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Enhance your wellbeing with a pregnancy massage

Pregnancy massage is a perfect way to reduce stress and promote general well-being during pregnancy. NurtureLife® Pregnancy Massage Practitioners are highly skilled therapists in pregnancy massage, guided by Catherine McInerney, Australia’s leading expert and educator in pregnancy massage, and founder of Pregnancy Massage Australia®. Assistance and education are also offered to partners so that they may provide positive support during labour.

What is NurtureLife®

NurtureLife® is a holistic perinatal massage therapy method developed by Pregnancy Massage Australia® that supports women who are nurturing new life. NurtureLife® was born from a desire to share our specialist knowledge and natural support techniques with women on their journey through pregnancy and beyond. Certified NurtureLife® practitioners deliver specialised massage treatment that focuses on nurturing both mother and baby. When looking for a pregnancy massage specialist look for a NurtureLife® practitioner and you will be in the best hands.

The NurtureLife® massage experience has a natural, comprehensive approach to perinatal care, offering a broad range of support with a unique focus on massage.

What are the benefits of NurtureLife®

Pregnancy is a constant state of change; a NurtureLife® pregnancy massage specialist offers wonderful support through the perinatal period. The body undergoes many changes and the discomforts of pregnancy can be relieved. At NurtureLife® we believe a well-supported mum will have a wonderful journey into motherhood. Regular NurtureLife® pregnancy massage helps to support the many changes occurring from week to week, allowing the body to adapt through the pregnancy. We focus on the mother baby connection creating a warm, safe, secure nurturing environment where mum can rest relax and recharge. The NurtureLife® experience assists in relieving many of the common causes of discomfort during pregnancy.

Some examples include:

  • Insomnia is eased through improved sleep patterns
  • A greater sense of relaxation helps to reduce stress and anxiety levels
  • Specialised massage techniques are delivered for pain management, addressing groin pain referred from the uterus, lumbar, back, pelvic, hip pain, and rib pain common in the third trimester
  • Shoulder and neck massage helps to relieve tension, and is also beneficial while in the breastfeeding position
  • Hormonal headaches are reduced
  • Oedema, swelling and discomfort in the legs and arms is eased, which reduces the risk of carpal tunnel syndrome
  • Leg cramps are minimised due to improved circulation
  • Focus on mother baby connection
  • Relaxation techniques
  • Promotes a sense of relaxation
  • Assists in maintaining muscular tone
  • Gentle exercise including pelvic floor

NurtureLife® Services include:

  • 75-minute consultation – 60 minutes massage (with a maximum 15-minute consultation).

Price $115

  • 90-minute consultation – 75 minutes massage (with a maximum 15-minute consultation).

Price $140

  • NurtureLife® Pregnancy Massage – 90 minutes labour preparation massage which is designed to aid relaxation and prepare the body for labour whether the mother is being induced, overdue or has a booked caesarian.

Price $140

  • NurtureLife® Postnatal Massage – 60-75 minutes treatment. We like to see the new babies with their mum. As the babies are sleeping, mum can have a nice, relaxing massage.

Price $115

Hope to see you soon at Ryde Road Physiotherapy

Appointments:  02 98172 080

Practitioner NurtureLife® Pregnancy Massage Carola van der Kooij









Physiotherapy and the Management of Blocked Ducts or Mastitis

Physiotherapy has been shown clinically to help manage some of the signs and symptoms of blocked ducts or mastitis. A blocked duct can be defined as a blockage of one or more of the ducts that carry milk to the nipple for the purpose of breastfeeding. Mastitis can develop if a blocked duct is not cleared and develops in to an infection.

Signs or symptoms of a blocked duct or mastitis include:

  • Redness
  • A lump or thickness in the breast
  • White spots around the nipple
  • Pain in the breast
  • Fever and/or flu-like symptoms

Causes of a blocked duct or mastitis include:

  • Poor posture
  • Putting off or missing feeds
  • Not allowing the breast to completely drain
  • Neglecting feeding from one breast
  • Wearing tight bras
  • Applying too much pressure with your thumb on the breast when feeding

It is important to effectively manage mastitis or blocked ducts, and in turn be pro-active with our advice and education to prevent further recurrences as research suggests that the greatest risk factor for developing mastitis is having had a previous episode (Fetherstone, 2003). In addition, mastitis has an incidence rate of up to 33% in the puerperium with most incidences occuring in the first 2-3 weeks post-partum (Spencer, 2008).

Physiotherapy can help manage these conditions through:

  • Postural education
  • Advice regarding appropriate clothing/fitting of bras
  • Advice regarding drainage of breast
  • Advice regarding appropriate rest
  • The use of manual techniques such as: heat and ice, massage of the pectoral muscles and breast, kinesio tape application, effleurage, lymphatic drainage and real time ultrasound.

When attending physiotherapy, our aim is to use this advice and manual techniques to allow you to effectively drain your breast. As a result, we ask that you time your appointment just prior to a feed to allow you to feed post treatment. We will help put you in an optimal posture, show you ways that you can appropriately hold your infant while maintaining a good posture and then finally give you privacy to perform a feed.

Results should be seen within the first session and occasionaly two sessions may be needed to completely clear the breast. If a follow up is needed, it will be organised the day post treatment, or closest to.

When seeking treatment for a blocked duct or mastitis, it is ideal to get in as soon as possible as the smaller the area affected, the easier to drain. That does not mean, however, that a large area cannot be treated. It certainly can.

When being on antibiotics for mastitis, you can still be treated with physiotherapy and be improving the condition of the ducts to allow for more opening, the effectiveness of the antibiotics may be increased.

If you have any questions, please do not hestiate to contact us.

Happy feeding!


Sports Massage

Sports massage is a deeper and more intense massage, often focusing on specific areas. It is based on the various elements of Swedish (relaxing) massage and often incorporates a combination of other techniques (such as Deep Tissue) involving stretching, compression, friction and trigger point response techniques. Sport massage brings together this blend of techniques, knowledge and advice during treatment.

Sports Massage is not just for the athletes: anyone can benefit from sports massage, including people in physically demanding jobs, or from sedentary work whereby there is a prolonged period of sitting at a desk or in flront of a computer and even those with repetitive work patterns or full time mums (carrying a child)! You could book a massage to reduce muscular tightness when you suffer from a stiff neck, shoulder pain, sore back, headaches or simple as relaxation.

For athletes, sports massage can be used prior to and after exercise and may enhance performance, aid recovery and prevent injury. Pre-sport: If you use a sports massage before a big sport event it will give a good blood flow to the muscles and prepare the muscles for the performance that is to come. Post-sport: A sports massage after the exercise reduces muscle pain, provides relief and accelerates the recovery so that you can prepare yourself for the next performance.

How we can use the 8 Limbs of Yoga to better our practice

There are 8 limbs of yoga that are designed as guidelines to be followed to better ourselves and our health. For many years, those in India have practiced the 8 limbs and as we become more westernised with our yoga we try to continue to incorporate these in to our practice. You’re probably thinking, what does this have to do with physiotherapy. Well, many physiotherapists are now incorporating yoga in to their treatment whether it is movement based or principle based, whether they are aware of it or not.

In this post, I want to draw your attention to the 8 limbs of yoga and how these can be incorporated in our physiotherapy, rehabilitation and pain management.

The first limb is “Yama”. Yama is the ethical standards and sense of integrity, our behaviour and how we conduct ourselves. It includes “Ahimsa” or non-violence. Non-violence can be interpreted in relation to ourselves by avoiding movements or behaviours that may injure or harm our self. An example of this is avoiding slumped sitting as this may cause neck, thoracic or lower back pain.

“Satya” or truthfulness is also included in the first limb and can be incorporated in to our practice by continuing to be truthful to ourselves. Did we do the exercises prescibed, have we focused on our postural behaviours, is what I am doing causing me pain? All of these questions we should be asking ourselves and responding in a truthful way. If we hide from our thoughts we are less likely to recover as barriers are not being addressed.

The second limb is “Niyama” or self-discipline. Self-discipline is particularly important in our recovery as it encourages dedication. When we are self-disciplined we become more independent and allow our selves to self manage better, reducing the amount of time needed to be spent at the physio and on massage tables. An example of being self-disciplined is that every day you wake up in the morning and do a short stretch routine that assists your body in participating in all of the tasks that you have planned for the day.

“Asana” or postures is the third limb. Postures do not need to be difficult, even a posture such as sitting is considered a yoga posture and actually, sitting was the first form of yoga. We need to be aware of our postures and recognise that some times we may be able to achieve something and some days we are not, but that’s ok. Circumstances change and often daily, so we need to acknowledge that and use the above guidelines such as non-violence, truthfulness and self-discipline to look after our own body.

The fourth limb, “Pranayma” or breath is probably the limb that I am most passionate about in terms of patient’s recovery, particularly for those in pain. Breath is an important tool and what is even more important is our breath control. Breath control simply means the ability to change our breathing pattern, whether that be to speed it up or slow it down, hold an inhale or exhale, or even just recognise what our breath is doing. Often when we have control over our breath our patterns of movement improve and we also notice a decrease in pain as the sensitisation of our nerves is lowered.

“Pratyahara” or withdrawal of the senses is the fifth limb. This can be a more challenging one for patient’s to grip on to it but with practice can be achieved and lead you to further achieving the following limbs. Withdrawal of the senses encourages us to draw our attention inwards and allow the external world and outstide stimuli to escape us. It’s importance in rehabilitation is great as it allows us to become more mindful, tune in to our bodies; what we are feeling and where we are feeling it. It allows us to recognise what may feel good and what may not feel so good. It gives us many answers as both clinicians and patients as we have a greater ability to pin point cause and effect.

In the sixth limb, we explore “Dharana” or concentration, our ability to focus on one single thing or point such as our foot. It allows us to engage with that single point and explore it more deeply. For example, with our foot it allows us to explore how we can ground through our toes, ball of the foot and heel, how we can raise our toes, push down through the ball and how each of these movements make us feel.

Some people may not ever achieve the next two limbs but then there are others who practice these on a daily basis. I can appreciate that with our western world it can be hard to draw our attention away and have little to no thoughts, we are so consumed with technology, business and the rush of our daily lives that it can be difficult to switch off.

The seventh limb is “Dhyana” or uninterrupted flow of concentration. The mind is still and quiet with the production of few or nil thoughts. This would be fantastic for pain management as you would presume that if you are not producing thoughts then you are not producing emotions and in term not experiencing the emotion, pain.

The final limb “Samadhi” or a state of ecstacy is a point where you transcend yourself altogether and achieve peace.

Do not be disheartened if you have just read this and thought that it sounded wonderful however you are not sure how to achieve such things. There is a famous yogi saying “practice and all will come”. Truly, practice.


Why is it important to get your pelvic floor checked post partum?



Our pelvic floor is a complex of muscles that sit on the base of our pelvis and are important in bladder and bowel function as well as protecting our pelvic organs (your bladder, bowel and uterus). During pregnancy, the ligaments that hold our organs up begin to sag due to the hormone relaxin and the weight of the baby. This in turn forces the pelvic floor to work a bit harder to “take up the slack” and support the organs.

During child birth these ligaments may be damaged as well as the pelvic floor muscles may be torn or have had an episiotomy. Even without a tear, a fair bit of stress is placed on the pelvic floor as the muscles are forced to stretch to allow for the baby to exit. A combination of these factors impact on the functioning of the pelvic floor and can make it less efficient in protecting our pelvic organs as well as influencing our bladder and bowel actions.

While symptoms of incontinence are the most common complaints post partum, feelings of heaviness, constipation and urgency may also be experienced. These are indicators that you definitely need a pelvic floor check by a women’s health physiotherapist. During an examination your symptoms, muscle coordination and strength will all be assessed to allow for a thorough recovery. The earlier that these are addressed the easier the recovery, as well as better outcomes for the future. A physiotherapist will help by providing appropriate exercise prescription and lifestyle advice that will help in improving your symptoms as well as protecting yourself against prolapse.

Even without symptoms it is generally sensible to see a physiotherapist for a pelvic floor check as you may not be currently experiencing any symptoms but as your life becomes more active and the weight of your child increases symptoms may develop. By addressing your pelvic floors strength and coordination early as well as getting the right advice, these symptoms may never arise for you.







When is it safe to return to exercise post partum?

There is no easy answer to this but I will try my best. Returning to exercise varies for every individual and is dependent on a number of factors such as your birthing experience, the recovery of your core muscles (pelvic floor, transverse abdominus, multifidus and diaphragm), your pre-birth fitness and your general feeling ie your personal level of fatigue.

There are some general rules that can be followed in return to exercise, however it is important to check with your physiotherapist, midwife or doctor before returning to exercise or sport post partum. The general rules are as follows:

0-3 weeks post partum:

  • Walking
  • Transverse abdominus exercises
  • Pelvic floor exercises

3-8 weeks post partum:

  • Low impact aerobics
  • Low intensity swimming or aerobics classes (provided that your bleeding has ceased)
  • Transverse abdominus and pelvic floor exercises

NOTE: it is important to wait until your six week check up before returning to a group exercise class

8-12 weeks post partum:

  • Slowly increase your intensity or weights from your exercise during weeks 3-8
  • Progress your core exercises

12-16 weeks post partum:

  • It may be safe to return to high-impact exercise, running, sport or abdominal exercises however it is best to visit a physiotherapist for a pelvic floor and abdominal check to ensure that you are safe to do so.

NOTE: Sit ups, curl ups, planks, hovers and mountain climbers are not recommended during the post partum period as they place pressure on the recovering muscles and may impact your recovery in a non-positive way.

These guidelines have been adapted from Pelvic Floor First – http://www.pelvicfloorfirst.org.au/pages/returning-to-sport-or-exercise-after-the-birth.html

Is sitting the new smoking?

Your body is designed to move. However, with the rapid technological advancements that took place in the mid-20th century we saw a transition from physically demanding jobs requiring people to move to more sedentary jobs.

Current statistics tell us that:

  • 12 hours is the amount of time the average person is sitting a day[1]
  • The 4th leading risk factor for global mortality is physical inactivity[2]
  • 2 million deaths a year are related to physical inactivity[3]
  • 125% increased risk in heart disease and 50% increased risk of death from any cause for those who spend four or more hours sitting per day [4]

Current research has shown that even if an adult was to take part in the recommended 150 minutes of moderate to vigorous activity per week, this does not compensate for the sitting you do in your daily  desk job.  Health risks include:

  • Musculoskeletal disorders – mushy abs, tight hips, limp glutes, strained neck, sore shoulders and inflexible spine
  • Cardiovascular disease – heart disease
  • Diabetes – over productive pancreas
  • Obesity
  • Poor mental health – “foggy brain”
  • Some cancers – colon, breast and endometrial

AIM: Alternate between sitting and standing every 30 minutes!

There is ever increasing evidence supporting movement.  Low intensity activities such as standing, marching on the spot, stretching and walking play a significant role in your health. These activities have a  vital metabolic role and account for more of our daily energy expenditure compared to moderate-to-high intensity activities.

TIPS to help you move more, sit less:

  • Take short 1-2 minute stretch breaks every 30 minutes
  • Switch to a stand up desk
  • Have a standing or walking meeting
  • Take phone calls in standing
  • Keep at your desk side a print out of simple stretches
  • Rotate between standing and sitting tasks across your shift
  • Walk to deliver a message to a colleague rather than emailing

Your posture paints a picture.  It says a lot about how your muscles, joints and body systems are working.  Therefore, for the time that you do spend sitting,  pay attention to your posture.

Here are some tips on how to set up your computer work station:

  1. Chair height:
  • Hips are bent slightly more than 90 degrees
  • Feet flat on the floor or on a foot rest
  1. Back rest height:
  • Lumbar curve of backrest is level with your level curve (belt line)
  1. Back rest tilt:
  • Tilted so that your upper body is just off vertical (approximately 100-110 degree angle)
  1. Monitor height:
  • Eyes level with top 1/3 of screen
  1. Monitor distance:
  • Slightly less than arms length
  1. Key board and mouse distance:
  • No more than 5-15cm from edge of desk
  • Directly in front of your body
  1. Upper body:
  • Head: ears, shoulders and hips aligned; chin tucked in
  • Shoulders: relaxed away from ears (remove arm rests)
  • Elbows: bent slightly more than 90 degrees
  • Wrist: neutral with hands resting on keyboard
  1. Lower body:
  • Pelvis: feel for sitting bones
  • Hips: as far back on the seat, bent slightly more than 90 degrees
  • Knees: equal or slightly lower than hips, 3-4 finger distance between knees and seat
the one

Fig. 1.0

[1] http://www.juststand.org/the-facts/
[2] http://www.juststand.org/the-facts/
[3] http://www.juststand.org/the-facts/
[4] https://mic.com/articles/104550/what-working-long-hours-actually-does-to-your-body#.hYQ9EJwVy
Fig. 1.0: https://zapier.com/blog/how-to-set-up-your-desk/

Lower Limb Injury Fact Sheets

Most of us are familiar with the phrase, ‘Knowledge is power.’ When it comes to musculoskeletal injuries, acquiring a deeper understanding of an injury enables us to implement both better recovery and prevention strategies. The ‘power’ that this gives an athlete is in reduced recovery time, less time off sport due to injury and a reduced likelihood of succumbing to the dreaded re-injury.

The fact sheets below from Sports Medicine Australia are a great place to start increasing your knowledge of some of the more common lower limb injuries. If you have any question regarding these injuries or would like to know more then please feel free to contact us.
















Promoting the perfect landing in NETBALL

Netball has the highest female participation rate of any sport in Australia. Adolescents athletes gain the social benefits of being a team member along with great physiological benefits such as improved bone density, lean muscles mass and cardiovascular fitness! Unfortunately like all sport it does have the risk of injury.
The most common injuries in netball are to the knee followed by the ankle. Insurance data indicates that 25% of all major injuries are due to rupture’s of the anterior cruciate ligament(ACL). ACL injuries lead to prolonged absence from the game usually in excess of one year. Current research suggests only 55% of athletes return to there formal level of competition following ACL reconstruction.
In netball the three most common ways to rupture the ACL are: Jumping and landing on a single leg allowing the knee to collapse across the midline An external force while mid air leading to loss of control and the knee collapsing The knee giving way during a cutting motion.
Research has shown that sport specific warm up programs that promote safe knee movements, can reduce ACL ruptures rates anywhere between 30% and 70%. The KNEE program has been created to help reduce the risk of ACL ruptures in netballers. It is the first prevention program specifically for netball.
The program aims to improve movement patterns on take off and landing. This is done by prescribing strength exercises for the muscles around the hip and knee, and practice drills to promote good landing technique. The success of the program depends on correct feedback to change athletes faulty movements to safer patterns.
The great part about the KNEE program is video demonstrations are provided on the website at http://knee.netball.com.au/. The program should be practiced twice a week as part of the normal warm up. The exercise’s are specific to ability and after a short period of practice will be become an easy routine for the athlete. Once athletes are comfortable with the program they can progress to more complex drills.
To find out further information and help with implementing the program at your local club or team contact the team at Ryde Road Physiotherapy.


Joint Hypermobility

Joint hypermobility is very common in the general population, affecting 20-30% of individuals to some degree either in isolated joints or more generalised. It is most common in childhood and adolescence, in females, and in Asian and Afro-Caribbean races. Joint hypermobility tends to lessen with ageing.

Signs and Symptoms

Joint hypermobility may be of no medical consequence and might even confer advantages for dancers, musicians and athletes. However, it may be associated with:

  • Hypermobility of joints, including axial as well as peripheral joints;
  • Joint dislocation and/or subluxation;
  • Degenerative changes of joints;
  • Recurrent soft tissue injuries that typically take longer than average to heal and may become chronic, persistent injury;
  • Skin fragility with stretchy skin, easy bruising, scarring, and stretch marks;
  • Weakness of the abdominal and pelvic wall with herniation and prolapse;
  • Cardiovascular and gastrointestinal autonomic dysfunction that manifest as hypotension, faints / blackouts, and ‘irritable bowel syndrome’ / gastroparesis;
  • Cardiac mitral valve prolapse;
  • Varicose veins;
  • Resistance to local anaesthetics;
  • Chronic regional or widespread pain
  • Chronic fatigue
  • Anxiety

The Beighton modification of the Carter & Wilkinson scoring system has been used for many years as an indicator of widespread hypermobility. However, it should be used with the other signs and symptoms mentioned above.

  • The Beighton score is calculated as follows:
  1. One point if while standing forward bending you can place palms on the ground with legs straight
  2. One point for each elbow that bends backwards
  3. One point for each knee that bends backwards
  4. One point for each thumb that touches the forearm when bent backwards
  5. One point for each little finger that bends backwards beyond 90 degrees.


The physical and pain manifestations of the syndrome are treated with a combination of

  • physical therapies (e.g., Physiotherapy, Occupational Therapy, Exercise programmes such as Pilates and Tai Chi);
  • analgesics that might include anti-depressants and anti-epileptics at analgesic doses; muscle relaxants; and
  • pain management programmes (that would include cognitive behavioural therapy).

There is high level of evidence for strengthening programmes and in particular pilates.