“Why reading this post is NOT good for you”

You’re probably reading this post inside, sitting on a chair, on a phone or computer screen. Yet spring in Australia is the time when the outdoors beckons. We go to the beach in droves, have picnics and barbecues, paddle and fish and swim. Some hike, others bike, and a few do both (although not at the same time!) But these good times in the outdoors are an exception to the rule, which is that most of us spend the vast majority of our time inside. According to one estimate, the average person spends 90% of his or her life indoors, and as we get older we become even more inclined not to venture out.

When we do, there’s a gantlet of precautions: slather on the sunscreen; take it easy if air pollution is bad; watch out for ticks, mosquitoes, and other creatures that might bite. It’s all very well-meaning but it also reinforces indoor ways. But despite these irritations, the study results are ticking up: spending time outdoors has discernible benefits for physical and mental health. Here are five potential benefits of spending more time outdoors:

  1. Your vitamin D levels will go up

Vitamin D is called the sunshine vitamin because sunlight hitting the skin begins a process that eventually leads to the creation of the biologically active form of the vitamin. Over all, research is showing that many vitamins, while necessary, don’t have such great disease-fighting powers, but vitamin D may prove to be the exception. Epidemiologic studies (i.e. studies on large populations) suggest it may have protective effects against everything from osteoporosis to cancer to depression to heart attacks and stroke. Even by conventional standards, many people don’t have enough vitamin D circulating in their bodies. The good news is that you’ll make all the vitamin D you need if you get outside a few times a week on a sunny day and expose your arms and legs for 10 to 15 minutes.

There are some snags. Vitamin D production is affected by age (people ages 65 and over generate about a fourth as much as people in their 20s) and skin colour. Another problem is that sunscreens are most effective at blocking the ultraviolet B (UVB) light, the part of the spectrum that causes sunburn, but UVB also happens to be the kind of light that kick-starts the generation of vitamin D in the skin.

The either-or of sunscreen and sunshine vitamin has stirred up a lot of controversy and debate between pro-sunscreen dermatologists and the vitamin D camp. But there is plenty of middle ground here: some limited sun exposure on short walks and the like, supplemented with vitamin D pills if necessary, and liberal use of sunscreen when you are out for extended periods, particularly during the middle of the day.

  1. You’ll get more exercise (especially if you’re a child)

You don’t need to be outside to be active: millions of people exercise indoors in gyms or at home on treadmills and elliptical trainers. Nor is being outside a guarantee of activity. At the beach on a summer day most people are in various angles of repose.

Still, there’s no question that indoor living is associated with being sedentary, particularly for children, while being outdoors is associated with activity. According to some surveys, children spend an average of 6 hours a day with electronic media (video games, television, and so on), time that is spent mainly indoors and sitting down. British researchers used Global Positioning System devices and accelerometers, which sense movement, to track the activity of 1,000 children. They found that the children were more than doubly active when they were outside.

Florence has many fun things to do for children of all ages!

Adults can go to the gym. Many prefer the controlled environment there. But if you make getting outside a goal, that should mean less time in front of the television and computer and more time walking, biking, gardening, cleaning up the yard, and doing other things that put the body in motion.

  1. You’ll be happier (especially if your exercise is ‘green’)

Light tends to elevate people’s mood, and unless you live in a glass house, there’s more light available outside than in. Physical activity has been shown to relax and cheer people up, so if being outside replaces inactive pursuits with active ones, it might also mean more smiles and laughter.

Researchers at the University of Essex in England are advancing the notion that exercising in the presence of nature has added benefit, particularly for mental health. Their investigations into “green exercise,” as they are calling it, dovetails with research showing benefits from living in proximity to green, open spaces.

In 2010 the English scientists reported results from a meta-analysis of their own studies that showed just five minutes of green exercise resulted in improvements in self-esteem and mood. It’s hard to imagine how a stroll in a pretty park wouldn’t make us feel better than a walk in a drab setting.

  1. Your concentration will improve

Richard Louv coined the term “nature-deficit disorder” in his 2008 book Last Child in the Woods. It’s a play on attention deficit hyperactivity disorder (ADHD). Researchers have, in fact, reported that children with ADHD seem to focus better after being outdoors. A study published in 2008 found that children with ADHD scored higher on a test of concentration after a walk through a park than after a walk through a residential neighbourhood or downtown area. Other ADHD studies have also suggested that outdoor exercise could have positive effects on the condition. So if you have trouble concentrating — as many do — you might see if some outdoor activity, the greener the better, helps.

  1. You may heal faster

University of Pittsburgh researchers reported in 2005 that spinal surgery patients experienced less pain and stress and took fewer pain medications during their recoveries if they were exposed to natural light. An older study showed that the view out the window (trees vs. a brick wall) had an effect on patient recovery. Of course, windows and views are different than actually being outside, but we’re betting that adding a little fresh air to the equation couldn’t hurt and might help.

So what are you waiting for? Leave your screen, and head outside. Your health, body, mood and mind will thank you for it.


Contact us for more information or to make an appointment.

For a complimentary copy of John Perrier’s book “Back pain: How to Get Rid of it Forever” please follow the links below.

In Australia – click here:  http://www.amazon.com.au/Back-Pain-How-Forever-Causes-ebook/dp/B00UV5450U/

Elsewhere – click here: http://www.amazon.com/Back-Pain-How-Forever-Causes-ebook/dp/B00UV5450U/

I acknowledge the work of the Harvard Health School for the sontent of this article. http://www.health.harvard.edu/newsletters/harvard_health_letter/2010/july


Arthritis: do I have it? What can I do about it?

What is Arthritis?

Arthritis is a group of musculoskeletal conditions in which there is wearing and inflammation of the joints causing chronic pain, swelling and stiffness.  Nearly 3.3 million Australians have a disability due to arthritis and related conditions, and more than half of these have chronic or recurrent pain. Even though many different conditions are labeled as arthritis,they each have very different causes and so require different treatments. The most common forms of arthritis are:

  • Osteoarthritis (OA). This is by far the most common type. It is caused by wear-and-tear that grinds away at the smooth lining of cartilage that covers the joint surfaces, exposing the rougher bone underneath. This process causes pain, stiffness, creaking and sometimes swelling. osteoarthritis_diag
  • Rheumatoid arthritis (RA) This is an inflammatory disease that primarily attacks the small joints in the hands and feet. It is caused by a dysfunctional immune system in which your own cells attack the joint linings.

    rhematoid arthritis

    rhematoid arthritis

  • Gout is usually found in the big toe joint. It is caused by a build up of crystals within the joint.
  • gout


  • There are many other different but rarer types of arthritis such as Ankylosing Spondylitis, Juvenile arthritis and Systemic lupus erythematosus (lupus), just to name a few!

Is my sore joint arthritis?

There are many different reasons why your joints may be sore. Not all pain in your joints is caused by arthritis. It could be from an injury or using your joints and muscles in an unusual way (for example, playing a new sport or lifting heavy boxes). Talk to your physio if you have pain and stiffness that:

• starts for no clear reason

• lasts for more than a few days

• comes on with swelling, redness and warmth of your joints.

How can I find out if I have arthritis?

Your physio will ask you about your symptoms and examine your joints. They may do some tests or x-rays, but these can be normal in the early stages of arthritis.  Your physio may also send you to a doctor for blood tests, or to a specialist for a surgical opinion, if either is warranted.

The Role of Exercise

Moderate, regular exercise has been proven to aid in the prevention of arthritis, and offers you a host of side benefits.  Exercise can reduce your joint pain and stiffness, build strong muscles around your joints and increase your flexibility and endurance.

The Role of Physiotherapy

If you have OA you could benefit from physio work to loosen your joints, and electrotherapy to ease your pain and inflammation. We can also give you muscle strengthening exercises to realign your joints—almost like giving your car tyres a wheel alignment. Localized, specific massage techniques can also break up the ’rust’ from your affected joints, greatly reducing your pain.

hip stretch

Loosening a hip joint to lessen the effects of arthritis

Physiotherapy can reduce arthritic pain and reliance on drug therapy. Unlike pharmaceuticals, physiotherapy has few side effects or contraindications. So although arthritis is a chronic disease, treatment and management techniques can control and reduce the effects of the condition, and prevent further deterioration.

Almost like a miracle cure!




“How to get rid of joint pain that is bought on by cold and rainy weather.”

With autumn now approaching and the temperature starting to drop, you may hear a lot of people complain that their bone and joint discomfort worsens. This is a common statement around this time of year. This change can be due to a drop in barometric pressure.

rainy day

How does air pressure relate to joint pain? When there is less pressure on the outside of the joint it allows the swelling inside to increase just a tiny bit. This extra swelling can be the difference between a good day and a bad one.  Air pressure tends to drop even more when it is raining, so cold wet days often feel the worst.  

A hot bath or heat pack married with a good anti-inflammatory cream is often enough to ease the symptoms, but if you find your aches and pains are overstaying their  welcome then your best  treatment is, of course, a few sessions of physiotherapy.

The Role of Physiotherapy

Patients with arthritic or wear-and-tear  disorders may benefit from joint mobilization, electrotherapy,  hydrotherapy and muscle strengthening exercises. Localized, specific massage techniques can also break up the ’rust’ from the joint, greatly reducing the pain.  When done together, these techniques not only reduce the swelling and inflammation in a joint but they loosen it up, giving everything more room to move. This extra space means that the joint does not ache as much, even if the weather outside is cold or rainy.

The Role of Exercise

Moderate, regular exercise has been proven to aid in the prevention of arthritis and joint stiffness, and offers a host of benefits to  sufferers.  Exercise can reduce joint pain and stiffness, builds strong muscles around the joints and increases flexibility and endurance.

What type of exercise should I be doing?

  • Water exercise- such as aqua aerobics or swimming laps—especially if done in a warm pool. This non-weight bearing exercise provides the fitness without the joint pounding associated with land-based activities.
  • Tai chi, yoga, and stretching will help to get you looser if done on a  regular basis
  • Pilates will help to strengthen your core muscles and make sure that you are balanced. When your muscles are balanced your joints will move properly, minimizing the wear and tear.
  • Walking or light jogging, depending on your body’s general condition and specific problems such as knee or hip wear-and-tear.

Please contact us if you have any queries, especially aches that appear as the weather cools.

More on bursitis: what is it, and how is it treated?

A bursa is found where muscles and tendons glide over bones.  We have more than 150 bursas in our bodies.  These small, fluid-filled sacs lubricate and cushion pressure points between our bones and the tendons and muscles near the joints.  Without the bursa between these surfaces, movements would be painful due to friction.

Swelling ion the elbow is usually due to bursitis

Swelling in the elbow is usually due to bursitis

The bursa can be thought of as a self-contained bag with a lubricant and no air inside. If you imagine rubbing this bag between your hands; movement of your hands would be smooth and effortless. That is what a bursa is meant to do; offer a smooth, slippery surface between two moving objects.

What is Bursitis?

Bursitis is a painful inflammation of a bursa, that normally cushion the bones, tendons, and muscles from rubbing against each other. When a bursa becomes inflamed, the bursa loses its gliding capabilities, and becomes more and more irritated and painful when it is moved. The added bulk of the swollen bursa causes more friction within an already confined space. 

What Causes Bursitis?

Repetitive Irritation

Bursitis usually results from a repetitive movement or due to prolonged and excessive pressure. People who have weak hip muscles and tend to sway as they walk can develop hip (trochanteric) bursitis. Similarly in other parts of the body, repetitive use or frequent pressure can irritate a bursa and cause inflammation.

Traumatic Injury

Another cause of bursitis is a traumatic injury. Following trauma, such as a car accident or fall, a patient may develop bursitis. Usually a contusion causes swelling within the bursa. The bursa, which had functioned normally up until that point, now begins to develop inflammation, and bursitis results. Once the bursa is inflamed, normal movements and activities can become painful.

Systemic Diseases

Systemic inflammatory conditions, such as rheumatoid arthritis, may also lead to bursitis. These types of conditions can make patients susceptible to developing bursitis. 

How is Bursitis Commonly Treated?

Bursitis pain usually goes away within a week or so with proper treatment, but recurrent flare-ups are common and can be frustrating.  You should apply ice, avoid activities that reproduce your pain and seek professional advice. Non-steroidal anti-inflammatory drugs are usually ineffective in the treatment of bursitis since the bursa is isolated from your blood supply. You may however try applying an anti-inflammatory gel.

Bursitis is a symptom caused by many other factors, that if you don’t solve, will render you vulnerable to recurrences. Our Physiotherapists are highly trained in identifying the biomechanical or training causes of bursitis to quickly solve your pain and stop it returning again.  We recommend that you seek the advice of one of our Physiotherapists to tailor a program to suit your specific needs and to get you back on track again.

For more information in Bursitis please see our main website, our previous post on this condition, or contact us  

“What has a newspaper cartoon got to do with my back pain?”

A recent B.C. cartoon published in our local newspaper reminded me of the evolution of the human spine. Remarkably, the cartoonist goes a long way to explaining why about 3/4 of people end up with back pain at some stage of their lives.


This cartoon remarkably goes a long way to explaining the prevalence of back pain. Read on to find out why.

The following extract is from my book “Back Pain: How to get rid of it Forever“. It takes a light-hearted look at the science behind this cartoon. Enjoy!

The Evolution of the Spine – from Elasmobranches to Human Beings

Mother Nature designed our spinal column over a very long period. Helped by her design team of natural selection and evolution, she gradually fashioned the extremely complex systems that form the human spine.

The process began about half a billion years ago, when an otherwise inconspicuous ocean-dwelling animal called an Elasmobranch developed a spine. The Elasmobranch’s spine was a flimsy affair, whose chief function was to provide protection for the bundle of nerve fibres that ran down the creature’s back. Despite this inauspicious beginning, the vertebral column had arrived.

Over the next lazy 100 million years or so, other sea life such as primitive fish slowly evolved spines. These spines were also very simple, and made from soft cartilage rather than bone. They gradually assumed another job besides protecting the nerves: to provide an attachment for the fish’s muscles. This extra control allowed them to swim, and thus survive, more efficiently.

Then, about 400 million years ago, the fish did something that had a huge effect on our spinal development: they migrated to land. With this audacious move came a new problem for the spine. Gravity.

Helped along by the very small changes that are evident from one generation to the next, these early amphibians gradually developed newer, different models of the spine. The quality control manager, natural selection, tested each new design. Those animals with more efficient spines had a better survival rate, meaning that their descendants, the reptiles, inherited better backs.

By the time mammals arrived about 250 million years ago, the vertebral column had developed many desirable characteristics:

• The individual building blocks of the spine were now constructed from dense bone rather than cartilage. This change allowed them to bear more weight.

• The vertebrae – the back bones – developed joint structures that allowed extra movement.

• Shock-absorbing mechanisms evolved that helped to protect the bones from fracturing in the rough-and-tumble of prehistoric Earth.

• Strange lumps and bumps of bone developed on the vertebrae. These protuberances provided leverage for muscle attachments, allowing more precise movement control.

For a time, everything was happy in Mother Nature’s spinal design department. She had an efficient, working model that allowed good movement, offered a firm attachment point for both muscles and ribs, while offering vital protection to essential nerve structures.

Then about fifteen million years ago, probably just on a boring Tuesday or Wednesday afternoon, all that contentment dramatically changed. Something happened that would alter the requirements of the spine, and therefore its structure, forever.

An apelike creature began to walk on two legs.

Why did the ape do this? Well, nobody knows for sure. However, scientists and anthropologists suspect that the motivation was so that the creature could use its front legs – its arms – for tasks such as using crude tools, or brandishing weapons for self defence. Two-legged stance also liberated the front legs for the useful purpose of carrying objects like food, or beer cans.

ape cartoon

Mother Nature and her design team now had a new function required of the spine: to support the trunk in the upright position. Suddenly, the architecture of the lower back needed a drastic overhaul.

Undoubtedly, the first versions were poor. Any decent spinal health practitioner would have made a fortune had they been around during these early reformative millennia. However, as the centuries ticked by, evolution again provided gradual improvements. The pelvis and hips gradually changed their alignment so that the legs were roughly in line the trunk, rather than jutting out at right angles like a quadruped’s limbs. The abdominal muscles also changed their function so that they supported the spine in an upright position, rather than simply being a sling for the stomach and intestines.

As we developed, tree climbing became an occasional diversion rather than a semi-permanent home. Our tails, which were no longer necessary, steadily disappeared … which I, for one, think is a bit of a shame. Imagine how much fun you could have at a party with a fully functioning tail.

Recently, only a mere two or three million years ago, we human beings emerged from the developing gene pool. We now walked upright most of the time. In response, the spine made one further adaptation: it developed some inward and outward curves. Besides providing some extra leverage for the postural muscles, the curves had a springlike effect that helped the spine to absorb shock.

Finally, after a 500 million-year journey that started with a mutant fish, the spine arrived at the current model.

Despite the miracle of design, I award Mother Nature only nine out of ten for her efforts in spinal architecture. Why the deducted mark?

The lower back is probably the weakest mechanical link in the entire human body. It is responsible for more musculoskeletal pain than any other area. Compared with other masterpieces like the brain and the hand, the lower back looks decidedly amateurish. Paradoxically, the probable reason for this weakness also lies in the mechanism of evolution.

In our earliest caveman days, health problems of all kinds beset the average human being. Even a simple cut or abrasion was often fatal, while the most common form of death was infection from tooth decay!

Because of these appalling health problems, most human beings died at a very young age, usually less than thirty. Of course, most reproduction and parenting had to be completed by the early twenties to squeeze into this limited lifespan.

Because of the early parenting age, the natural selection process had no chance to attack the residual problems in the lower part of the spine. Most people had already produced their offspring and/or were dead before they had even begun to develop a bad back, which, as we will see later, usually occurs first in early middle age.

So we passed this weak genetic link from one generation to the next, while it patiently waited to make its presence felt when the human lifespan elongated. Now, as the average length of life approaches eighty years, we are, as a race, suffering with far more back pain than our early ancestors could have imagined.

“Back Pain: How to get rid of it forever” is available from the PhysioWorks web site, direct from our Brisbane practices at Bulimba and Mansfield, and online from www.amazon.com or www.smashwords.com . It will soon be available as an e-book online, so please watch this blog for more information.

Rugby injuries: how to prevent them.

Rugby is a fast-moving and high-intensity team sport. Most teams are now starting the competitive phase of their season. It is a sport with a high injury rate, although with physio input and sensible rule changes, that rate is dropping. Let’s have a look at some injury statistics, and discuss what can be done to help further.

rugby injuries
Rugby injuries can be serious

As many as 1 in 4 rugby players will be injured during the season. On average each player performs up to 20-40 tackles per match. Approximately half of all injuries occur while a player is tackling or being tackled.

Other factors that injury analysis shows are risk factors include:

  • A lower ranked or less skilled team within the division. Almost 25% of neck injuries occur when there is a mismatch in experience between the two opposing front rows.
  • a forward position
  • beginning of the season. This suggests that pre-season conditioning could reduce injuries. Physiotherapy can play a large role.
  • Most injuries are experienced by 10-18 year olds.
  • More injuries occur during matches (57%) than in training, and more often in the second half of the game.

Injury prevention strategies to reduce the incidence and severity of rugby injuries include coaching on defensive skills, correct tackling technique, correct falling technique and methods to minimize the absorption of impact forces.

To reduce scrummaging injuries at lower rugby levels, props should crouch, touch, and then set. This technique is called Depowering the Scrum. Another alternative is Sequential Engagement where the front rows engage first and then the second row joins in, so that a stable scrum is established.

Many injuries are those that linger through the season, or are exacerbations of previous problems. Physiotherapy can sort these injuries out now so that your chances of playing an uninterrupted season are much higher.

To read more about rugby injuries, please see http://www.physioworks.com.au/Injuries-Conditions/Activities/rugby-union-injuries or visit us directly at http://www.physioworks.com.au/Bulimba/bulimba.htm or http://www.physioworks.com.au/Mansfield/mansfield.htm