RHP Physiotherapy Blog

The latest from RHP Physiotherapy

RHP Physiotherapy is one of Brisbane’s premier physiotherapy practices. We’ve started this blog in order to provide an informed and authoritative discourse on a range of health related topics.
Our hope is that we can provide you with up to date information and events associated with a range of health topics not limited to sports injuries and musculoskeletal problems as may be associated with traditional ‘physio’ or physiotherapy.

Our sports physiotherapists are amongst the country’s elite but we have worked hard to establish a culture of excellence across a range of health related issues. Many of these topics we hope to discuss in coming blogs.


Recent posts:

Posted by admin on May 5, 2014

Flexibility for Swimming: Are you stretching enough?


A RHP Physiotherapy Swimming Screening checks flexibility in all of the key areas for a fluid stroke and compares them to known desirable ranges. The screening can highlight which areas could be affecting technique or causing your injury problems. Screenings can be done on an individual basis in the clinic or for groups at your club pool.


Want to Improve Your Streamline Position?


  • The better your streamline position, the faster you will travel through the water.
  • To test your streamline ability, perform those 2 simple tests.

1. Standing streamline

  • stand side-on to a mirror and put your arms up into the streamline position
  • Looking from the side, draw an imaginary line from the point of your elbow, through the middle of your shoulder, down the side of your chest and through the middle of your hip.
  • This line should be vertical and straight!!

2. Combined Elevation Test (CET)

  • Lie face down on a bed (Your chin on the end of the bed and arms over the end).
  • Keeping your arms straight with thumbs touching together, lift your arms up as high as you can (i.e. towards streamline position), keeping your chin on the bed.
  • Have someone look at you from side on. Have them draw an imaginary line along the middle of your upper arm (humerus bone) to your shoulder and compare this with a horizontal line drawn along the side of your chest.
  • The line along your arm should be horizontal or above the horizontal line.
  • If your standing streamline is not vertical or your CET is not horizontal, try the stretches below or call Red Hill Physiotherapy on 3856 5566 to find out how we can help.

To help improve your flexibility in these areas you need to focus on stretching the front part of your ankle, the front of the hip and thigh, the upper abs and back, and the pec and lat muscles.

To improve swimming performance and reduce injury risk it is important to stretch for 15-20 minutes at least 3-4 times per week and before and after training sessions. Take care when stretching your muscles. You should hold a COMFORTABLE STRETCH for 30 seconds and repeat 2 times on each side. You should feel NO PAIN with normal stretching.Pain means you are causing damage to your muscles.

Discontinue if you experience pain in the shoulders or spine.Clunking in the shoulder indicates a problem and requires professional attention. Please Contact Us should you experience such discomfort.

Posted by admin on May 5, 2014

Core Control Swimming: What is your core doing?

  • It allows more of the power produced by your kick to push you forward through the water.
  • Good body position in the water leading to a better “streamline” position and a more efficient stroke due to less drag.
  • A more stable attachment point for the powerful shoulder muscles to work from. This means that they can work more effectively and move your stable trunk through the water more easily.
  • Helps reduce over activity of some muscles. This means less general muscle tightness.
  • Less chance of injury.

Adding a couple of simple drills to your workout sessions can be enough to ensure you core is strong and stable throughout your entire training week.


Core Control Check


Stand facing a mirror with your finger tips on the bone at the front of your hips. Lift one leg off the ground so that the foot is held in the air near the opposite knee without touching. Bend the leg you are standing on so that you squat to 90 degrees and return to the starting position. Repeat 10 times on each leg.


If you notice any of the following then you will benefit from some specific trunk and pelvic control work:

  • your knee buckles inwards toward the other leg as you squat
  • your hip moves outward so that it is not above the foot
  • the two points under your fingertips do not stay level as you squat
  • you cannot keep your body from bending sideways or twisting as you squat
  • if the left looks different from the right during the test

To improve swimming performance and reduce injury risk it is important to perform these exercises for 2-3sets x 1min at least 3-4 times per week. You might use them as part of your warm up before each training session.

Swiss Ball Bridging

Aim: To improve trunk and hip control.
Start: Lie as shown on the ball. Rest your head and shoulders on the ball and ensure knees are bent to right angles. Activate deep abdominals, and gluts.

Action: The key to this exercise is to use your buttock muscles Swiss_Ball_Bridgingto keep your thighs and pelvis in a straight line. Hold your arms directly above your head and then slowly bring one arm down to the side and then return to the start. Alternate left and right.


Aim: To isolate the deep abdominals whilst flexing / extending the hip. Stabilise pelvis and lower back.
Start: As shown. Feel for the deep abdominal muscle.

Action: Activate the deep abdominal. Relax the chest. Whilst maintaining muscle tension practice breathing evenly and then relax. Keeping the spine and pelvis level slide one heel out along the floor, half straightening your leg, and then bring it back to the starting position. Alternate left and right.

If you want to learn which other exercises will help improve your core call (07) 3856 5566 for an individual assessment with one of our physiotherapists.

Plus check out other info sheets for swimmers including:

“Shoulder blade stability” and “Flexibility for a better streamline”.

Posted by admin on May 5, 2014

Looking after your Lumbar Intervertebral Discs


Injury to a disc can be quite painful and limit your ability to do everyday activities. Discs are most vulnerable when your spine is flexed and rotated, that is, when you bend forward and twist. When you sit your spine will also be in a flexed position so it is important to remember that sitting is like bending. These positions increase the pressure that your disc has to manage, which can lead to tears in the outer fibres of the disc and possible herniation.


There are many ways to prevent injuring your back. Obviously keeping a good posture at all times is essential. This means keeping your spine in a neutral position and to avoid sustained positions (greater than 5-10 minutes), that don’t allow your spine to be in neutral. In the lumbar spine this position is referred to as a lordosis, or an inward curvature. It is important that your lumbar spine is maintained in a correct amount of lordosis, as too little or too much can lead to increased pressure in your discs. To maintain this position when lifting objects you must bend your knees and keep close to the object you are lifting.


The core stabilising muscles include the deep abdominals, back muscles and buttock muscles. These support our neutral spine position and need to be strong with good endurance to hold our desired position for long periods. Flexibility at the hip joints is also very important so we are able to move adequately at the hips and not early or excessively at the lumbar spine.

The following are exercises to maintain flexibility around the hips and strength of our core to help minimise risk of back injury. Aim to do these exercises at least five days per week.


Hold 30 seconds, repeat 3 times.
Gluteal stretch


 Hip flexor stretch


Hamstring stretch


Control exercises

4 point kneel
Repeat 10 times, slowly.



Repeat 20 times. Build up to 50 times.


Sit to Stand

Repeat 10 times, slowly.


Posted by admin on May 5, 2014

Pre-season Injury Prevention Report

• Decreased exercise levels during the off-season lead to:

• A deterioration in the load tolerance of our tendons
• Reductions in muscle strength, endurance, and power.
• Reduced balance and co-ordination via a dampening down of the brain to muscle nerve pathways.
• Reduced aerobic fitness
• Loss of flexibility
Points to Consider with pre-season training:
• Begin early so there can be a gradual build up to full match fitness for the first game. Research shows that it can take several weeks for the collagen cells within your tendons to adapt to the increasing demands. Time will vary according to how much inactivity there was during the off-season, and the older athlete is generally more susceptible to tendon injuries.

• Include strength training specific to the sports requirements. For example:

1. Sports involving sprinting will require hamstring strengthening to decrease the risk of hamstring tears.
2. Sports requiring jumping will require calf, quadriceps, and gluteal strengthening
3. Sports involving lots of changing direction such as soccer will require adductor strengthening to minimise the risk of groin strains
4. All sports require strengthening of the “core” muscles. These are the muscles that provide stability to the pelvis and spine so the limbs work off a platform that is not moving excessively. I consider the pelvic floor, abdominals, diaphragm, deep back, and gluteal muscles make up the core.

• Include balance and co-ordination drills. This may include:

1. Foot speed drills
2. Single leg balance drills
3. Change of direction
4. Exercising on unstable platforms
5.Drills with training partners involving controlled body contact perturbations.

• For sports involving jumping and landing, include landing training and teach correct landing strategies. Research into ACL preventative strategies show that teaching deep landing strategies and improving lower limb and gluteal strengthening is very effective at reducing ACL injury rates.

• Sports specific training is crucial for development of higher-level movement skills and adaption of strength, coordination and flexibility into performance. Game situations are best performed earlier in training sessions before bodies are fatigued so injuries are less likely to occur during the most difficult training aspects.

• Static stretching is useful for maintaining or developing flexibility in our muscles. This is best at the end of a training session or away from training in the athlete’s own time. Tight regions need to be stretched daily in order to improve.

An example of a 20 minute warm up routine that has been advocated for football players can be found at www.fifa.com. It is called the “11+” program and includes many of the aspects mentioned above.

For more information or an introduction to specific exercises that can be incorporated please Contact Us.

If you are a coach or trainer and would like our skilled physiotherapists to provide or assist with your teams training session(s) please Contact Us.

Posted by admin on May 5, 2014

The Link Between Cortisol, DHEA and Insulin

As a consequence, excessive carbohydrate intake often leads to excessive cortisol secretion.  There are several causes of adrenal overload or fatigue, but if the gland has to continually produce excess cortisol due to carbohydrate overload, this will contribute.

Because DHEA and cortisol act to balance each other, and because there is a finite amount of DHEA available over a lifetime, reduced DHEA levels are a sign that too much has been used and, an early sign of adrenal exhaustion.

Because insulin also promotes fat storage, if there are large amounts of carbohydrates to be broken down, there will be high levels of insulin in the system and more fat being formed and stored.

As mentioned, when insulin is high, excess levels of cortisol are produced as a back-up mechanism to mobilise more blood sugar, which is done at the expense of the adrenal glands.

One way to counteract this process is to include more protein in the diet.  Protein is in part, broken down by glucagon from the pancreas.  Amongst its other functions, glucagon stimulates the production of glucose from amino acids (protein) and lactic acid in the liver.