Kiwi Avocado Smoothie - Physio Direct NZ

Kiwi Avocado Smoothie

½ Large ripe avocado

2 Peeled kiwi fruit

1 Tbsp fresh lime juice

¼ Cup almond or coconut milk

Honey to taste

2-3 Ice cubes


Place the liquid in the blender first, then fruit and ice. Cover and begin blending on a low speed, increasing to high speed. Blend until creamy and smooth.

Serves one | Preparation time: 15 mins

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Pasta Al’Pomodoro - Physio Direct NZ

Pasta Al’Pomodoro

8 large Roma tomatoes, diced

1 large Spanish onion

1 clove of garlic, crushed A teaspoon of salt to taste Tbsp Olive Oil

Fresh basil for garnish.

Fresh pasta sauce straight from Italy.

Place the oil, garlic and onion on medium heat and sauté until onion is clear.

Add tomatoes, already diced and salted, then allow to cook on medium until a sauce begins to form. Turn heat down, cover and simmer for 20 mins, stirring regularly. Occasionally add a few tablespoons of water if the sauce becomes too thick.

For taste you can add chilli, bacon or mushrooms but this makes a great starting base and is surprisingly tasty as it is.

Cook your favourite pasta in a separate pot and stir into sauce when ready. Garnish with fresh basil and parmesan cheese.

Serves two | Preparation time: 1 hour

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Five Healthy New Year’s Resolutions - Physio Direct NZ

Five Healthy New Year’s Resolutions

Need some inspiration for a worthwhile New Year’s Resolution that you might actually keep? Here are a few recommended resolutions that will act as investments in both your short and long term health.

  1. Sit Less:

New studies showing just how bad sitting is for your health are starting to really convince us that a lifestyle change is in order. Limit your sitting to four hours a day, set an alarm to remind you to get up every hour or invest in a standing work station. Any way you can find to do it, this is one great investment in your long term health.

  1. Find a physical activity that you actually like:

Too many of us fail to stick to an exercise program because we don’t choose the right activity. The gym isn’t your only option. This year, try to find an activity that you really enjoy. It can be anything from laser tag, to dancing, to rock climbing. It doesn’t matter what the activity is as long as it gets you moving.

  1. Drink more water:

Are you getting your recommended eight cups a day?

If not, this is an easy resolution to keep that can make a surprising difference to your overall wellbeing. Staying hydrated has been shown to help with concentration, fatigue and even reducing pain.

  1. Get that niggling pain or stiffness treated:

You might feel a bit self indulgent if you visit a physio for a problem that really hasn’t been bothering you much. However, most chronic health problems start out as something small. They are also much easier to treat in the early stages. Invest in your body now and treat pain before it does get in the way of your day to day activity levels.


  1. Learn how to strengthen your pelvic floor correctly:

Pelvic floor weakness is a common problem that affects both men and women, often resulting in incontinence and pain. The good news is that most pelvic floor disorders can be treated with specific exercises. Unfortunately, many people actually do these exercises the wrong way, making the problem worse.

Speak to your physiotherapist to find out how they can help ensure you have correct technique.


The verdict is out and it’s not good news. Sitting for long periods of time is terrible for your health.


With all the media attention lately this probably hasn’t escaped your notice, however if you’re having trouble getting your head around exactly why sitting seems to cause so many diseases check out this video that explains it perfectly.


To watch go to

Worried About Growing Pains? - Physio Direct NZ

Worried About Growing Pains?

Growing Pains


The short answer is that yes, growing pains are real and usually harmless part of childhood. Though poorly understood, they are recognized as a common phenomenon occurring most often between the ages of 3 and 12. The pain is commonly felt in both legs, particularly at night with no clear cause of pain. As yet no one is able to explain why they happen but growing pains are thought to be a normal response of a growing body as it adapts to new heights, sizes, strengths and skills.


Not so fast. While growing pains are harmless and usually transient, there are many childhood illnesses and conditions that do require professional assessment and, if left untreated, can cause serious harm. These include but are not limited to;

Juvenile arthritis, childhood cancers (which often first present as knee or jaw pain), developmental hip dysplasia (abnormality of the hip joint), Perthes disease and a variety of other musculoskeletal disorders.

While it’s true that children are generally more resilient and heal well, they are also vulnerable to injuries just like adults. All serious strains and sprains should be rehabilitated correctly to ensure no long-term problems occur down the track. Many childhood pains can also be relieved with physiotherapy in the short term even if the child will eventually grow out of the pain.



Unfortunately, unless you are a trained professional you wont be able to tell. If there is any doubt in your mind always contact a physiotherapist or doctor. Many clinicians have great respect for a parent’s intuition and acknowledge that parents are usually very good at knowing if something is wrong with their child.

Even if you’re sure nothing is wrong, there are a few signs and symptoms that you should take particular notice of.

Pain that is severe, pain that occurs suddenly without obvious cause, pain that is one sided, pain that affects your child’s activity levels, causes a limp or is associated with signs of general illness/fever.

Constant, severe and unrelenting pain is a serious sign that should be investigated at any age.


The first step is to consult a physiotherapist or general practitioner. They can help to either reassure you that your child’s pains are harmless or recommend further investigation and treatment.

Rotator Cuff Tears - Physio Direct NZ

Rotator Cuff Tears


The rotator cuff refers to four small muscles in the shoulder joint that connect the shoulder blade to the upper arm. They stabilize the shoulder joint, keeping the joint where it is and also act to rotate the shoulder inwards and outwards.

The muscles attach at different points around the shoulder blade and attach as four tendons into the top of the humerus (upper arm bone).


These tendons are commonly injured through a fall onto an outstretched arm. However, they can tear from seemingly harmless movements of the arm repeated over a long period of time if the tendons are weakened. This is often referred to as ‘repeated microtrauma’. Tears occur most commonly at the point where the muscle turns into tendon, called the musculotendinous junction.


What to expect after a rotator cuff tear depends on how bad the tear is. It is possible to tear the tendon completely in   two,   which   usually   requires   a surgical repair and subsequent rehabilitation. Partial tears can heal with physiotherapy rehabilitation and the length of time required will depend on the severity of the tear.

Unfortunately, while many rotator cuff tears are resolving and healing, secondary complications begin to occur. The shoulder girdle is a very complex and flexible part of the body and as such is quite vulnerable to pain caused by poor movement patterns

Many people move differently when they have pain. They might tend to elevate the shoulder blade, move their neck less to that side or simply move that arm less.

A common condition associated with rotator cuff tears is shoulder impingement, which is where, due to poor muscle control, structures within the shoulder joint are compressed and irritated as the arm is moved.


Physiotherapy is an important part of the rehabilitation process of rotator cuff tears, both surgically and naturally repaired. Your physiotherapist will help to prevent secondary neck and shoulder problems and give you a strengthening program to restore you to your previous function. For the best outcomes it’s important to seek treatment as soon as possible and get started on your rehabilitation program.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

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Understanding Chronic Pain - Physio Direct NZ

Understanding Chronic Pain

Many people use the term Chronic to convey just how excruciating a pain is. However, what the term really means is simply that the pain has been there for longer than three months, even if it’s not very bad. The distinction is made after three months because most injuries to tissues, either muscle, bone or joint has had a chance to heal and resolve by this time.

Why make the distinction?

The difference between pain that has just happened and pain that has been there for a long time has implications for treatment and the way you approach it. Chronic pain requires different management and is likely to be caused by more than one thing where as short-term pain (also known as acute pain) often has a distinct cause, such as a fall.

What are some examples of acute conditions?

A sprained ankle, torn muscle, a bruise and even a broken bone are all examples of injuries that occur suddenly   and   usually   follow   a typical pattern of healing. They usually go through an inflammatory reaction with the area being red, hot, swollen and painful to touch. This period usually lasts for a few days and is a normal part of the healing process as the body works to   remove   damaged   tissue   and repair the affected area. Different tissue types take varying amounts of time to heal. The severity of the injury will also affect healing times.

Some acute injuries can become chronic if something goes wrong in the healing process. Some acute injuries are so bad they won’t heal without medical care. For example, fractures need to be kept as still as possible to allow the broken bones to heal together in the correct position.

Some pain and illnesses develop over time and are chronic in nature, usually starting insidiously and becoming progressively worse. Osteoarthritis, multiple sclerosis and rheumatoid arthritis are all examples of chronic conditions that cause chronic pain.

For some people, even though their injury has healed and no significant cause can be found, pain persists. This type of pain can be particularly distressing and requires a holistic approach to treatment, particularly addressing the emotional costs that come with suffering from long-term pain.

Certain factors will predispose someone to developing this type of pain including recent or past emotional trauma, anxiety and depression. Unfortunately chronic pain often causes people to adopt a vicious cycle of rest, which causes more stiffness and pain, which then leads to more pain and so on.

Your physiotherapist is well trained to help you cope with chronic pain and get you back to a more functional level and doing the things you love.

Chronic Pain Project

Sometimes the internet can be a confusing place, full of misinformation, particularly from people trying to sell you things. A recent website developed by the Department of Health in Western Australia aims to provide evidence based support and education to pain sufferers.

Have a look here at

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