Firstly, knowing that physiotherapy can help headaches is a good start.

With any headache a full physiotherapy assessment is required to provide an accurate diagnosis for the correct course of treatment.

Headache is a pain in any region of the head. Headaches can range from an ache, throbbing pain or sharp pain that is on one side of the head or both. It can be isolated in one area or radiate to a large vague area around the head. While there are many types of headaches, tension type headaches, migraines and cervicogenic headaches are the most common. Below we will provide some insights into these headaches.

Tension type headache

Tension type headaches are the most common type headaches (commonly known as stress headaches). These headaches are more common in females than males (3:2 ratio). They are a dull pain, tightness or pressure around the forehead or the back of your head – it is commonly described like a clamp squeezing the skull.

Common symptoms

Tension headaches do not have nerve symptoms such as weakness or blurred vision. They do not have sensitivity to light or noise, stomach pain, nausea or vomiting.

Causes of tension type headache

Physiotherapy treatment for tension headaches

Physiotherapy and ongoing posture correction helps to prevent chronic problems. If you have excruciating pain in the head, or if it is your first or worst headache, you should consult your GP or attend the nearest emergency department to rule out any serious condition.

Cervicogenic headaches

Cervicogenic headaches are a referred pain arising from irritation to the neck. They are caused by problems with the nerves, bones or muscles in neck. This type pf headache affects males and females similarly (1:1 ration).

Cervicogenic headaches can be aggravated and relieved by certain neck movements. The headache presents as a steady ache or dull feeling with varying pain intensity. Usually mild to moderate and always accompanied by neck pain that moves to the head or face.

Common symptoms

Causes of cervicogenic headache

Physiotherapy treatment strategies for cervicogenic headaches

Migraine headache

A migraine can be episodic or a chronic headache. It is thought to be caused by an overactive nerves cell that cause sensations to be felt over the head and face. As a result of this overactivity, the body responds by releasing various chemicals causing increased swelling/inflammation leading to pain.

Prevalence of migraine

Common symptoms of migraine

There are many different types of migraine with varying symptoms and severity. Migraines may present either with or without aura. The headache can last between 4 hours and 3 days and have a mixture of symptoms.

Symptoms include:

Often feel vaguely unwell for a day or two beforehand (prodromal) with symptoms including:

Physiotherapy treatment for migraine headaches

The use of medicines to manage acute pain and symptoms is effective. In addition, prophylaxis is often needed to prevent recurrence and chronic migraine is often needed. Physiotherapy treatment can help in the ongoing prevention of migraines.

What is frozen shoulder?

Frozen shoulder is also called adhesive capsulitis. It presents as difficulty or inability to raise the arm above the head, or move the arm in different directions due to pain or stiffness. It is one of the most painful musculoskeletal conditions. Frozen shoulder occurs in up to 5% of people.

It is common to present with a lot of pain and stiffness. The shoulder capsule becomes inflamed and fibrotic resulting in pain and progressive stiffness. There is a significant restriction in range of motion (typically external rotation). It can take up to 2-3 years to recover.

Signs and symptoms of frozen shoulder

The main symptom is sharp, eye-watering shoulder pain when moving the shoulder, especially in movement of turning shoulder inward, outward and lifting above the head. There is a progressive loss of range in moving the shoulder.

In the early stages, there are difficulties with sleep due to the pain in the shoulder

People with frozen shoulder may have, difficulty:

How to confirm a diagnosis

Involving a physiotherapist in the diagnosis and management plan is best practice.

  1. Complete a thorough examination and assessment.
  2. Differentiate the diagnosis from rotator cuff injury as the treatment is different.
  3. Identify whether there is limited range of movement secondary to mechanical restriction or secondary to pain.

3 Stages of frozen shoulder

It is fairly well understood that frozen shoulder involves several stages. These stages reflect the series of processes from capsular inflammation and fibrosis to spontaneous resolution of this fibrosis.

1. Freezing (pain) phase: from 2 - 9 months.

2. Frozen (stiffening) phase: from 4 - 12 months

3. Thawing (resolution) phase: from 4 - 24 months

All 3 phases of frozen shoulder overlap by varying amounts

Some studies suggest that frozen shoulder is a self-limiting condition, but can last up to three years. However, other studies have shown that up to 40% of patients may have persistent symptoms and restriction of movement beyond three years. It is estimated that 15% of people may have persistent pain and long-term disability. However, effective treatments which shorten the duration of the symptoms and disability will have a significant value in reducing morbidity.

Risk factors for frozen shoulder

Managing frozen shoulder

Find a physiotherapist who understands your body’s anatomy and condition and start rehabilitation as soon as possible to speed up the recovery.

Treatment strategies

Strategies will vary depending on the phase and will include:

All exercise activities must be in the pain-free range and not provoke pain.

Does physiotherapy work for frozen shoulder?

Yes. physiotherapy is effective for frozen shoulder. Physiotherapy can help speed up the recovery process by reducing pain, improving stiffness and range of motion as well as strengthening the shoulder.

If you think you have a frozen shoulder call us to book an assessment. Our physiotherapists at Hurstville Physio Plus understand your condition and we will get you back on your road to recovery. We will plan your shoulder rehabilitation and give your body the treatment it deserves.

At Hurstville Physio Plus we prioritise building an exceptional team of physios. This allows us to continue to provide excellent physiotherapy services to our clients. We wouldn’t have it any other way!!

Meet Heath, our newest but not youngest member of our team. Hear him share his insights to what it's like to work at Hurstville Physio Plus.  An enthusiastic, energetic and driven young guy who just loves being a physio. So he certainly manages to brighten everyone's day!

Heath has a Master of Physiotherapy from the University of Sydney. He believes in a holistic approach to better health, using hands-on treatment, exercise prescription and coaching to help motivate clients to achieve their goals.

With a passion for treating Sports injuries, he easily gains a great rapport with our sports injury clients. He has experience working with National Premier League soccer teams so, soccer injuries and rehabilitation are right up his alley. He will soon have you safely back on the playing field.

He has also worked in a variety of different physiotherapy settings including geriatrics and neurological rehabilitation.

He enjoys training in the gym, spending time with his friends and family and has a keen interest in Formula 1 racing and Rugby League.

With gyms reopening this week you need to have a plan for how to safely return to your pre-isolation gym exercise routine. A lot can happen to your body in 3 months and you need to be kind to it to get the rewards you're looking for.

How will isolation affect your return to the gym?

Many people have continued with regular exercise at home but the type and intensity may have been quite different from what they were doing before, leading to reduced strength and conditioning. For those who used their extra time to increase walking, cycling or running their cardiovascular fitness may have dramatically improved however their strength may have deteriorated. Many have been more sedentary and significantly reduced their energy output leading to reduced overall fitness.

Your muscles and tendons are likely to have shrunk during COVID-19 isolation and this makes you more susceptible to injury. You may feel great after your first few sessions, however, niggles may appear or you may get a flare-up of a previous injury. This is your body telling you to slow down, decrease frequency, intensity and duration, or take a rest.

If you start off by placing too large of a demand on your body, you run the risk of injury and a return to isolation – exercise isolation!!

Tips for a healthy return to the gym and to avoid injury

Most of all you need to look after your own health and safety in the gym. You may choose to drop your weights rather than have a spotter or do exercises you are familiar with rather than trying something new and having poor technique.

Be mindful of your end goal and do your best to stay on track – avoiding injury setbacks.

You know where we are if you need us to check your technique and advise you on safely returning to your pre-COVID exercise program.

Physiotherapy is an essential healthcare service during the COVID-19 pandemic. Mobile physiotherapy home visits to clients in their own homes and Aged Care facilities are encouraged to continue. It is essential that vulnerable patients with chronic health conditions or those recovering from operations or injuries continue to have the best physiotherapy treatment they deserve.

We provide mobile physiotherapy service to St George and Sutherland Shire. Our experienced physiotherapists visit clients in their own home to help them continue moving well and following their path to recovery. This may be particularly helpful for clients who are strongly advised not to leave the house for their own protection during the COVID-19 crisis:

Our experienced physiotherapists can visit you or your ageing loved ones in the convenience of your own home to support healthy and mobile living. We provide effective physiotherapy treatment in the comfort of the client’s own home for:

Making sure you or your loved ones remain safe, mobile and happy is now more important than ever because usual social arrangements have been cancelled and visits from relatives and neighbours are now restricted. We can develop balance, strengthening and mobility exercise programs to help you or your loved ones be more confident and safe at home.

Our caring and experienced team will guide you and your loved ones through how we can work together.

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