Superfoods – the Fermented Frenzy!

Superfoods – the Fermented Frenzy!

Over the past decade the term ‘superfood’ has became a house-hold name and has seen many people fighting over the last bunch of kale in the supermarket! However, there is a new trend that has recently risen to the nutritional hall of fame: fermented foods.

I’m sure we all know a few friends that have traded in their morning coffee for a glass of kombucha, but is there any truth to the claims of endless health benefits associated with the ancient process of fermenting that has been practiced by humans for thousands of years? Can we supplement our physical health and performance by swapping our sweet potato for a side of kimchi? Let’s have a look at some of the facts:

What actually are ‘Superfoods’?

There is no official standard for what is classified as a ‘superfood’. It is commonly understood that any natural food containing a high-concentration of nutrients, such as antioxidants, qualifies for the title. A few of the favourites in this category include berries, acai, kale, chia seeds and coconut oil – extra virgin of course!

Despite the hype, it is important to take a holistic view of diet and exercise. Choosing your groceries based on high antioxidant content alone is not going to help you reach optimal health or that next fitness goal.

Why ferment your food?

The main reason that people ferment their food in the modern era is for the suggested health benefits that it provides. Fermentation is a metabolic process where organisms, such as bacteria or yeast, covert organic compounds such as sugars and starch into alcohol or acids.

For example: Lacto-fermentation uses bacteria to convert sugar and starch into lactic acid. This produces foods such as yogurt, fermented vegetables like saurkraut and kimchi, and cheese.

I have a ‘gut’ feeling about some of the benefits of fermented foods..

Fermented foods contain ‘good bacteria’ and microbes which can increase your gut health.

Other suggested benefits include:

  • Increasing the levels of micronutrients in foods
  • Aiding digestion. Fermented milk products for example can contain enzymes which help to break down lactose, potentially making it easier to digest for people who are lactose-intolerant.
  • Increased availability of minerals. Some natural foods such as legumes and seeds contain phytic acid, which binds zinc and iron together. This means our bodies aren’t able to utilise these minerals. The fermentation process breaks this acid down, allowing our body to use those minerals.
  • Changes taste: If you prefer a tangy or sour twist to your food, this could be for you. Similarly, the process produces carbon dioxide, giving the food a bubbly quality; like soft-drink but without the guilt.

Be sure to read the fine print

Lacto-fermented vegetables are one of the most common fermented foods in Australia. Be warned: these are not mass-produced. So if you are buying these products, such a sauerkraut, from the supermarket then chances are they have either been preserved using vinegar or the organisms are already dead. You would be much better served setting your kitchen bench up as a fermentation station, or visiting your local health-food store or delicatessen for these products.

If you do decide to ferment at home, hygiene during this process is very important as you are working with bacteria. So please take care to avoid contamination with microbes such as E. coli and botulnum, which have been linked to multiple illnesses.

Also be wary that some of these fermented products contain a high sodium content, particularly if lacto-fermentation has occured.

The Verdict?

There certainly appears to be some health benefits associated with this latest craze, the most plausible being the live microbes that are added to the existing ones within our gut. This can aid in digestion and enhance our immune system functioning.

Some of the more far-fetched claims, such as reducing risk of cancer, do not appear to have any merit. In fact, the World Health Organisation has actually classified pickled foods as potentially carcinogenic.

My mantra as a physiotherapist is ‘knowledge is power’. If a client understands their condition, what contributed to it and what will help them recover, they are far more likely to achieve great outcomes. The same goes for nutrition. Be aware of whether the so-called ‘superfood’ you are eating actually lives up to the promise.

Don’t forget that correct nutrition is only one piece of the puzzle when it comes to optimal health. You also need to stay active and have an exercise routine that works for you.

Feel free to give us a call at SPS, where we pride ourselves on being experts in exercise prescription and advice.

Clinical Pilates at SPS Castlereagh Street


We are excited to announce that Clinical Pilates is now offered at our Castlereagh Street clinic! All of the classes and private sessions will be lead by our experienced physiotherapist and Pilates clinician Talia, who will provide a personalised approach to your exercise regime – whatever your fitness or experience level may be.

We are offering:

  • Mat classes: These are ideal for those who are new to pilates, returning to exercise from injury or would like to focus on the fundamentals of pilates and correct core activation. You will work through a variety of exercises on the mat using small equipment to challenge your posture and core control.
  • Equipment classes: For those of you who have Pilates experience or are wanting to be further challenged on the pilates equipment, these classes progress and challenge your core control with the use of the Reformer, Trapeze Table and small equipment such as swiss balls, foam rollers and hand weights. The class is run as a circuit providing a taste of each equipment in every class. Close supervision to posture and technique is maintained.
  • Pre-natal classes: Our pre-natal classes are suitable to join at any stage of your pregnancy if you have been cleared for exercise. These classes have an emphasis on exercise and education to give you confidence throughout your pregnancy and into labour. Activation of your pelvic floor and deep abdominals will be taught in functional positions, as you work through a variety of exercises using equipment such as the Reformer, Swiss Ball, Theraband and small weights to challenge your stability in different postures. As the class is led by a physiotherapist it is a great chance to manage any musculoskeletal aches or pains you might be experiencing.
  • Private (1:1) and Duet (2:1) sessions: These allow for more individualised sessions to introduce the participants to both mat and equipment-based exercises. The fundamentals of pilates can be consolidated and a home exercise program can be developed. These sessions afford you the freedom to book whenever suits your schedule and can be a great way to enhance your current training regime, or get you back into exercise.

To ensure correct technique and to maximise benefits from each session, we have a maximum of four people per class. This allows close supervision and the power to tailor each class to the participants needs.

TIMETABLE: Next term begins 26th June 2017

7AM – 7:45AM Equipment
8AM – 8:45AM Mat
12:30PM – 1:15PM Pre-natal
6:45PM – 7:30PM Equipment


  • Assessment: $136 (45 minutes)
  • Internal Assessment: $FOC (30 minutes)
  • Pilates Pack Private: $655 (45 mins) (Buy 5, get 1 free)

$535 (30 mins) (Buy 5, get 1 free)

  • Duet classes $86 (45 mins)
  • Duet class pack $430 (45mins) (Buy 5, get 1 free)
  • Small group class: $41/class ($328 – 8 week term)

$33/class ($528 -16 week term)

$45 casual class

Reception can be contacted on: 02 9264 4153 or for further information or to speak with Talia.

Pilates and Low Back Pain

Core Stability Exercise vs General Exercise for Chronic Low Back Pain

It has been well documented that Lower Back Pain, (LBP), is one of the most frequently reported disabilities (affecting between 60% – 80% of adults), we face in the community. Unfortunately, 40% of those suffering with LBP will not fully recover within the first 3 months.

As Physios and Pilates Clinicians, we see this type of presentation everyday.   At Sydney Physio Solutions, we are continuously striving to find the best way of helping to improve the experience and recovery in this population group.

A recent study, published earlier this year, found that people with LBP who undertook exercises to activate and gain control of their deep spinal stabilisers, aka “The Core”, had better outcomes in the first few months of treatment than those who didn’t.

In a nutshell……

  • “Core exercises”, (learning specific & correct activation of your muscles supporting the spine and pelvis), provide a better outcome during the first 3 months of intervention compared to general exercise alone for people with LBP.1


  • People with LBP display a decreased activation or delay in Transverse Abdominus (deep abs), and Multifidus (supporting spinal muscles). Thus core exercises consist of regaining the strength of these muscles through specific training. 1

At Sydney Physio Solutions, all of our Pilates Clinicians are physios, and thus have the ability not only to assess your core in real time via Ultrasound, but can also guide you personally on what exercises will help and how to progress these if you suffer from low back pain. Using this technology, you can guarantee you are receiving the most up-to-date, effective and evidenced based approach to managing your pain.


  1. Brian JC, Kenneth EG, Elizabeth RN, Lindsey EE. Core stability exercise Versus General exercise for Chronic lower back pain. Journal of athletic training 2017 Vol 52 (1) 71-72.

Clinical Pilates at Sydney Physiotherapy Solutions Chatswood

Clinical Pilates has landed at Sydney Physiotherapy Solutions Chatswood


Do you suffer from persistent or recurrent low back or pelvic pain?

  • A 2016 study on back pain and Pilates exercise showed significant improvements in disability, pain, flexibility and balance in patients with low back pain.
  • Multiple studies have also shown altered muscle activation patterns around the low back to be related to acute, and/or persistent low back pain.
  • Pilates exercises teach you how to effectively activate the deep core muscles of your back, abdomen and pelvic floor. Thus, helping to manage the source of your low back pain.
  • We also use real-time ultrasound to assess the activation patterns of your deep core muscles. This allows us to directly assess muscles and provide visual feedback to you.

The new Clinical Pilates classes are run by our Physiotherapist and Pilates Clinician, Brittney Marlowe. We cater for all experience levels from beginners to advanced. You will need to have an initial Pilates assessment prior to beginning classes, so we can identify your individual status, your needs and requirements, and goals for the term.

Health  Fund rebates may apply.

Class timetable

Monday 7.30am – 8.15am

Tuesday 1pm – 1.45pm

Thursday 6.15pm – 7pm


Group class (max 4 people per class)

Casual class – $45/class

One term (10 pack of classes) – $40/class (buy 9 get one free)

Private session – $98

Initial consultation – no gap*

Reception can be contacted on: 02 9419 2553 or for further information or to speak with Brittney.

Defying Gravity with the Alter-G

Here at Sydney Physiotherapy Solutions we understand how important it is for runners and other athletes to recover quickly so that they can continue participating in the sport that makes they love. We are dedicated to continuously educating ourselves in order to provide the the most current and effective treatment possible. This is why we have decided to introduce The Alter-G anti-gravity treadmill to our brand new clinic at 155  Castlereagh Street.

Working with runners and athletes is a specialty here at the clinic. Many of our therapists are runners themselves which gives us an advantage when treating running injuries as we understand the sport and have the necessary experience in treating the associated injuries. More importantly, we understand that most of our athletes would prefer to keep running while injured and so we have introduced the Alter-G to ensure that we can keep our athletes running.

Advantages of the Alter-G Treadmill

  • Helps minimize time lost from training, especially those training for an event such as a marathon
  • Maintains cardiovascular fitness during rehab
  • Reduces stress on joints
  • Improves bone density measures
  • Suitable for runners who may be overweight
  • Allows gradual loading as our injury heals during rehabilitation

Specific injuries that the Alter-G is suitable for

  • Knee osteoarthritis
  • Complex regional pain syndrome
  • Fibula stress fracture
  • Lumbar disc herniation
  • Metatarsal stress fracture
  • Plantarfasciatis
  • Ankle sprains
  • Tibial stress fractures
  • Navicular stress fractures
  • All types of muscle strains

To find out how the Alter-G AntiGravity Treadmill works read more here.

Physiotherapy in the Sydney CBD

A new physiotherapy clinic has opened in the Sydney CBD. SPS Pitt St, a favourite for city physio in the CBD, has moved to Castlereagh Street, and is now located at 155 Castlereagh Street. We offer flexible hours for those city workers who want to fit their treatment around work, right in the centre of Sydney CBD. SPS Castlereagh Street continues to provide Physiotherapy, Pilates, Massage and Corporate Injury Management Services, the same services you have come to expect, so for all your Physiotherapy needs in the city come and visit our new location.

We are very proud of  our team of expert physios, our state-of-the-art technology including the revolutionary anti-gravity treadmill and we are  committed to superior service from the moment you book your appointment. To read some reviews of past clients click here.

For general physio needs for everybody, to restore function and movement after an injury, illness or an operation, for specialised sports physiotherapy to assist you with acute or chronic injuries, for advice about beginning training and dealing with pain, the provision of exercise programmes and for clinical pilates, SPS Castlereagh Street is your one stop physio location.

To contact SPS Castlereagh Street you can call the same number 9264 4153 and for your convenience we offer the same online booking service so that you can schedule your appointment at a time to suit you.

Who is the top Physio in Sydney?

At Sydney Physio Solutions we aim to be the best physio practice in Sydney, providing physiotherapy, pilates, massage therapy, men’s health physiotherapy and corporate physiotherapy services. We are trusted for the knowledge and experience of our staff members. Our physiotherapists are experts in specific areas of the body so if you are searching for a physiotherapist, see an expert, not a generalist.

At SPS we offer the latest technology to assist in your rehabilitation, superior communication & the ease of online bookings in real time. We aim to make your physio experience the absolute best it could be.

100% of surveyed clients say they would refer us to friends & family: “I have been healed yet again at sydney physio solutions! A wholistic service designed to super charge your recovery and give you the tools to self manage the everyday wear and tear on the body  ” and “Fantastic physio providing great service! Helped heal issue I had with my right hand removing the pain and increasing my quality of life. Staff are wonderful and super friendly! Highly recommend this place for all your physio needs.” To read some of our reviews click here or more here

We have two clinics in Sydney CBD and a brand new physiotherapy clinic in Chatswood. All our clinics are staffed by highly qualified and expert clinicians whose motivation is to find the cause of your problem & return you to pre-injury fitness as soon as possible.

All clinics also contain a fully-equipped rehabilitation gym, private treatment rooms  and the latest technology such as dorsaVi and ShockWave Therapy.

Our professional and caring team of expert Physiotherapists are all highly qualified and continually engage in on-going professional development. There is a commitment to communication with you and a customised treatment plan focussing on the cause of your complaint not just the symptoms.

With two centrally located Sydney CBD Physiotherapy clinics conveniently located on Macquarie Street and Castlereagh Street, and a brand new clinic in Chatswood, Sydney Physiotherapy Solutions provides Physiotherapy, Pilates, Massage Therapy and Corporate Physiotherapy Services using the latest state-of-the-art technology.

Top Tips

Each week Virginia gives us her top tip. These are quick little snippets of advice which, if followed, will make a difference to your well being. Check back regularly to see updates or, if you would like to receive these tips, accompanied by an exercise of the week, delivered by email, let us know.

# 1. This week my focus and top tip is based around the timing of the activation of your deep core muscles.  In the ideal world, your core should activate prior to any change of position, exercise or general movement.  Failure in the timing of this can lead to your body “stealing” stability from elsewhere and becoming less efficient (e.g gripping through your hip flexors).  Pick at least 5 things you do everyday, and try to activate or check your core is on before and during the activity – don’t forget to breathe!

# 2.  This week my top tip is all about your feet.  Some of you will know if you have been in my pilates classes that I occasionally go on “foot patrol”, to see the posture of your feet as you stand, sit, or lie.  Ideally we like to see the feet sitting underneath the knee, and hips in good line.  Watch for one turning out to the side, or taking more of your weight. Remember, your feet are highly sensitive and take on a lot of load when when walk – so don’t forget to look after them!

# 3. This week my top tip relates to how we breathe. Often we can get caught up with taking short and shallow breaths from the upper part of the chest, which can tighten up the muscles of the neck and shoulder, but also means that we aren’t getting the most out of each breath. Diaphragmatic breathing encourages a full deep breath, relaxes the muscles around the shoulders and means we can optimise the uptake of oxygen.

Try placing your hands around the base and sides of the ribs as you breathe, feel the ribcage expansion as you inhale, and soften as you exhale.

# 4.  My top tip for this week relates to sitting posture.  If your day involves a lot of sitting, try to ensure good posture by keeping your feet flat on the ground and your lower back against the back of your chair.  Ideally you should directly face your monitor (if you are working at the computer), without any rotation through the spine.  Shoulders should feel relaxed from the ears and chin gently tucked in.  If you can, try to change your posture regularly through the day from sitting, to standing, walking etc.

# 5. My top tip for the week is all about how we look after our spine.
The spine is a machine which is designed to move, and remains strong and flexible by staying active.  By moving around, or even just a subtle tweak to your posture through the day, you allow the spine to manage the loads placed on it.

# 6. My top tip for this week relates to relaxing the muscles around your face and jaw.  Sometimes, without realising, we tend to clench our teeth and tighten the jaw.  This can sometimes lead to pain referring into the neck and face, or even a headache.  Through the day try to open and close the jaw and allow it to remain relaxed as you work.  You may be surprised at how tight it has been!

#7. My Top Tip this week relates to your lower back.  This is one of the most commonly strained areas of the body, so needs to have some attention!  Maintaining good flexibility around the lower back, hips and thighs, along with a regular strength and cardio programme can make a real difference to spinal health.  Variation in what you do is also important, so try to mix it up every 6-8 weeks to keep your body strong and your mind motivated!

#8. This week my focus returns to maintaining your neutral spine throughout the course of the day…we are all built with different spinal curves, so it’s helpful to be aware of where your neutral position is.  Try tilting your pelvis forward and back several times to find a comfortable middle ground. This should reduce pressure building up through your back with day to day posture & hopefully improve your awareness of your body position.

#9. This week my focus is all about your balance.  Sometimes we can become reliant on one side of the body more than the other, and naturally become much stronger on this side.  When you can, try and balance on 1 leg and see how steady you are compared to the other.  Try and aim for at least 10 seconds each side.  If you are a little unsteady, make sure you are near a wall or something solid for support.  If you find one side isn’t as good, work away on this as you can to help restore similarity.

#10. This week my focus is all about your balance.  Sometimes we can become reliant on one side of the body more than the other, and naturally become much stronger on this side. When you can, try and balance on 1 leg and see how steady you are compared to the other.  Try and aim for at least 10 seconds each side.  If you are a little unsteady, make sure you are near a wall or something solid for support.  If you find one side isn’t as good, work away on this as you can to help restore similarity.

#11. My Top Tip for this week relates to your feet, and more specifically, the small internal muscles that lie within them.   Like any other muscle group, the internal muscles of the feet can get tired and weak, and can be strengthened to help offload the joints of the foot and ankle.  My favourite exercise for this I call “The toe grippers”.  Take a small towel, place it under your foot and start to grip it as if you are trying to pick it up.  Repeat this on and off for 30-45 seconds, 1-2 times per day.

#12. My Top Tip for this week relates to your hands.  Similarly to your feet, your hands work a lot through the day and the small muscles within them, (along with the larger ones of the forearm), can get very tight and tired.  Give your hands some love by stretching out the arms every hour or so at work…this may simply be stretching the fingers out or extending the forearm and drawing the palm up or down.

#13. My Top Tip this week is all about keeping active.  Don’t underestimate the impact of going for a brisk walk, getting in the pool or even doing a home based programme with small weights.  With the seasons changing and the nights creeping in earlier it may be more tempting to head straight home after work, so try to mix up your routine and try something new!

#14. This week my focus is on looking after your neck whilst at work, especially if you sit or stand a lot through your day.  Try to keep your chin tucked in just a little, and if working on a computer ensure the screen is set at the right level, just so you aren’t looking down or twisting the neck to see it.  Every so often stretch the neck side to side and reset your posture.

#15. My Top tip for the week relates to the Thoracic (middle) spine.   This part of the spine is often the area we lean forward and hunch from when sitting, typing and even texting!  As it supports the rib cage and has an important role in our posture, it is important to keep it mobile and strong.  Simple movements such as rotating the trunk as you sit, or a cat stretch on hands and knees, can keep it from stiffening up.  Lifting the chest bone up slightly in sitting, along with broadening the collarbones, can be easy ways of encouraging a little more extension and length of the spine…

#16. This week my focus is on the ribcage.  Ideally, when we breathe, there should be a slight emphasis on getting your breath to the base and the side of the ribcage.  This is called “lateral breathing”, and encourages the diaphragm to be part of the process.  You can feel this happening if you gently rest your hands on the base of the ribs as you inhale. Whether you are sitting, standing, or simply lying down, test this out and you should feel the rise and fall of the chest wall.  This can help also to activate your deep abdominals, assist in relaxation of the body and also help direct stress away from your shoulders.

#17. My top tip for this week relates to how much we rest and sleep.  With life being as busy as it is, it is important to allocate sufficient downtime,  and get to bed early where possible, to allow our bodies to slow down and recharge.  Your body is busy as you sleep repairing itself and preparing you for the day ahead…so reward yourself by getting your 6-8 hours as often as possible!

#18. This week my focus turns towards planning your exercise for the winter months.  As the seasons change, the days get shorter and more chilly, it can be harder to go for the morning or evening walk or run.  Have a few alternative options if the weather is against you that you can do inside no matter what.  Maybe try your hand at swimming, the local indoor tennis centre, or even a touch of Pilates to see you through!  

# 19. My Top Tip for this week relates to those people who stand a lot through the day.  With the option in many workplaces now of the sit- stand desk, more of us are spending time on our feet, which is great.  If you are on your feet more through the day, keep an eye on your posture and every so often check that you haven’t started to stoop or lean too heavily on one side.  Small, subtle corrections and movements through your day can make a world of difference!

#20. As winter is now upon us, try to make sure you still get out at some stage through the day to get your dose of fresh air and Vitamin D.  It can make such a difference to your day just to get outside and get the legs moving, energising you for the rest of the day.  Alternatively, wrap up warm and hop off the bus or train a stop early and get a few extra steps in on your way home….it all adds up!

#21. This week, my focus is on how we hold up the weight of our head through the day. Every morning on the bus, I look around and sure enough the majority of commuters have the head down, scrolling along their texts, reading the news or checking out Instagram posts they may have missed overnight.  Although this definitely makes the trip go faster, it certainly doesn’t help the pressure around the muscles of the neck and shoulders.  Where possible, try and take a quick break from your phone and take the time to stretch out your body.  Think about lengthening up through the spine, rolling the shoulders and nodding the head side to side.

See you in the studio,

Virginia & the Pilates team

Hamstring Injury Guide


The hamstrings are a group of 3 muscles located in the posterior of the thigh, between the hip and the knee. They consist of the semitendinosus, semimembranosus and biceps femoris.                                                                                                                                                                                                                            The hamstring muscles run from the “sitting bones” (ischial tuberosity) at the base of the pelvis and finish behind the knee, attaching to the top of the fibula on the outside of the knee (bicep femoris) and tibia on the inside of the knee (semimembranosus, semitendinosus).


The main job of the hamstrings is to bend the knee, as well as helping to decelerate the knee during extension in activities such as walking and running. As the hamstrings cross both the hip and the knee, they also have role in extending the hip.


The main common origin of the hamstring complex is the ischial tuberosity. This is commonly called the seat bone and can be felt as a hard spot near the gluteal folds.

From here the hamstrings split into 3 muscle bundles. One passes towards the outside of the knee (biceps femoris) the other two head towards the inside of the knee (semimembranosus and semitendinosus).

The lateral hamstrings insert into the lateral tibia, lateral collateral ligament and fibular head.

The medial hamstrings insert into the superior and medial tibial border. They blend with the tendon of the gracillis muscle to become the pes anserinus tendon.

There may also be a bursa present at this location.


The hamstring is a prime mover for all activities which include flexion (bending) of the knee and extension (straightening) of the hip. It is also responsible for braking a knee or hip movement in the opposite direction.  

 Activities which depend on the hamstring to do both of these functions include walking, running, squatting, bending, lifting, kicking and rowing to name a few.                                                                                                                                                                                                                                                 If you combine some of these activities such as running and bending, or picking a ball up from the ground while running, the intensity demanded of the hamstring increases dramatically. 

The hamstring is also responsible for pelvic control. It pulls the pelvis into posterior rotation and facilitates anterior rotation by not activating. This has great importance for pelvic stability during static and dynamic activities.


The feeling of hamstring tightness is ambiguous and does not necessarily mean the hamstring’s physical and mechanical properties are under excess tension or shortened. It is possible to have one without the other.

It could be one of several different complaints which may include the following:

There has been a loss of range of motion around the hip joint, knee joint and lumbar spine.

End of range of motion around joints is restricted and requires extra effort to achieve this.

The movement around the joints may be fine but the hamstring just never feels relaxed.

The movement may be fine around the joints and the hamstring feels relaxed, but there is a mild pain in the hamstring, and is perceived as being “tight”.


Depending on what hamstring injury you have, pain can either occur in the muscle or the tendon. There are 3 main muscles that make up your hamstring, therefore depending on which hamstring muscle you have injured this will indicate the area of pain.                                                                                                                                                                                                                                                     Common areas of pain are centre of the muscle belly, where the muscle meets the tendon, where the tendon inserts into the bone, such as your sitting bone or tendon pain above the back of the knee.


Acute Hamstring injuries such as a tear are generally due to high velocity, intensive load being placed on the muscle. These also occur as a result of weakened or unconditioned muscles around the hip/pelvis and quads which can in turn put more strain through the Hamstring as it tries to compensate.  

Posture-wise you may be more at risk if you stand and move with your pelvis tipping forwards, or slumping back - this can put the Hamstrings at a disadvantage mechanically and may render them in a long, weak and or tight position.


There are two distinct types of Hamstring injuries, therefore it depends on the situation and the Sport undertaken as to which hamstring muscle can become injured;

Type 1 Hamstring strains occur during high-speed running. This is the more common type of Hamstring strain, and usually affects the Biceps Femoris, one of the parts of the Hamstring muscle, which meets the tendon near your Ischial Tuberosity (sit bone). These injuries are often more severe in their initial presentation, but recover much more quickly.

Type 2 Hamstring strains occur during movements leading to extensive lengthening of the Hamstrings when the Hip is also flexed, such as high-kicking, sliding tackle, and front-split – these injuries may occur at slow speeds, such as in gymnasts and ballet dancers, and can take much longer to rehabilitate.


Early management following a hamstring tear is crucial in determining your recovery time frame. The hamstring may bleed for several days. A RICE (rest, ice, compression, elevation) regime should be incorporated, whilst stretching should be avoided in this early period.

As soon as possible, pain permitting, exercise should commence to strengthen the hamstring again whilst also maintaining strength and flexibility of the unaffected musculature (eg glutes, calf). The PATS (progressive agility and trunk stabilisation) program is an example of an exercise program that studies have shown improves return to sport times and reduces re-injury rates.                                                                                                                                                                                                      Hamstring strengthening programs should progressively increase in intensity and incorporate different speeds and movements specific to your sport. When the hamstring is strong enough, you may return to training but you should successfully complete one week of full training prior to match play.

If the tendon, as opposed to the muscle, of the hamstring is thought to be the injured then you should follow a tendinopathy protocol. If you suffer from recurrent hamstring injuries then you may have a 'driver' from another area such as nerve tension which should be addressed using a neural mobilisation regime. To get a rehabilitation program tailored to your injury and needs, see an experienced physiotherapist.


A grading system is used to determine the extent of a hamstring injury:

Grade 1 = a mild strain - few muscle fibres torn, minimal/no loss of muscle strength, and minimal pain on contraction. May present with some mild swelling and bruising.

Grade 2 = moderate strain/tear - significant number of fibres torn, muscle weakness and significant pain on contraction of that muscle. Usually presents with significant bruising and swelling. Please note this can take a few days to appear particularly if the tear is very deep.

Grade 3 = Complete tear - this means the muscle has been torn completely with a severe weakness/loss of function and is often pain free on resisted testing. This injury presents with signficant swelling and bruising.


Hamstring cramping, especially cramps associated with a physical performance, is common and can be a painful and frustrating experience. However, despite their prevalence the exact cause is still unknown.

There is likely to be a combination of contributing factors though muscle fatigue seems the most likely. Muscle fatigue, or overload, may result from insufficient training/preparation, environmental conditions, intensity and duration of activity. The result of this overload is an increase in the excitability of the motor neuron, which may lead to cramping.

Several other theories, including the serum electrolyte theory, where it is thought that decreased electrolytes (e.g. Sodium, magnesium, potassium) caused by excess sweating (or overhydration) are being explored further by leading medical and sports scientists.There is a lot of potential in these studies for explaining and perhaps helping to prevent cramping.

The best that a person can do to prevent exercise induced cramps, is to ensure they prepare adequately for an athletic performance. This includes completing proper training, warm up, having the correct equipment and having an adequate diet and hydration.


Stopping a future hamstring injury is impossible, however, minimizing the likelihood of injury can be achieved through specific hamstring exercises.

These exercises should aim to achieve ‘strong and long/flexible’ hamstrings in comparison to ‘weak and short/tight’.

Whilst stretching exercises can help achieve ‘long’ hamstrings, certain strengthening exercises are more effective. Think ‘strengthen to lengthen.’

The godfather of hamstring strengthening is the Nordic Hamstring Exercise. (See below). 

According to at least half a dozen recent studies, almost two-thirds of hamstring injuries might be prevented by practicing the simple steps below. 



Steps: 1) Grab a partner or lock your ankles under a stable bar. Place your knees on a padded surface

2) Maintaining a straight torso (no bending at the hips or arching lower back), slowly lower yourself forward towards the ground.

3) Maintain position for 5 seconds and then break your fall onto the ground by placing your hands out in front of you. (Similar to a push-up position)

4) Repeat 10 times.


Hamstring curls:

As the hamstring muscles are knee flexors the aim of a hamstring curl is to strengthen these muscles by bending your knee.


Lying on your front with foot pointing down over the edge of a couch/table/bed, the athlete fully bends the knee – trying to touch your buttock with your heel.

Provided this is pain free, a resistance band or ankle weights can be used to increase difficulty.


Lying leg curls are the most direct exercise in isolating pure hamstring activity and strength. Other exercises such as Romanian deadlift or hyperextension exercises are hinging movements at the waist, working the hamstrings via the hip joint. That makes it more of a stretch exercise. The lying leg curl is more of a true and direct hamstring contraction exercise.


The lying leg curl is difficult to load unless you have access to a machine in a gym setting. The movement is not very functional in a sense that it is not a movement that happens naturally during the course of daily living (vs squat or deadlift).

Pain Triggers – Shoulder Rides




Most parents know kids can cause pain… literally. Lifting and carrying children can result in stress and strain on the parent’s body, back, shoulders and neck. The shoulder ride is a typical suspect. Despite being great fun for the child, it can quite literally be a pain in the neck for the parent as sometimes it is just quicker and easier to pick up a child when walking a long distance.

So how can a parent minimise the stress and strain on their own bodies?

  • If you absolutely insist on lifting a child up onto your shoulders, try having them stand on a higher (make sure it is safe!) surface such as a table, so that they are at the correct height. Remember its always much better to lift with your legs, rather than your back and this is no different
  • There are carrying devices on the market to assist in carrying children on the back or shoulders. These devices are potentially a safer option for the parent, and avoids the child needing to use a tight grip on the neck or head to hold on.
  • If carrying a baby or infant in the arms be conscious of alternating sides regularly to avoid overloading on one side only.
  • Limit the amount of time or the regularity of shoulder rides.
  • Know when to say no. Don’t attempt it if you are tired, or sore.
  • Know your limits. At some point in time your child will be simply too big to carry. Try and explain to them that it is no longer safe to keep carrying them.
  • Learn a few smart stretches to help keep you limber. Your friendly physiotherapist can guide you, or help you out if you’ve already suffered the effects before reading this advice.shoulder-rides


If you suffer from neck or back, it is best to commence neck treatment straight away.  Your physiotherapist has numerous tricks that can help to quickly relieve your neck pain and muscle spasm.

If you have had neck pain or stiffness for a month or more, your GP may be able to refer you to a physiotherapist in Sydney as long-term stiffness can be treated effectively at any time.

If you are not sure what to do, please contact Sydney Physio Solutions for advice or to make an appointment with one of our neck physiotherapists.