cycling neck pain

Neck and Upper back pain for Cyclists

How you can relieve neck and upper back pain from cycling.

Whilst everyone is focused on the legs of cyclists, as a physiotherapist I tend to be busier looking after their necks and upper backs. Just like a professional that works at a desk, athletes that spend time in flexed positions such as cyclists are also at risk of neck pain and tight shoulders (1). In fact, a study of 518 recreational cyclists showed the prevalence of neck pain was 49%! (2) This doesn’t mean that neck pain has to be part of cycling – and in most cases it’s preventable. If you follow the advice from this article you should find that you are enjoying your ride, and that cycling isn’t so much of a pain in the neck (sorry but I had to).

Article by Scott Rolph, Physiotherapist at Point 2 Point Physiotherapy in Sandringham and Oakleigh. For more details click here.


A cycling posture on a road bike involves a forward inclined seated position.  The thoracic spine (upper back) is made of 12 vertebrae that attach the ribcage to the body. The shoulder blades sit against the ribcage and the muscles working to control the shoulder blades, extend the spine and head all have attachments here. The forward inclined position means the upper back and shoulder blades are more rounded, the arms and shoulder girdle weight bear and neck is extended to maintain a forward gaze.

cycling neck pain

Courtesy of

Recent research argues that posture alone is not a cause of injury (3). Simply sitting in a slouch position for a second doesn’t cause pain, because you are moving your body in a way that it is naturally capable of. However holding this posture for long periods of time can result in the neck and shoulder feeling very tight and sore. This overuse type injury comes on slowly. It occurs when tissue accumulates damage caused by repetitive and sustained submaximal loading. The sustained posture fatigues the muscles of the neck. With inadequate recovery microtrauma stimulates the inflammatory response and other processes, resulting in weakness, loss of mobility and chronic pain. Cyclists can develop:

  • tender muscles with areas of localised spasm (trigger points)
  • headaches
  • cervical and thoracic joint pains
  • back, chest and arm referred pains


Bike Setup

Suboptimal bike setup can place undue stress on the neck, shoulders and upper back. Some things to look out for include:

  • Excessive reach to the handlebars: If the length is too long between the saddle and the handlebars, the rider will have to over reach. This will create more forward lean, greater weight bearing through the arms and more extension occurring at the neck. This will also occur if the handlebars are too low.
  • Excessive width of handlebars: The handlebars should be shoulder width apart. This will allow better riding posture, more bend at the elbows, less stress on the back and neck.
  • Poor saddle: If a saddle is too uncomfortable to use properly, the pelvis may roll back (posterior pelvic tilt), increasing curvature of the spine and therefore affecting the upper back and neck.

bike setuo physiotherapy

Load Management

Poor load management can be another cause of issues for cyclists. Simply put, if you increase the amount you are doing too rapidly the body doesn’t have adequate time to adapt. One study has shown that 40% of injuries occurred during exercise as a result of increasing training load by more than 10% on the previous week (4). Another study showed that the risk of injury was increased about 10% when training loads were increased by less than 10%. When training loads were increased 15% the rate of injury jumped to between 21% and 49% (figure 1)(5).

This isn’t a blanket rule, and individuals will respond differently, but it can be used as a rule of thumb. Too rapid an increase in workload may result in built up tension in the area. To avoid this, ensure you are consistent with your workload. Gradually build up your volume over time. Also pay attention to what else you do with your day. If you are a desk worker ensure you have a good ergonomic set up. Stand often or use a standing workstation. Break up your sitting posture with exercises or with your schedule.

physiotherapy load management

Figure 1. Likelihood of injury based on the increase of training load per week.


Exercise program

The following exercises help to maintain mobility of the spine and shoulders and prevent neck and upper back pain.  These are great exercises but are general in nature.  For an individualised exercise program to help you book a thorough assessment today.


Cervical retractions

This is a great exercise to reverse forward head posture that helps cause cyclists’ neck pain.  Slide the head back slightly and hold for 10 seconds. You will be lengthening the muscles at the back of your neck and contracting the important postural muscle at the front of the neck.

neck pain posture exercise

Foam Roller Thoracic Extension

Extending over a foam roller can be a simple and effective way to reverse the forward bending posture on a bike. You’ll want to put your hands behind your neck to prevent extension and use your tummy muscles to prevent you arching your lower back. Try and arch over the roller for 5 seconds and repeat.

thoracic extension foam roller

Thoracic rotations “Open book”

If our mid back becomes tight we will loose our ability to rotate well. Laying on your side as shown, watch your upper hand as you raise it to the sky and over to the ground on the other side. Maintain your leg position. It is very important to breath with this exercise, as you should with all mobility exercises. Repeat on both sides for repetitions.

thoracic rotation stretch pilates

Wall Openers

This exercise presents a great and simple way to break up sitting postures throughout your day. Put your hands straight in front of you on a wall, take a small step back and then bend at the hips. Keep your abs switched on so you don’t arch through your lower back and instead mobilise the mid back.

stretch posture backpain

Foam roller Postural Stretch

This is a fantastic movement to stretch the muscles of the chest and shoulders that become tight with prolonged seated postures.  This creates a more rounded posture leading to neck stiffness and pain in cyclists.  Lay on a foam roller length ways. Let your hands come down to the ground palms facing up. Keep your abs switched on to prevent excessive arching through the lower back. Lower your arms out to the sides, sweep the ground up towards your head and continuing up to the sky to complete a full repetition. You will feel a pulling in the front of the shoulders and chest. If the movement is too strong you can hold a stretch position instead.

thoracic posture foam rollerposture stretch foam roller


Theraband shoulder exercises

When seated the muscles of the shoulders are kept in a lengthened posture for a sustained period of time. This can cause them to feel tight and sore. By exercising these muscles you help to prevent this and also get stronger. In exercise one hold a band with your elbows bent at 90 degrees. Pull the band apart squeezing your shoulder blades together and hold for five seconds and repeat. In exercise two hold a band straight in front of you and pull it apart in diagonals. Alternate arms and don’t let your shoulders shrug up.

shoulder pain postural exerciseposture exercise theraband


To learn more about how Point 2 Point Physiotherapy can help you click here.



(1) Asplund C, Webb C, Barkdull T. Neck and back pain in bicycling. Curr Sports Med Rep. 2005;4:271–274.


(2) Wilber CA, Holland GJ, Madison RE, et al.: An epidemiological analysis of overuse injuries among recreational cyclists. Int J Sports Med 1995, 16:201–206.


(3) Laird, Robert & Kent, Peter & Keating, Jenny. (2016). How consistent are lordosis, range of movement and lumbo-pelvic rhythm in people with and without back pain?. BMC Musculoskeletal Disorders. 17. 10.1186/s12891-016-1250-1.


(4) Piggott B, Newton MJ, McGuigan MR. The relationship between training load and incidence of injury and illness over a pre-season at an Australian Football League club. J Aust Strength Cond 2009;17:4–17


(5) Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 2016;50(5):273–80.




painful knee with osteoarthritis

The best treatment for hip and knee osteoarthritis

The GLA:D program is a 6 week exercise and education program provided by a certified physiotherapist reflecting the most up to date research helping people manage with hip and knee osteoarthritis.

Did you know that osteoarthritis affects about one in eleven Australians?  That’s 2.2 million Australians!  Many risk factors exist that increase your likelihood of developing the condition. Whilst some risk factors can not be altered many are modifiable.  These include being overweight, a lack of muscle strength, over loaded joints and physical inactivity.

Clinical guidelines recommend exercise, education and weight loss (if needed) as front line treatment.  However, too often clinical practice doesn’t follow these recommendations, instead relying on medication and referrals to an orthopaedic surgeon.

GLAD facts and myths about knee oseteoarthritis

Danish researchers developed The GLAD Program, or Good Life with Arthritis, Denmark Program,  for people with knee and hip osteoarthritis symptoms. Exercise and education offer a better and safer alternative to surgery.

Research in Denmark has shown the GLA:D program reduced symptoms by 32% on average.

Recorded symptom improvements include less pain, reduced medication use and improved function.  Follow up studies reveal an increased level of physical activity in patients 12 months after starting the program.

The goal is to strengthen, improve function, prevent symptom progression and reduce pain.

What does the program involve?

The GLA:D exercise program includes:

  • Initial Appointment: to assess and fully understand your current level of function and pain, to explain the GLA:D program and to cover any questions you may have.
  • Two education sessions: which will help to educate you about osteoarthritis, how to manage it and how the GLA:D program can help.
  • 12 group exercises sessions: completed twice a week over 6 weeks working on exercises to reduce symptoms and improve your quality of life.
  • A Follow Up Appointment: to reassess your condition 12 weeks after commencing the program.

glad exercise osteoarthritis of knee and hip

Can I do the program?

Anyone suffering osteoarthritis symptoms of the hip or knee, regardless of the severity, can complete The GLA:D program.  You may not complete the GLA:D program if you:

  • Have another cause for your pain such as inflammatory joint disease, a fracture, a soft tissue cause or tumour.
  • Have other symptoms that are more pronounced than the osteoarthritis problems.
  • Are unable to communicate in English.

Cost of the GLA:D exercise Program

The initial and follow up appointments are priced as physiotherapy appointments.  The two education sessions are provided at no cost. The 12 exercise sessions are $420 ($35 per session).  No referral is needed. You can discuss with your doctor to see if you qualify for a Health Care Plan, which would cover part of the cost of the program.  You can also check with your health insurer, Workcover, TAC and DVA.

GLAD osteoarthritis exercise program

click here to book your appointment today. 

Like or Share this article with a friend if you think they would benefit from this program.

To find out more contact us on 9521 6633 (Sandringham) or 0414 199 664 (Oakleigh).  The GLA:D Exercise Program is available from both Point2Point Physiotherapy practices.

For further information read more here about the structure of GLAD at Point 2 Point Physiotherapy.


Physio foam rolling painful ITB

Foam Rolling – Keep on Rolling?

is foam rolling beneficial or are we wasting our time?

Foam Rolling has risen in popularity recently as a self-massage tool. It’s believed that some benefits of foam rolling muscles over different areas include breaking up adhesions, scar tissue and loosening the connective tissue of the body. On first glance this makes sense. Similar to rolling out a piece of dough until it is nice and smooth. However is this really what occurs? It’s important to take a minute to review the evidence to best understand how it works, what benefits of rolling out muscles exist, and how you can implement it to best achieve your goals.  If you still have any questions after you’ve finished please contact me or book an appointment if you have an issue.

Does foam rolling cause structural changes?

A study by Hayashi et al. (2011) made this seem very possible. In this study humans used tools to apply pressure to the ligaments of rats. This showed successful remodelling of the collagen fibres in the ligaments. So how well would this apply to humans performing self-myofascial release on a foam roller? Well there are some issues with applying this study to humans. The main issue is the relative size of a human applying the force to a much smaller rat. Extremely large forces would be required on a human to come to the same findings. In fact Chaudhry et al. (2008) quantified this. It was estimated that approximately 852kg of pressure would be required to alter our tissue structure just 1%. It’s no wonder why the rats were unconscious during the study! Therefore it is very unlikely that foam rolling alters the tissue structurally.

What is this tissue and how is it so strong?

The connective tissue (fascia) we are trying to release by rolling is made up mostly of collagen. Collagen is a protein primarily responsible for resisting and adapting to tensile stress. It lies beneath the skin and attaches, stabilises, encloses, and separates muscles and organs. Think of it as your body’s natural glad wrap. Now this tissue is very strong. In fact studies have come to conclude that fascia is proportionally stronger than steel. Further studies show that no meaningful deformation of the tissues was achieved after foam rolling.

So what is actually happening when I foam roll?

Instead of physically breaking down tissues, what is occurring is a bit different. Firstly what is the feeling of tightness? Well there is a difference between a muscle feeling tight and a muscle actually being structurally tight. Firstly if a muscle is actually tight it is due to the tissues becoming physically tighter. For example if you took your arm out of a cast it has been in for 6 weeks.

A very different example of feeling tight would be if you’ve been sitting down at a desk for a prolonged period of time. Afterwards you feel tight in your middle back or the tops of shoulders. However, in this posture your muscles were held in a lengthened, not shortened, position. So tightness in this example has nothing to do with the tissues being structurally tight, it’s a sensation. A feeling of tightness is related to muscle tone. Muscle tone is the subconscious level of nervous system activity to the muscle. If the nervous system perceives a threat it can tighten up such as an injury due to muscular weakness or a prolonged posture.

Physio foam rolling painful ITB

Now you know when you have bumped your knee on the edge of a desk and you rub it to make it feel better? Physically you are not changing what just happened. What you are doing is giving your body another stimulus. And that is exactly what foam rolling does. And that’s why foam rolling can relieve the feeling of tension in a matter of seconds.

IMPORTANT NOTE:  Tone is used for protection and so if something is regularly tightening up there may be an underlying cause that needs to be addressed. An increased amount of tone to an area for an extended period of time may lead to a physical tightening of the tissues. I’d strongly suggest seeing a good physiotherapist to access this.

So what are the benefits of foam rolling?

Improved mobility.

Studies have shown that performing foam rolling prior to exercise can improve mobility. This effect is short term however, lasting about 10 minutes. This does make sense given the nature of improvement appears to be due to a change in the nervous system as opposed to any meaningful structural change. This may explain why rolling out one leg improves the mobility in both legs not just the one treated and why in another study massage to the sole of the foot could improve hamstring flexibility.

A study showed that foam rolling and stretching was twice as effective as static stretching alone. Another benefit found was that foam rolling doesn’t have the same decrease in performance that static stretching causes prior to exercise. This is likely due to the fact that foam rolling doesn’t stretch the neural tissues like static stretching does.

Improved recovery

2 studies done in 2014 and 2015 looked at groups performing squats (10 sets of 10 repetitions). They demonstrated that the group who foam rolled had benefited from less soreness at 24, 48 and 72 hours after exercise.

In the 2015 study they also measured how quickly performance measures returned to baseline where the foam roller group was superior to the control group. These same positive foam roller effects were demonstrated with professional soccer players in a 2017 study where they enjoyed the benefits of decreased post exercise soreness and also a quicker return of their agility measures between training sessions.

A 2017 study looking at participants completing 40x15m sprints showed no difference between the control and the foam roller group. However, a dynamic warm-up was completed prior to assessment, as opposed to the other studies where the control group did nothing. This would suggest that other methods of recovery are effective.

So looking at the evidence yes it would appear that foam rolling helps to reduce post exercise muscular soreness and can assist in the quicker restoration of performance measures after training. It also seems that when compared to an active/dynamic approach there is little difference. Therefore the recommendation would be to utilise foam rolling but to understand it’s just a tool in the toolbox to assist your recovery, not the be all and end all.

Physio Foam rolling his glutes

Take Home Message

The mechanism of how a foam roller works is different from what was previously thought. It seems much more likely that it causes changes in the nervous system to effect change rather than having any meaningful effect on the structure of soft tissues. Given we better know how foam rolling works we now have a better idea on how to implement it. Short-term mobility improvements should be taken advantage of prior to training but don’t waste a long period of time doing it as the results are short lived. Benefit from utilising a foam roller after a workout to reduce post exercise soreness and improve recovery.  This may lead to more productive training sessions and a reduced rate of injury. There are definitely great benefits of foam rolling.


Chaudhry H., Schleip R., Ji Z. Three-dimensional mathematical model for deformation of human fasciae in manual therapy. Journal of the American Osteopathic Association. 2008;108(8):379–390
Cheatham S., Kolber M., Cain M., Lee M. The effects of self myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance: A Systematic Review. Int J Sports Phys Ther. 2015 Nov; 10(6): 827–838.
D’Amico A., Gillis J.The influence of foam rolling on recovery from exercise-induced muscle damage. J Strength Cond Rep. 2017 Sep 6.
Hayashi K., Ozaki N., Kawakita K. Involvement of NGF in the rat model of persistent muscle pain associated with taut band. J Pain. 2011;12:1059–68.
MacDonald G., Button D.Drinkwater E.Behm D. Foam rolling as a recovery tool after an intense bout of physical activity. Med Sci Sports Exerc. 2014 Jan;46(1):131-42.
Pearcey G., Bradbury-Squires D, Kawamoto J., Drinkwater E., Behm D.Button D. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015 Jan;50(1):5-13.
Ray E., Padron-Cabo A., Costa P,. Barcala-Furelos R.The Effects of Foam Rolling as a Recovery Tool in Professional Soccer Players. J Strength Cond Res. 2017 Oct 7.
Schroeder A,. Best T. Is self myofascial release an effective preexercise and recovery strategy? A literature review. Curr Sports Med Rep. 2015 May-Jun;14(3):200-8.
Sullivan K., Silvey D., Button D., Behm D. Roller massager application to the hamstrings increases sit and reach range of motion within five to ten seconds without performance impairment. Int J Sports Phys Ther. 2013 Jun; 8(3): 228–236.











The Deadlift: a back’s Friend or Foe?


One thing I’ve heard a lot, during my time as a physiotherapist, is how bad deadlifts are. Usually those complaining have come to see me for their back pain after they had hurt themselves deadlifting in the gym. Now of course people can get a sore back from deadlifts, but the cause is usually a breakdown of technique, the use of excessive load or poor programming. But doesn’t the same go for any exercise?

The deadlift is a basic functional movement where you are picking something off the ground. So why do so may people fear it when we do it all the time during daily function? Why do many health practitioners, including physiotherapists, turn away from the deadlift? Is the deadlift good or bad for your back when performed properly?

If you have back pain have it seen to. Book your appointment today and get it sorted!

Proof is in the powerlifter

A study by McGill et al (1992) looked at highly trained elite powerlifters and what sort of flexion forces were applied to their spines by deadlifting when compared to just standing and bending forwards. The idea was that in a flexed position the load would put excessive strain on the vertebrae and ligaments, possibly leading to injury.

A real time x-ray was used to assess the participant bending and the deadlift of 400 pounds. With the exception of one subject in one lift, all lifters completed their deadlift within normal range. They were completed without excessive force applied to the wrong tissues when compared to just bending forwards. As a result, good technique and the use of an appropriate weight, the deadlift is not dangerous for a well functioning back.  Please note the importance of correct technique to avoid back pain from deadlifting.

Practice makes perfect: use correct technique

I often tell patients that if they want to be good at something, practice it. Think of it this way; If you’re not usually a runner, but decided to run for hours one day, it should be no surprise to became very sore and possibly sustain an injury. However if you’re conditioned to run for hours, a different result would be expected. Therefore, it makes sense that if you want to become better at lifting and bending during daily function, you practise these tasks in order to condition your back for them.

The paraspinal muscles are big cable like muscles running up each side of the spine. 80% of people with lower back pain have poor paraspinal muscle strength. Strong paraspinal muscles reduce the sheer force occurring in the spine, meaning strong back muscles, put less force onto the discs of the lower back. A study by Colado et al. (2011) demonstrates that the deadlift is the most effective exercise at recruiting the paraspinal musculature compared to other exercises. It is also extremely functional and has great application for progression given the compound nature of the exercise. Essentially, the deadlift is an effective method to build the muscles that are very important for supporting the spine.

Another study by Welch et al. (2015) showed that over a 16 week free-weight-resistance based program 30 participants with over 3 months of lower back pain reduced their pain by 72%, their disability by 76%, greatly improved their back strength endurance and paravertebral size. There was also a decreased presence of fat infiltration in the spine, which is a common finding in MRI of people with longstanding lower back pain. Interestingly, a maximum weight intensity of  6-10 repetitions was used in the study. Therefore the intention was getting the participants strong using relatively heavy weights, not shying away from them.

Deadlifts proven to reduce back pain

A study by Aasa et al. (2015) showed a group of participants with over 3 months of lower back pain improved greatly with exercise. Participants were broken up into high-level lifting loads, including the deadlift, and low-load motor control exercises, such as Pilates.  After eight weeks both groups showed similar improved results with pain, strength and endurance. The only difference between the groups was that the low-load motor control group showed better results with movement control. Given this is what they were training this makes sense. So what would happen if these two methods were combined? Should they be combined, or should we just get stronger given the improvements were similar across the board?

Later Aasa et al. published the paper Which Patients With Low Back Pain Benefit From Deadlift Training? (2015). The paper broke the study down further to assess what participants did better, with deadlifts as their prescribed form of treatment. It was found that patients that did better with the implementation of the deadlift generally had better back endurance during the Biering-Sorensen Test, and less pre-exisiting pain (VAS <60mm) prior to commencement of the study.

Consequently, deadlifts are a very valuable tool in the rehabilitation process for someone with lower back pain. When performed with proper form and appropriate load, deadlifts are not dangerous. Aasa et al. (2015) study results demonstrate it’s advised to undertake low-load exercise to improve back endurance and pain, prior to commencing functional strength work such as the deadlift. Importantly, all study participants were instructed with correct lifting form. If unsure of the proper technique, or having trouble in the gym – seek the advice of a trained professional.


Berglund LAasa BHellqvist JMichaelson PAasa U. Which Patients With Low Back Pain Benefit From Deadlift Training? J Strength Cond Res. 2015 Jul;29(7):1803-11. doi: 10.1519/JSC.0000000000000837.

Burton AK, et al. Chapter 2. European guidelines for prevention in low back pain: Eur Spine J, 2006.15 Suppl 2: p. S136-68.

Cholewicki JMcGill SM. Lumbar posterior ligament involvement during extremely heavy lifts estimated from fluoroscopic measurements. J Biomech. 1992 Jan;25(1):17-28.

Colado JCPablos CChulvi-Medrano IGarcia-Masso XFlandez JBehm DG. The progression of paraspinal muscle recruitment intensity in localized and global strength training exercises is not based on instability alone. Arch Phys Med Rehabil. 2011

Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics and MRI- defined lumbar fat infiltration and functional cross- sectional area in those with chronic low back. BMJ Open Sport Exerc Med 2015;1:000050. doi:10.1136/ bmjsem-2015-000050



How to fix your Neck Pain from Text Neck

Use these tips to prevent your neck pain caused by text neck

The term ‘Text Neck’ describes a repetitive strain injury to the neck which occurs when a person looks down at their mobile device for a prolonged period of time. With the increased use of mobile phones and computers we have seen an increased rate in the presentation of neck and shoulder pains.  Is this coincidence or is there a cause and effect relationship?

Scott Rolph is a Physiotherapist at Point 2 Point Physiotherapy. Click HERE to learn more.

S.Lee (2015) showed that when using a mobile phone most users maintain a flexed neck measurement somewhere between 35-45 degrees. It was also shown that this angle increases during texting when compared to other tasks. It was also higher in seated positions when compared to standing ones. This is important because this increases the load on the neck and the musculature that supports it.

Hansraj, the chief of Spinal Surgery at New York Spine Surgery, published a study in 2014 assessing the incremental differences of force acting on the neck as the head is tilted forwards into worsening postures. The study showed a dramatic increase in the force the neck experienced as a result of postural changes (see figure below). For instance, when we look down to text, our neck may be experiencing up to six times the load of normal!  Imagine trying to lift a weight that is six times what you normally lift and do that for prolonged periods of time. Do you think you would get sore, tight and achy?

How posture affects neck pain on mobile phones

The most common symptoms of Text Neck are pain and soreness. As expected it was shown in a 2011 study by Berolo, that with the increased use of smart phones, the severity of pain and soreness increased. Other studies show that poor postures, such as a forward head, and slouched or rounded shoulder postures may be adopted. Due to the altered load that occurs in these postures, others complications that may arise from Text Neck. These include:

  • Altering of the spinal curvature (flattening with the loss of lordosis)
  • Onset of early osteoarthritis and spinal degeneration
  • Disc compression and bulging
  • Nerve compression
  • Headaches

tips to prevent text neck pain

So what are some things you can do to help prevent the progression of Text Neck and improve your symptoms?


Don’t spend too long in one continuous session of phone use and attempt to reduce the amount of total time you spend on your phone.

  1. Improve posture during mobile use

Hold your phone higher, as close to eye level as possible. For general posture you should think about keeping you back straight and tall, shoulders pulled back and chin slightly tucked in. If you are having trouble reading the screen increase the size of the text.

  1. Being active

If seated for long periods throughout the day, ensuring you spend time getting your body moving. Do so through a wide range of movements. Continually change your posture throughout the day by alternating between sitting and standing positions to reduce fatigue.

  1. Stretches

Make sure you perform a series of neck, mid back and chest stretches to maintain your mobility. See my neck and shoulder exercises section in my post about neck pain in cyclists.  Another option if you find it difficult to motivate yourself is  to join an exercise group.  Yoga can be a great idea for some both through mobility and posture awareness improvements, as well as the psychological benefits of mindfulness and decreasing stress.  I really like Tidal Flow Yoga (click to check them out).

  1. Strengthen posture

Doing movements to strengthen the muscles that support your posture is very important. See myneck and shoulder exercises section in my post about neck pain in cyclists. Exercises should be used to also brea up periods of prolonged postures.

If you have neck pain and would like to learn please contact me here.


  • Sojeong Lee, H. K. Head flexion angle while using a smartphone. Journal of Ergonomics, 2015, 58(2), 220-226.
  • Berolo S, Wells RP, Amick BC 3rd: Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: a preliminary study in a Canadian university population. Appl Ergon, 2011, 42: 371–378.
  • Janwantanakul P, Sitthipornvorakul E, Paksaichol A: Risk factors for the onset of nonspecific low back pain in office workers: a systematic review of prospective cohort studies. J Manipulative Physio Ther, 2012, 35: 568–577.
  • Bonney RA, Corlett EN: Head posture and loading of the cervical spine. Appl Ergon, 2002, 33: 415–417.
  • Hansaraj, K. Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical Technology International, 2014, (9), 227.



Do you really need an operation for a knee meniscal tear?

Can specific physio for the knee assist after tearing your meniscus?

An injury to the cartilage of the knee can occur suddenly on the sporting field or can occur gradually.  A surgeon will typically smooth damaged cartilage and remove fragments in an attempt to address the cause of the patient’s symptoms. This is knee arthroscopic surgery. The most common orthopaedic procedure performed. Often you’ll hear about a football player getting a “clean out” of their knee.  Well that’s a knee arthroscope. A knee arthroscopy is often used as the first treatment for meniscal tears. But is this a good idea?  Continue reading


Physio for back pain? Do I need a scan?

How targeted physio for lower back pain can help reduce pain

Require physio for lower back pain? You’re not alone. Lower back pain is the most common presenting complaint in the clinic on a daily basis. It is estimated that 85% of the Australian population suffer from lower back pain at some stage during their lives. 70-80% of sufferers will recover from an acute episode of lower back pain within a 3 month period. However, 20-30% of sufferers will suffer from persisting pain and loss of function. In fact, reoccurrence rates are as high as 80%. Continue reading