Laura Silcock

Looking for the best pillow?

A good pillow is just as important as a comfortable bed for getting a good night’s sleep ….

However if you suffer from back or neck pain, it’s important to look at your pillows.

There is no single pillow that will be best for everyone. The key to a good pillow is to make sure it is appropriate to your size, shape and position of sleeping. It is best that you sleep with your neck in a neutral alignment.

So, if you have broad shoulders and are a side sleeper you will need a larger pillow or possibly two flatter ones, to achieve a neutral neck alignment. If you are a back sleeper you will need a flatter pillow and very unlikely you will need two. The diagram below demonstrates this:

If you suffer from neck or back pain why not contact the team at Sydney Physiotherapy Solutions to make an appointment at either of our Sydney CBD physio clinics or at our recently opened Chatswood Physiotherapy clinic.


Protect Your Knees when Skiing

With winter approaching, Physio’s are getting ready for the influx of knee injuries from the slopes. Although knee pain from the kneecap is very common, the far more serious problem we often see is an ACL rupture. This is the ligament right inside the knee and it can get damaged from twisting injuries. Although obviously not all skiing injuries can be avoided here are a few simple tips to best look after your knees whilst skiing:

  1. Train your legs for at least 6 weeks leading up to your skiing holiday. Focus on gluteals, hammys and quads especially in single leg loading exercises.
  2. If you have the luxury of spending a long time on the slopes think about building up gradually to a full days skiing (especially if your body is just used to sitting all day) – also think about rest days to reduce injury from muscle fatigue
  3. Skiing technique – this is something you are probably going to need a ski instructor to help you with. Good form will inevitably lead to reduced injury.
  4. Binding setting – check with your ski technician these are set correctly for you and are functioning correctly. If you fall and your binding doesn’t release it will increase your chances of twisting at the knee joint!
  5. Of course most importantly if you are worried about a knee injury make sure you stick to your comfort zone! Happy skiing.


Top Back Exercises

My favourite exercises for back pain usually include lots of mobility exercises around the lumbar spine, thoracic spine and pelvis, such as…


Piriformis Stretch

Piriformis Stretch


Lumbar Rotation

Lumbar Rotation

Gluteal Stretch

Thoracic Extension

Thoracic Extension

Cat Stretch

Cat Stretch

Once these muscles are nice and loose we want to train the deep core muscles; these are muscles that help support the spine and are best visualised using RTUS (Real Time Ultra Sound)

If you are suffering from back pain please feel free to contact the team at Sydney Physio Solutions to make an appointment.

Shoulder Rehab Exercises Using Pilates

Pilates can be an interesting and fun way to rehab your shoulder.

My favourite Pilates shoulder rehab exercises are:

  1. Book Openings:

This exercise aims at increasing upper back range of motion in a gentle way

Book Openings 1                                                                                 to

Book Openings 2

  1. Superman in kneeling: this exercise works the shoulder blade stabilisers on the arm pushing the ground away. You can also add a leg lift simultaneously to increase the demand on the core and train your posterior oblique sling system.



Both of these shoulder rehabd exercises are commonly used in our Mat classes here at Sydney Physio Solutions.

If you would like to join a Pilates class to assist with your shoulder rehab, check our website or call 9252 5770.

Pilates for Runners!

I spend at least 50% of my day treating injuries caused by running! Most of these injuries could have been avoided if my clients had adequate control of their pelvis and lower limbs so they could run with good technique.

I know some patients find Physio exercises to be super boring and hard to keep up with once your pain settles down, which is why I suggest my patients join Pilates… or more specifically ‘Pilates for Runners!’

Pilates for Runners classes involves functional strengthening of the butt, abs and thighs in running specific positions. This means we do plenty of single legwork to practice stabilising the pelvis for running.

I find my patients really enjoy the classes and even once they are pain free and have improved their running form they stay on for maintenance as they  find it reduces their incidence of injuries.

If you don’t have a specialised ‘Pilates for Runners’ class in your area – a general Pilates class is a great start! I would struggle to think of a client who wouldn’t benefit from having a bit more Pilates in their life!

The Knee – Meniscus Injury

What is it?

–       The meniscus is a crescent shaped fibrocartilage  structure located within the knee joint

–       There is both a medial meniscus located on the inside of the knee and a lateral meniscus located on the outside

–       The menisci’s role is to absorb shock and distribute load at the knee joint

How is it caused?

–       Most commonly meniscal injuries are from a twisting mechanism

–       Can be degenerative or traumatic

–       Degenerative tears are more common in the older population but can also be due to repetitive overload

–       Traumatic tears are more common with athletes and more commonly medial injuries


–       Swelling and stiffness

–       Pain especially when trying to bend or twist the knee

–       Knee instability and giving way

–       Locking, popping or catching

What can be done to alleviate pain?

–       Rest, ice, compression , elevation

–       Strapping

–       Avoid aggravating activities

–       Guided strengthening programme to reduce meniscal overload

–       If tear is large may need MRI and onward referral to Orthopaedic surgeon for arthroscopic repair/debridement

Chances of requiring surgery?

–       Depends on size and location of the tear.  The meniscus has a poor blood supply; especially in the inner portion so if the tear is small and on the outer portion it will have a better chance of healing


Knee Pain (PFPS)

A common type of knee pain is patellofemoral pain syndrome or PFPS

What is it:

–       PFPS is pain experienced at the front of knee, normally around the knee cap.

–       It is very common especially in runners

How is it caused?

–       PFPS is normally caused by muscle imbalance and poor alignment at the knee


–       Pain at the front of the knee

–       Normally worse going downstairs and squatting

–       Can be painful with prolonged sitting

–       Can be associated with crunching or grinding when bending

What can be done to alleviate pain:

–       improve lower limb strength and control; primarily glutes (gluteus medius) and quads (VMO)

–       release lateral structures such as rolling on the ITB

–       improve sequencing of the inside vs outside quad (VMO vs VL)

–       taping the knee cap for pain relief

–       retraining mechanics to improve alignment

Can Too Forum – Ask a Question

At Sydney Sports & Orthopaedic Physiotherapy we are very proud of our association with Can Too Run & Swim.

In addition to the special offers to Can Too participants for Initial consultations  for physiotherapy and pilates assessments, we are again pleased to provide an open forum for quick advice from our expert physiotherapists.

If you have a question regarding training or injuries, please feel free to ask & our response will be within 24 hours.  If the leave a comment box is not displaying,  simply click the Read More button below.

We look forward to assisting in making your training more enjoyable and your goals more attainable.

Happy Training from the team at Sydney Sports & Orthopaedic Physiotherapy



Ice – When and How Much?

By Laura Silcock




As a physiotherapist, I have often been asked about the value of using ice on an injury. Ideally, ice should be applied as soon as possible after injury and treatment continued for 20-30 minutes.

A study by Mac Auley DC suggests that melting iced water applied through a wet towel for repeated periods of 10 minutes is most effective. The purpose of the treatment is to reduce the temperature by 10-15 degrees C to reduce the bleeding into the tissue, prevent or reduce swelling and to reduce pain. Using repeated, rather than continuous, ice applications helps sustain reduced muscle temperature without compromising the skin and allows the superficial skin temperature to return to normal while deeper muscle temperature remains low. This may be repeated every 2 to 3 hours for the next 24 to 48 hours.

More recently there has been debate over whether icing is limiting the body’s natural inflammatory response…. A 2004 literature review on the ability of cryotherapy to affect soft tissue injury healing looked at 22 eligible randomized controlled studies to determine if ice was actually helping, and the results were interesting. They all seem to conclude that ice is beneficial for pain control however not necessarily swelling or range of motion.

It looks like the jury is still out… I think icing, compression and elevation are still the current thoughts and not yet disproven but be careful not to overdo the icing as you do require a natural inflammatory response to make sure you do not delay healing.

Laura Silcock Physiotherapist