobility to enable a successful return to work or pre injury function. An example of this may be following a major fracture where due to immobilisation there is a large loss of range and muscle wasting but not a lot of pain.

The FRP is similar but addresses those patients who continue to have pain as a major part in their overall presentation. Pain management and ways to cope with the pain will be addressed during the course of the program along with an individualised and tailored gym and home exercise program.

FRP is for clients whose pain has persisted for over six weeks following an injury. The programme addresses key pain-related disability factors using a physical reactivation approach.

FRP’s major goal is to return clients to independence at home or work, or help them achieve work-readiness. The rehabilitation programme consists of:

• an individual exercise programme, and

• education in pain management with practical applications of self-management principles including skills training in Cognitive Behavioural Therapy.

The exercise programme targets key pain-related disability factors using a physical reactivation approach to help clients return to the maximum possible level of functional independence and to participate in their usual activities at work and at home.

Each individualised programme is designed to be relevant to the client’s social, work/home surroundings, and within their economic means.

The service is provided in a facility where the client can have an individualised prescribed exercise programme. This may be, but is not limited to, the treatment clinic, an exercise facility, gymnasium, or swimming pool.

The Work Hardening program is a specific exercises and cardiovascular program to assist the Client to achieve work hardening, strength and fitness and to participate in their usual acitivies at worl and at home. The WHP is for clients for whom pain is not a serious limiting factor.

The objective of the WHP is to ensure that the client achieves the maximum possible level of functioning through:

a) the use of activity and exercise; and

b)Adopting a self-management approach; and

c) Enhancing the level of independence and participation in usual activities such as work.

The client will hve been off work for 6 or more weeks due to their injury.

This is a form of treatment that utilises needles which can be inserted and manipulated at areas on the body with the aim of reducing pain. There are different types of acupuncture. Scientists are studying the mechanisms and efficacy of its therapeutic use. Researchers using the protocols of evidence-based medicine have found good evidence that acupuncture can be helpful in treating some conditions. While there is ongoing research into its efficiency, it is safe when administered by trained practitioners.

Several physiotherapists at our clinics have had post graduate training in acupuncture. They may choose to use it as a form of treatment in combination with other treatments or as a treatment on its own. Sterile single use disposible needles are always used.

How does it work?

Currently, there is not one western scientific theory that collaboratively explains all of the physiological mechanisms underlying the effects of Acupuncture. This is because Acupuncture has a variety of therapeutic effects on the body thus the action must vary depending on the type of pathology. However it is proposed that acupuncture primarily produces its effects through regulating the nervous system. Regulation of the nervous system aids the activity of pain-killing biochemicals such as endorphins and immune system cells at specific sites in the body. In addition, studies have shown that acupuncture may alter brain chemistry by changing the release of neurotransmitters and neurohormones. These affect the parts of the central nervous system related to sensation and involuntary body functions, such as immune reactions and processes that regulate a person’s blood pressure, blood flow, and body temperature.

In summary, scientists have deduced a number of theories from observing a number of individual clinical effects of acupuncture treatment. These theories and the observed clinical effects on which the theories are based can be summarised as the following:

Augmentation of Immunity Theory – Increased Immune Function & Resistance to Disease

Endorphin Theory – Reduction of Pain

Neurotransmitter Theory – Inflammation Reduction & Promotion of Feelings of Well Being

Circulatory Theory – Improved Circulation & Smooth Muscle Relaxation

Gate Control Theory – Increased Pain Tolerance

Motor Gate Theory – Hasten Motor Recovery from Paralysis

Homeostatic or Regulatory Effect – Regulation of Body’s Homeostasis to Disease or Abnormal Conditions

Bioelectric Theory – Stimulation of cells of tissue growth & repair

Nervous System Theories – Central nervous system, spinal & peripheral nerve stimulation, resulting in some of the above-mentioned effects.

The information in this article was current at 02 Dec 2011

Keywords: Acupuncture, Clinical Pilates, Exercise, Physiotherapy, Rehabilitation