Paul Atkinson Physiotherapy | Physical therapist

Paul Atkinson Physiotherapy

Phone: +61 474 063 353

Address: 9 leura avenue 6010

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25.01.2022 The biggest effects in life long health come free to us. Eating well, exercising regularly, Sleeping well and taking time to look after our mental health show the best long term health effects. Great post from @adammeakins #health #healthylifestyle #perthhealth #perthmentalhealth #exercise #sleep #diet #nutrition #physio #physicaltherapy #exercisetips #perthphysio #claremontphysio #fitness

25.01.2022 ACL Re-injury: Those who fail to achieve greater than 90% of the contralateral side in strength and hop distance tests, have a risk of injury of 38.2% (vs 5.6% in those who did achieve >90%).Grendem et al. 2016. This is a major reason why rehab of an ACL must be thorough, with objective measurements to assess progress and suitability for return to sport. This study, with 100 participants also found that the re-injury rate was reduced by 51% for each month return to sport wa...s delayed until 9 months. After 9 months no further risk reduction was found. Remember, leg symmetry indexes are important, however, it is likely that deficits are present on the unaffected side. This means additional tests that utilise normative data and objective measures are also required. If you have had an ACL reconstruction or injury, I am starting a new periodical testing service. Follow the link below (follow to senior physio review-Paul) to book in for a full review. Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L., & Risberg, M. A. (2016). Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med, 50(13), 804-808. doi:10.1136/bjsports-2016-096031

24.01.2022 Returning to Exercise after child birth can be challenging. This is due to significant changes in the body during this time, as well as the mental and physical challenges that come with caring for a newborn. This guide gives a great timeline to both the person and clinician to safely guide the return to activity. BJSM, 2019. Feel free to tag anyone who may be currently pregnant, or are returning to exercise post pregnancy. #Exercise #pregnancy ... PA

24.01.2022 Hip and Groin Pain Clinical Assessment Here is the recommend clinical recommendations from the Zurich Hip Consensus, BJSM 2020 . If you are managing athletes with hip and groin pain, or you currently are undergoing treatment yourself, these areas should be addressed and used as an assessment tool ... @bjsm_bmj #hippain #groinpain #physiotherapy #sportsmedicine #sportrehab #sportrecovery #perthphysiotherapy

23.01.2022 Females are 1.7 times more likely to sustain ACL injury This disparity is also highest at an amateur level of participation, meaning that the lower the level of participation the higher the risk. ACL's are one of the best known sporting injuries. We even have commentators diagnosing the injury on tv, pointing out the tell-tale pivot-shift mechanism. Although there are more men sustaining ACL injuries, there are also more men participating, so the number of injuries is only pa...rt of the story. One in 29 female athletes ruptured their ACL in a window that spanned from 1-25 seasons. Vs 1 in 50 for male athletes. Incidence rate is high in both groups, but higher in females. Interestingly amateur athletes were at a higher risk of injury. My thoughts as to why are due to less strength and conditioning history, less expert input to training and biomechanics. So know matter what part you are participating; improving strength and movement control should be a pillar of your training. Montalvo AM, Schneider DK, Yut L, et al What’s my risk of sustaining an ACL injury while playing sports? A systematic review with meta-analysis British Journal of Sports Medicine 2019;53:1003-1012. #ACL #ACLrehab #ACLinjury #kneeinjury #knee #claremontphysio #physioperth

23.01.2022 11 ways to know if your Healthcare Provider giving you best practice management. In clinic it is difficult to do all of these all the time, but regular self reflection can enhance your client care and outcomes by prioritising these 11 elements. Great infographic by @sportsmedicineni . #perthphysiotherapy #physiotherapy #physicaltherapy #physicaltherapist #fitness #perthfitness #claremontphysio #healthtips #healthcare #healthcareeducation #exerciseismedicine #sportsmedicine #injuryadvice #sportsinjury #sportsinjuryrehab

22.01.2022 Complete ACL Rehab reduces risk of osteoarthritis progression. . Osteoarthritis (OA) is highly prevalent following an ACL Injury. This study showed that those who completed functional testing of 90% leg symmetry testing at 12 months had a much lower incidence of OA progression. . The testing performed here focused on hopping / landing / plyometric ability. This is often an area that is insufficient in many ACL rehab programs. This should be a key component in ACL rehab, an...d can be incorporated at an early stage in a controlled manner. If you are seeking more individualised advice on your ACL rehab, email me on [email protected] for a Telehealth review. . #physicaltherapy #physicaltherapist #fitness #perthfitness #claremontphysio #healthtips #healthcare #healthcareeducation #exerciseismedicine #sportsmedicine #injuryadvice #sportsinjury #sportsinjuryrehab #paulatkinsonphysio #painadvice #aclrecovery #aclrehab #kneerehab #aclsurgery

21.01.2022 ACHILLES TENDINOPATHY: Risk Factors - what the evidence says. Tag a friend you know who has, or treats those with Achilles injuries. Although the Achilles tendon is the largest and strongest tendon in the human body, it is prone to injury. Achilles tendinopathy is a load related injury, and is characterised by pain and swelling locally in the Achilles with a reduced loading capacity. ... Over half of elite runners will experience an Achilles Tendinopathy in there lifetime. Clinically we will see an onset of symptoms with an increase in loading intensity or frequency, and this is consistent across general and athletic populations. This systematic review (high level of scientific evidence) found the following to be risk factors for achilles tendinopathy: 1. Prior low limb tendinopathy or fracture 2. Use of ofloxacin (quinolone) antibiotics * 3. Moderate alcohol use 4. Training during cold weather 5. Decreased calf strength 6. Abnormal gait pattern with decreased forward progression of propulsion 7. More lateral foot roll-over at the forefoot flat phase 8. Creatinine clearance of <60ml/min in heart transplant patients Clinical Pearl: Note how quinolone antiobiotics are a risk factor- if you have taken these medications a slow and gradual increase in loading is essential. This is a perfect example of why taking a full medical history can give you key clinical information. If you suffer from Achilles Tendinopathy, a management that emphasizes strengthening the lower limb (especially the gastrocnemius and soleus) and gradually increases training load is going to give you the best results. Unfortunately just rest and return to previous activity levels can result in reinjury as the tolerance of the tendon to load has not increased. #physiotherapy #perthphysiotherapy van der Vlist AC, Breda SJ, Oei EHG, et alClinical risk factors for Achilles tendinopathy: a systematic reviewBritish Journal of Sports Medicine Published Online First: 04 February 2019. doi: 10.1136/bjsports-2018-099991

21.01.2022 Bang for your buck Excellent post by @thestrengthcontinuum giving a simple breakdown of which training method shows the greatest efficacy in terms of injury prevention. . 1.Are you prioritising strength training as part of your training? . 2. If you’re currently rehabbing an injury; remember that becoming pain free or restoring full function is only half of the way there: maintaining this status through continual progressive strength training is key for long term benefit.... . #physiotherapy #physio #physicaltherapy #strengthtraining #strengthandconditioning #perthphysio #perthsportslife #exercise #exerciseroutine #exerciseadvice #physioeducation #kneeinjury #kneepain #kneerehab #claremontphysio #claremont #perthphysio #perthphysiotherapy #exerciseroutine #deadlift #squat #movementismedicine @ Perth, Western Australia See more

21.01.2022 Staying Healthy while Working from Home. Simple and effective advice. With many of us, as well as our colleagues / employees / friends having to quickly adapt to working from home. We can easily leave one important thing to the side. Our Health. Now, more than ever, this should be seen as a priority. Having performed a number of working from home ergonomic assessments over the last fortnight; it's clear that many of us are struggling. Managing a new work environment, additi...onal external stresses, juggling work and family life, and previous avenues for exercise halting; have left many with musculoskeletal discomfort, poor sleep, low mood and energy levels. Hopefully the below tips help you, or tag someone who you feel may benefit. For a more individualised assessment or to liaise with me for your business email me on [email protected]. #health #wellness #employeehealth #corporatewellness

21.01.2022 New clinic in PROmotion in Claremont. Great clinic, with awesome rehab facilities. For those asking for an appointment; you can book online at the link below (Senior Physio Initial Appointment) or call (08) 9284 4405. Drop me a message for any queries. https://promotionphysio.cliniko.com/bookings#practitioner PA

20.01.2022 Physiotherapists in the workplace. An example of some recent work I’ve done in engaging and empowering work crews to improve their workplace. Incorporating a holistic approach is vital, considering not just the work environment but the persons own physical and mental wellbeing.

18.01.2022 Can you do 40 push ups? The more you can do, the greater benefit in terms of reduction in cardiovascular disease. Get started ... If you struggle to do one full push up, then start from your knees. Each day try to do one more Thanks The Musculoskeletal Wrangler

18.01.2022 Day 10 #100burpeechallenge. 1000 burpees done For some one who loves exercising, it’s a big challenge for me doing it every day. This has been a great incentive and motivation for compliance. . Exercise Tip: make yourself accountable and get it done. Posting on social media about your fitness journey could be a great way to boost your own motivation. .... @billvicenzino & @adammeakins cheers for the incentive for a fit November perth #perthphysiotherapy #perthphysio #perthfitness #claremont #claremontphysio #claremontfitness #perthsport #perthfitfam #running #perthrunning #perthexercise #exerciseismedicine #sportsrehab #gym #gymtraining #gymfitness #100burpees #exercise

18.01.2022 Great work Marshall Strength and Conditioning. You’ll be back in no time. Great video!

17.01.2022 Working within Available Range . To ensure longevity and pain free exercise sometimes it is necessary to recognise our own limitations . Although there is a plethora of information out there on increasing mobility to improve squat or deadlift depth; for some these deep positions are not suitable at that time ... . Using a rack of plates under a deadlift, or squatting on to a box is a great way to reduce end of range hip or knee positions. . Starting with these modified positions can allow you to develop strength, master the movement, and work towards greater depth if that is your goal PA

16.01.2022 Learn more about shoulder pain; rehab pathways and why your scan result may not be as important as you think! PA

13.01.2022 Lateral Hip Pain (hip pain that originated from the side of the hip). . This is one of the most common hip conditions that comes through the doors clinically. Middle aged, females are most as risk. Symptoms tend to be persistent. Aggravating activities are normally activity related such as sitting for long periods, stair climbing and unaccustomed exercise. Simple things like lying on your sides can also be problematic. . An amazing study done by the UQ research group, foun...d that exercise and education on load management is the best practice intervention. Outperforming the first line treatment of a steroidal injection in the short and long term. . The intervention was based on education on the condition, as well as an 8 week progressive exercise program that strengthened the muscles in the hip area and improved movement efficiency. . If this is something that you, or someone you know may suffer from; message me or email at paulatkinson4@icloud .com for further information and individualised intervention via Telehealth. #perthphysiotherapy #physiotherapy #physicaltherapy #physicaltherapist #fitness #perthfitness #claremontphysio #healthtips #healthcare #healthcareeducation #exerciseismedicine #sportsmedicine #injuryadvice #sportsinjury #sportsinjuryrehab #paulatkinsonphysio #painadvice #hippain #glutealtendinopathy #lateralhippain @ Perth, Western Australia

12.01.2022 Achilles Tendinopathy Rehabilitation Tag a friend that you know who needs to see this See my earlier posts on the risk factors and overall management for Achilles Tendinopathy... Main Points: -dedicate 12 weeks to see significant changes -aims are to increase the Achilles tolerance to load -work to pain levels below 2-4/10. If symptoms persist 4-5 hours after session; reduce intensity to level you the tendon can manage -start with exercises you can do relatively pain free, for many this is starting with isometric holds and progressing to isotonic (through range) and finally plyometric -remember it’s progressive overload to change muscle and tendon properties so each week add difficulty, reps, or weight #achilles #physiotherapy

12.01.2022 Excellent advice for athletes experiencing low back pain: keep active, make sure your sleeping and eating well. Physiotherapy can help with guiding you in your recovery, increasing your bodies resilience and durability and reducing risk of future injury. Thanks The Musculoskeletal Wrangler... PA

12.01.2022 Knee Pain? Exercise is the best Medicine. Rethinking Knee Pain (specifically Patellofemoral Pain): Progressive Loading more important than getting bogged down with specific Vastus Medialis Obliquus (VMO) retraining. Knee Pain is one of the most common low limb injuries across both sporting and general populations. Patellofemoral pain is a term dedicated to pain in and around the knee cap, which is increased with loaded flexion activities such as squatting, stair climbing and... running. Research has shown a slight delay in VMO timing in those with knee pain, and has also been found to be predictive in nature of knee injury. It is theorised that a delay in VMO timing increases the load on the Patellofemoral joint (PFJ). Physiotherapists have utilised treatment techniques to improve VMO activation, however, it has been found that general strength programme also shows improved VMO timing. Translating this into practice, it means that graduated strength training of the low limb is sufficient to improve outcomes of pain and disability, as well as VMO timing. Gluteal and quads specific strength programs combined have been shown to be most effective. If you, or your patient is suffering from knee pain, it is clear that exercise is the best medicine. This must be graduated and progressed. The best exercise is one that you can do without a significant exacerbation of your symptoms and that can be progressed. In clinic I like to use a box or bench to assist in reducing the depth of squat in the early stages of rehab. The front box squat and single leg squat are staples of my graduated low limb loading programs, and are particularly useful for those suffering from knee pain. Give them a try and let me know what you think. Crossley, K. M., & Cowan, S. M. (2019). Vastus medialis obliquus (VMO) retraining or graduated loading programme for patellofemoral pain: different paradigm with similar results? Br J Sports Med. doi:10.1136/bjsports-2017-098736

12.01.2022 Knee OA risk factors Post injury. No surprise to see many of the risk factors are modifiable. Choose your own path! Great post regarding the risk factors for OA following traumatic knee injury by @bjsm_bmj (credit to: @ewa_roos @jwhittakphysio (twitter handles) ) .... #perthfitness #sportsrehab #aclrehab #aclrecovery #kneepain #kneepainrelief #kneefix #arthritisrelief #osteoarthritisawareness #sportsrehab #exerciseismedicine #claremontphysio #claremont #promotionphysio #perthphysio #perthphysiotherapy See more

10.01.2022 Keeping people doing the things they love should be a priority in all walks of life. This post from @running.physio gives a great insight into the negative impacts of ceasing running. . In clinic all too often we see people who have been told to stop running; however, our role as rehab specialist should be to return people to their previous function or activity. Easiest way to do this is to find a way to make this possible from the start. . Great place to start is a 100m ...walk/run program and progress from there as tolerated #perth #perthphysiotherapy #perthphysio #perthfitness #claremont #claremontphysio #claremontfitness #perthsport #perthfitfam #running #perthrunning #perthexercise #exerciseismedicine #sportsrehab #gym #gymtraining #gymfitness #running #runrehab #kneepain #kneerehab #achillesrehab #sportsrehab

10.01.2022 ACL revision rates rising faster than primary reconstructions in Australia. . Are we doing enough for our athletes in terms of rehabilitation and return to play decision making? . My answer is no. However, this leaves a massive area for improvement. I’m currently developing a a new service in ACL rehab and testing with @promotion.health to improve how we guide our athletes on rehabilitation ... . #aclrecovery #perthsports #aclrehab #aclsurgery #acltear #physiotherapy #physio #exercise #exerciseroutine #exerciseadvice #physioeducation #rehabadvice #claremontphysio #claremont #perthphysio #perthphysiotherapy #exerciseroutine #deadlift #sportsaustralia #squat #movementismedicine @ PROmotion See more

09.01.2022 Knee Pain Rehab Program: follow up from last weeks evidence review. (Can be applied to any low limb strength and functional control program) Exercise is proven to reduce pain, improve function and out perform all treatments in long term outcomes for knee pain. However, it is must be progressive, develop strength, improve function and increase resilience to have best results. ... Here’s a sample loading program that you can get started on in the gym. Note: 1) for the first 4-6 weeks focus on building confidence and control. Master the movement. 2) initially aim for 3 sets of 12 as a Simple start point. To progress difficulty use Increased weight. Roughly, if you feel you can do 2 more easily after a set of 12 your ready to move up in weight 3) this should not increase your baseline pain. Work within pain free ranges on the leg press. Using the box on squat exercises should assist in reducing irritability in deeper ranges. 4) Visit a Physio for coaching on any of the above. A full review and assessment of your individual needs is gold standard. PA

08.01.2022 What does the Science say about Protein Supplementation? Protein Supplementation is widely to aid in muscle growth following resistance training. The theory behind this is that we need additional protein to get bigger and stronger. But what does the science say? This meta-analysis (high quality scientific evidence that analyses a multitude of published research) found that: ... 1) Protein supplementation resulted in a greater amount of muscle gained. But, not by much (about 0.5kg). 2) People did get stronger: up to 9% boost. 3) Protein supplements were more effective in people who were previously trained 4) It was less effective in those over 60 years of age 5) There was no difference between food or special protein product supplementation. 6) 1.6g of protein / kg of body weight / day was found to be most appropriate for muscle gain; anything after that had minimal effect. Bottom Line: Supplemental Protein does improve outcomes for resistance training, however, this difference is relatively small. Special protein products are no more effective that normal food sources, so I would recommend these where possible. PA Murphy, K. T., McKellar, S. R., Schoenfeld, B. J., Henselmans, M., Helms, E., Aragon, A. A., Phillips, S. M. (2019). Infographic. The effect of protein supplementation on resistance training-induced gains in muscle mass and strength. Br J Sports Med. doi:10.1136/bjsports-2019-100990

08.01.2022 Deep Core Training Transversus Abdominis and Internal Oblique act in both trunk control and breathing. . Previous studies (Paul Hodges work in UQ) found that in some people with Low Back Pain these muscles activation was delayed. Improving their activation has been found to show benefits in pain and disability. .... This study found that TransAb and Internal Oblique muscle thickness is greatest at the end of expiration. This can be useful for curing for activation, and measuring if using ultrasound. . For me, it’s certainly worth checking if someone can activate these muscles, and spending time if they can’t. Clinically I’ll tend to see this more in those who have increased mobility and reduced control: bendy Wendy’s #physio #physiotherapy #perthphysio #claremontphysio #waphysio #lowbackpain #research #physicaltherapy #exercise #backpaintips #physioresearch #physicaltherapy #chiro @ Perth, Western Australia

07.01.2022 Injury Rates and Team Performance: . Here's 12 reasons why reducing individual injury rates pays dividends in of terms team performance. . A huge study has trolled through the injury data in elite level Australian Football. This data was then correlated against the teams performance (reaching finals / playoffs and ladder position). Between the years of 1997 and 2016; over 15,000 injuries caused players from 18 teams to miss over 50,000 games. Amazing work to capture thi...s amount of data. Following extensive statistical analysis: the researchers found that the impact of injury explained for 12% of the variation in final table position. Basically if your team had less injuries than there closest rival; they had a 12% greater chance of reaching finals. With elite sport now been seen as a game of fine margins; this is colossal. . This is an elite population of AFL players, however, similar results have been found across a plethora of sports. Its simple, keep your players on the field and off the treatment table and your chances of success are increased significantly. . Bottom Line: Paying it forward by implementing a holistic approach that prioritises injury prevention, player welfare, training load, and identifying those at risk will reap rewards in the long run. . Research is for everyone . PA . Hoffman DT, Dwyer DB, Bowe SJ, et al Is injury associated with team performance in elite Australian football? 20 years of player injury and team performance data that include measures of individual player value British Journal of Sports Medicine Published Online First: 26 June 2019

07.01.2022 Sitting for more than 8 hours per day as detrimental to health as smoking. However, exercise can ameliorate these risks. Tag a friend who is spending too much time sitting down ... #perthphysiotherapy #exercise

07.01.2022 Pain Dominant Stage 1. Reduction in Aggravating Activities -e.g reduce running load to pain free distance or replace running with lower load activity such as cycling... 2. Begin Strength Training to Increase Load tolerance of tendon -if painful with isotonic (moving) exercises, use isometrics (static) 3. Additional: Some people find heel raises to be beneficial in the early stage to reduce pain Load Dominant Stage 1. Gradual Increase loading of Activity -e.g. running reload. Begin with a walk-run programme (100m on/off). Gradually increase this, with one days rest in between runs. -mild discomfort during the activity can be expected, however, if this is sustained post run the load must be reduced. Increase Intensity of strength training 3. Add plyometric and sports specific training Clinical Pearl: A tendon injury should feel a little better every day. Expect recovery to take any where up to 12 weeks or more #perthphysiotherapy #achillesrehab

06.01.2022 ACL rupture is a single leg injury but a double leg problem: too much focus on ‘symmetry’ alone and that’s not enough Comparing ACL recovery and rehabilitation to the unaffected side is insufficient. -Many ACL return to play protocols and testing procedures use the leg symmetry index as a marker of recovery. Many studies use 90% of the unaffected side of a cut-off. With scores of less than 90% in tests such as isokinetic strength tests and hop tests shown to be predictors of ...re-injury. -One issue with this method is that an athlete is as likely to injure the unaffected side on return to play as the repaired ACL. Meaning that its use as the ‘gold standard’ lacks credibility. -This is due to the fact that many athletes will have strength, power, and movement deficits on the unaffected side as well, making its comparison of recovery inadequate. -Using normative data such as quads / hamstring strength scores, objectively assessing movement strategies with pre-determined scoring systems and additional subjective questionnaires for return to play should be used. -Leg Symmetry indexes (LSI) do still give very useful information, so I wouldn’t eliminate it from my exam. However, it should be incorporated into a battery of tests to ensure objectivity. -If you are interested in having a periodical ACL review, follow the link below and book an appointment with me or drop me a message. I perform a full battery of tests, utilising 3D software (ViMove) and give you and your referring Physio & Surgeon a full detailed report on your recovery as well as areas to work on. Benjaminse A, Holden S, Myer GD ACL rupture is a single leg injury but a double leg problem: too much focus on ‘symmetry’ alone and that’s not enough! British Journal of Sports Medicine 2018;52:1029-1030 #ACL #ACLrehab #ACLreview #claremontphysio #perthphysio

05.01.2022 Burpee and Sprint challenge . Great session for anyone looking to get a good high intensity cardio session in. . Mark out 100 metres at the start and away you go. ... . Fitbit / pedometer is handy to keep track, as it’s easy to lose track . Beat your time the next time you do it. So leave some in the tank the first time . . #perthphysiotherapy #physiotherapy #physicaltherapy #physicaltherapist #fitness #perthfitness #claremontphysio #healthtips #healthcare #healthcareeducation #exerciseismedicine #fitness #workout #cardioworkout #burpees #sprints #run

04.01.2022 Any previous injury increases your risk of future injury. This includes other areas of the body, not just a repeat of the same injury. That’s the reason for a full rehab and progressive return to play post injury. Thanks The Musculoskeletal Wrangler for the great post. PA

03.01.2022 Strength training and movement control is used for treatment of many musculoskeletal conditions. However, in the neck, even though its efficacy has been proven; it is not utilised. Strength exercise ideas coming in the next week. PA

03.01.2022 STRESS A great depiction of how it not only affects the mental, but physical as well. -clinical pearl: try to manage stress by staying in the present, and take time every day for yourself. Try the headspace app for 10 minutes of guided meditation. Credit: @ylmsportscience ... #perthphysiotherapy #physiotherapy #physicaltherapy #physicaltherapist #fitness #perthfitness #claremontphysio #healthtips #healthcare #healthcareeducation #exerciseismedicine #sportsmedicine #injuryadvice #sportsinjury #sportsinjuryrehab #mentalhealth #stress #mindfulness #meditation

01.01.2022 A good read for anyone that has been told to completely stop their activity of choice. There are always other options; and a gradual progression of an activity, in addition to building resilience and strength is a good place to start in many cases.