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Why scans are not the answer!
Shane O'Sullivan • March 9, 2021
Find out how MRI can be counter productive.
That niggling low back pain has persisted for months. You have tried various types of therapies & medications without a resolution!
You decide to get an expert opinion from your trusted GP.
“Doctor, should we get a scan to see what is going on?”
A common sequence of events that occurs with longstanding pain. Surely a scan will provide the answers, attribute a cause to the symptoms, and direct a pathway back to a healthy, active, pain free lifestyle.
Over recent years, our understanding of the relationship between pain and abnormalities on an MRI, has evolved substantially. Traditionally, an episode of low back pain lasting for multiple weeks would end in an MRI – finding a disc bulge – and would direct a specific line of treatment to resorb or ‘unbulge’ the disc.
Recent studies have found that these abnormalities on MRI are not necessarily related to pain, but rather are related to the normal ageing process. One group of researchers found that in people without any pain, the likelihood of an MRI showing abnormalities increased the older we get.
90-95% of low back pain is what we consider non-specific - no specific structural cause- where 5-10% can present as a sinister pathology, and your clinician will be able to identify if you fit into this group.
A similar story exists with knee imaging. 115 pain free adult knees were scanned under MRI – 97% were found to have abnormalities of the bones, cartilage and ligaments! This further highlights the idea that what we see on imaging doesn’t necessarily explain the symptoms.
The negative consequences of imaging are two fold – the excesses of radiation that accompany Xray & CT scans can be harmful – combined with the fear and anxiety that is provoked when hearing of the damage inside our joints. The latter has been shown to contribute to worsening of symptoms and can prolong the pain experience.
While majority of injuries and pain states can be rehabilitated by identifying specific causes and intervening with the appropriate rehab strategies at the right time, it makes sense to avoid imaging!
Brinjikji W, Luetmer PH, Comstock, B et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am j Neuroradiol 2015: 36: 811-6
Horga, L. M., Hirschmann, A. C., Henckel, J., Fotiadou, A., Di Laura, A., Torlasco, C., D'Silva, A., Sharma, S., Moon, J. C., & Hart, A. J. (2020). Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal radiology, 49(7), 1099–1107. https://doi.org/10.1007/s00256-020-03394-z
As another sports season kicks off, so does the conversation around concussion . While not every head knock leads to a concussion, recognising and removing players when in doubt is crucial. ‘If in doubt, rule them out.’ Most discussions on concussion focus on recognising symptoms , but what happens after a concussion diagnosis? Here are six key facts parents need to know about managing concussion recovery.
This one goes out to all our field based athletes out there! For many of you, the start of your footy or soccer season is on the horizon. You might have played a few practice games, the team’s running load has picked up, and you’re starting to do more game -like drills. Whilst this is exciting and often more enjoyable than earlier parts of pre-season, it can also spell trouble. A ramp up in intensity, plus more kicking and more running can be a lot of change for any athlete. Whilst most of you will have a smart watch to track your running (or access to GPS systems if you’re lucky), how many of you track your kicking load?
Knee pain can really put a damper on your day-to-day life. Whether it’s from arthritis, an old injury, or just wear and tear , living with sore knees isn’t fun. Luckily, modern treatments like injection therapies offer new hope. Let’s break down what PRP (Platelet-Rich Plasma) and other injection treatments are all about—in plain language that’s easy to understand.
I’m sure it won’t surprise you to hear that a high proportion of New Year’s Resolutions fall to the wayside by the time February rolls around. For our patients, this comes in the form of gym memberships being cancelled, running plans falling away or the tennis racquet being put back in the cupboard until the next Australian Open. Change is hard . It is easy to be critical of yourself when you aren’t able to stick to a new fitness goal without any hiccups along the way. In our heads, our progress will look like this:
Understanding Non-Specific Low Back Pain: What You Need to Know Low back pain is one of the most common complaints worldwide. For many, it comes and goes, but for others, it can persist, affecting daily life . If you've been told you have "non-specific low back pain," you might be wondering what it means and what to do about it.
It’s a new year, and guess what? Your gut is ready for a glow-up! Often called your “second brain,” your gut isn’t just about digesting that extra slice of pizza— it’s a powerhouse that impacts your mood, immunity, and overall well-being. Time to give it some TLC! So, what’s the deal with gut health? It’s all about balance—the harmony of bacteria, fungi, and other microorganisms in your digestive tract. When your gut is happy, your body hums along smoothly. When it’s not? Hello, bloating, irregularity, and even chronic health woes. The MVP of gut health? Fibre . Think of it as the unsung hero of your digestive system, and it comes in two fabulous forms: Soluble Fibre : Found in oats, fruits, and legumes, this superstar dissolves in water, helping to regulate blood sugar and cholesterol. Insoluble Fibre : This tough cookie (from veggies and whole grains) adds bulk to your stool, keeping you regular as clockwork. But wait, there’s more! Power up your fibre game with prebiotics (the snacks your good bacteria love—think onions, garlic, and bananas) and probiotics (the friendly live bacteria in yoghurt and fermented foods). Don’t skip out on resistant starches like green bananas or cooled rice—they’re like a five-star meal for your gut. Now, let’s talk habits. Sure its been festive time over the last few weeks, and you might have had just one too many beers or wines. Excess booze and caffeine can leave your gut lining crying for help, and skipping hydration is a recipe for sluggish digestion. Even stress can throw off your gut’s mojo. So let’s take a whole-body approach to gut health! Practical Tips for a Gut-Healthy New Year Ready to treat your gut like the VIP it is? Here are four fun ways to make your digestive system your new bestie: Fibre First Thing : Start your morning with a fibre-packed brekkie—hello, oats and berries! Sip, Sip, Hooray! : Hydrate like a pro with at least 8 glasses of water a day. Fermented Fun : Add some zing to your meals with kimchi, sauerkraut, or yoghurt. Cut Back on the Gut Bullies : Swap caffeine overloads for soothing herbal teas or kombucha. Stay tuned for Part 2—we’re getting active in the name of gut health and making 2025 your best year yet!
New year, new you! The new year is a chance to rest, reset and create some resolutions (if that’s your thing). Whilst we’re big advocates for creating rehab goals all year round at Life Performance Sports Medicine, this might be the opportunity for you to create your own rehab goals. Have you been putting up with a niggle, pain, or problem for weeks, months, or even years? Is it something you are just attributing to old age, ‘wear and tear’ or a previous injury? It can be exhausting and frustrating putting up with pain, and it is easy to lose hope that it may not improve. We see many people who put up with pain for far too long before they do something about it. If this is you, keep reading! Conditions such as osteoarthritis are commonly seen as issues that will simply run their course, and there isn’t much you can do to stop them aside from wait for a joint replacement. This simply isn’t true. Whilst it may be extremely frustrating to put up with a sore shoulder or knee for years, or not be able to do the things you love, there is always something we can do to get your pain and level of function heading in the right direction. Whether it be seeing our dietician, Meagan, to help you eat and feel better Seeing one of our physiotherapists to come up with a targeted exercise program for you Having one of our podiatrists review the role that your footwear is playing in your condition. Whichever option it is, there are many avenues you can explore to improve your pain, all under the one roof . When it comes to exercise, we have a number of dedicated programs to meet your needs and improve your pain. We offer the GLA:D program, a proven exercise program aimed at knee and hip osteoarthritis. It has been rolled out across the globe and has been shown to reduce pain by an average of 36%! We also offer our very own Bones and Brawn program, which is aimed at individuals with Osteoporosis or Osteopenia. It focuses on improving the strength of your bones, boosting your mobility and assisting you with functional, day to day activities. So, use this festive season to relax, spend time with family and enjoy the sun, but I’d also encourage you to reflect on how your body is feeling, and more importantly, if it is holding you back from achieving your goals. Let 2025 be the year you get your body feeling like it used to!
Low back pain (LBP) is often dismissed as just a sore back that will go away on its own. But for many people, LBP can become a persistent, life-altering condition that goes far beyond a simple ache. The reality of chronic LBP is complex. It’s not just about the physical pain—it’s the ripple effects it creates across all areas of life. Tasks that used to be second nature, like picking up groceries or playing with the kids, suddenly feel monumental. Sleep becomes a nightly battle, with pain waking you at every turn. Over time, the frustration of dealing with constant discomfort can wear down even the most resilient people, leading to anxiety, depression, or a sense of helplessness. And the challenge doesn’t stop there. For many, LBP brings the fear of movement—an instinctive worry that bending or lifting could make things worse. Ironically, this avoidance often leads to stiffness, muscle weakness, and even more pain in the long run. It’s a vicious cycle that can feel impossible to break. So what’s the solution? Thankfully there is light at the end of the tunnel if managed correctly. The key is to treat LBP holistically . This means more than just pain relief—it’s about addressing the root causes, improving mobility, and rebuilding strength and confidence. Physiotherapy plays a vital role here, with targeted exercises and strategies that empower you to move safely and effectively. Education is another powerful tool, helping you understand your pain and how to manage it. Remember, LBP isn’t just a “bad back.” It’s an individual experience that affects different people in different ways. What works for one person, will not work for the next. Knowing which lever to pull at which time, is something that Life Performance clinicians know too well. Which exercise, how much and how often? Does the patient need psychological support? Do we need to empower the patient with confidence to move again? Are there fears and anxieties that must be faced & overcome? All of these questions are front of mind during a low back pain initial consult with our all star clinical team at Life performance. With the right support, you can break free from pain and get back to living life on your terms. Let’s work together to make that happen.
You’ve probably heard of Osteoporosis . It’s a relatively common condition affecting up to 1 in 4 women and 1 in 16 men over the age of 50. Osteoporosis is characterised by poor bone quality, making them more prone to breaking . Whilst nutrition and supplements such as vitamin D, protein and calcium are super important in improving health for people with osteoporosis, the importance of exercise is often overlooked. If you have osteoporosis, pause and reflect for a minute: what exercise do you do? How often do you exercise? When was the last time you lifted weights? When it comes to osteoporosis, unfortunately, walking your dog around the block won’t cut it. There are two forms of exercise which are really effective at improving bone health: Heavy Strength Training Jump Training / Plyometrics Heavy Strength Training involves lifting or moving weight, whether that be our own bodyweight (e.g. squat), or external weight, (e.g. a dumbbell bicep curl). Whilst this seems easy enough, the keys are how much weight we move, and how often strength training is completed. Bones and muscles get stronger when exercises are challenging , and when we experience significant fatigue. Strength training should also be completed at least 2-3x per week to maximise strength gains. Plyometrics, or jump training, involves rapid movements such as jumping, hopping or moving things quickly and powerfully . These kinds of exercises might seem a little optimistic or even dangerous, particularly if you are someone who struggles with your balance or mobility. Don’t worry, when completed under the guidance of one of our physiotherapists, they are a perfectly safe and effective exercise to improve your bone strength. Plyometrics are great to stimulate new bone growth, which is exactly what someone with osteoporosis needs! So where do you start? Our Bones and Brawn Exercise Program may be the solution you’re looking for. It’s been specifically designed by our physiotherapists to focus on key movements and areas that are prone to osteoporosis. See here to register your interest: Bones and Brawn Exercise Program If nutrition such as a Vitamin D, Calcium or Protein deficiency are part of the problem, we have just added a Dietician to our team! Meagan can help ensure your diet is ticking all the boxes to keep your bones in tip top shape.
Running success isn’t just about clocking miles—it’s a balancing act between pushing your body to its limits and staying injury-free. The secret? Tuning into both your internal environment —muscle strength, tendon elasticity, and explosiveness—and the external environment of footwear, surfaces, and recovery strategies. Internal Factors: Building Resilience Your body’s internal strength determines how well you absorb the impact of running. Muscle strength powers your stride, while tendons act like springs, releasing energy. Proper stiffness and ground contact times boost efficiency, while explosiveness (muscle power) enables quick acceleration. A strong aerobic system and good bone health are essential to keep your body resilient against the constant demands of running. While an element of internal resilience stems from genetics, a large part of how healthy and robust our body tissues are, is determined by physics! Forces that we put on our body - whether it be lifting weights, jumping rope or doing sprints, play a major role in how strong our tissues are. The classic example of a 30 year old who takes up running for the first time after being a competitive swimmer their whole life, can encounter issues with weaker bones and might be at a greater risk of developing a stress fracture. External Factors: The Environment Around You Your running environment is just as important. The right footwear supports your foot type and stride, while different surfaces (e.g., trail vs. pavement) impact joint stress. In fact, its variability in surfaces that wreaks the most havoc with causing injury. Lesson here is to keep a consistent surface. Smart programming —including rest days—helps you push yourself without going too far. Proper recovery , including time for your body to recover after a long or strenuous run, is crucial to let your body heal and adapt. Running Mechanics: The Cadence Sweet Spot Running mechanics play a major role in keeping you injury-free. Key adjustments like reducing stride length and increasing cadence (steps per minute) to around 160-180 can improve efficiency and minimize joint strain. Using a metronome or BPM music can help you lock into this rhythm and avoid overstriding, which commonly leads to overuse injuries. This tweak not only protects your joints but also helps optimize energy use for faster, smoother running. Finding the Perfect Balance There’s no one-size-fits-all when it comes to running technique. However, if you’ve struggled with injury or are currently dealing with one, analysing and adjusting your running mechanics is essential. Consulting with an expert clinician at Life Performance is crucial. Running is all about balance, and with the right combination of internal strength and external support, every step you take counts.
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info@errolstphysio.com.au