At Hawker Place Physiotherapy and Pilates, we offer a range of treatment techniques, including specialised exercise programs, massage and manual therapy, dry needling and mechanical traction, as well as clinical pilates. We also believe in the importance of educating patients about their condition, our treatments, self-management strategies and the management of more complex conditions, such as chronic pain.

Exercise Programs

Exercise forms an integral part of most rehabilitation programs. Exercise helps to increase energy and range of motion, build muscular strength, increase flexibility and improve cardiovascular health. Strengthening and stretching are often core components of exercise programs designed to reduce pain and rehabilitate injuries.

Strengthening

Muscle strengthening is essential for decreasing pain, improving function, increasing stabilisation around joints and preventing injury. For many conditions a structured program of progressive strengthening exercises has been found to be more beneficial than medication or surgical intervention. For example, the 2018 guidelines published by the Royal Australian College of General Practitioners recommends land-based strengthening exercises as the best form of treatment for hip and knee osteoarthritis.

Strengthening exercises should be undertaken following a thorough physiotherapy assessment and should be continuously monitored and progressed throughout the rehabilitation of injuries.

Stretching

Stretching aims to increase the flexibility of muscles and improve joint range of motion (ROM) by elongating muscles and associated soft tissues, such as connective tissue and scar tissue. Stretching is often indicated following periods of inactivity or rest, or in the presence of excessive muscular tightness. Rehabilitation programs for many injuries often include stretching as it can also promote healing and prevent future injury.

Massage & Manual Therapy

Soft tissue massage and manual therapy aim to improve circulation, decrease tension, increase joint range of motion, decrease stiffness and relieve pain.

Massage

Massage therapy can be an important adjunct to exercise-based physiotherapy treatments. Conditions that may benefit from massage therapy include postural tension and headaches, neck and back pain and general muscle tension following sporting injuries. Massage therapy includes several different techniques, which are applied based on individual patient needs. Some of these techniques include:

• Trigger point massage: Also known as ischaemic pressure, involves sustained holds over trigger points, which often present as tight, painful knots in muscles
• Myofascial release: A form of soft tissue manipulative therapy that stretches the thick fibrous bands of tissue beneath the skin to remove tightness and reduce tension
• Effleurage: Long, gliding strokes in the direction of the lymph nodes, which can improve circulation and promote relaxation

Manual Therapy

Manual therapy includes techniques such as mobilisation and manipulation, designed to improve joint range of motion and decrease stiffness. Manual therapy can be particularly useful following periods of immobilisation, such as prolonged use of a sling following shoulder surgery, or immobilisation in a cast following a fracture.

Although soft tissue massage and manual therapy can provide short-term relief, they are most effective when combined with an individualised and structured exercise program. In many cases, massage and manual therapy should not be used as stand-alone treatments if long-term improvements are desired.

Dry Needling

Dry needling is a physical modality that aims to relieve trigger points in tight muscle tissue. Not be confused with the Eastern practice of acupuncture, dry needling is a technique that can be implemented by physiotherapists with specific training.

Dry needling can be categorised into superficial and deep dry needling. As the name implies, superficial dry needling does not reach the myofascial trigger points and is painless. Deep dry needling however, elicits a twitch response by releasing myofascial trigger points. In some cases, this can provide immediate pain relief. However it is also possible for deep dry needling to elicit the full pattern of referred pain, before providing relief.

While dry needling can provide temporary relief of pain and muscle tension, it is important to still determine the source of pain with a thorough physiotherapy assessment.

Mechanical Traction

Traction is a treatment technique most often used in the presence of low back or neck pain. It involves drawing adjacent vertebrae apart to increase intervertebral space and relieve pain and associated symptoms. Traction can be applied manually with a therapist’s hands, or mechanically via a machine.

Research shows there is limited evidence that mechanical traction is an effective treatment for low back or neck pain. However, some patients find it provides significant relief and enhances their other physiotherapy treatments.