Author: Amy Cram

Physio Tips for Better Running - Physio Direct NZ

Physio Tips for Better Running

Distance running can be a surprisingly complicated sport. In this article, we offer some words of wisdom from our physiotherapists to help you get the most out of your training and avoid injuries. 

Choose your shoes carefully:

Repeated stress from running long distances will show up any biomechanical flaws in your body relatively quickly. Choosing the wrong shoes can exacerbate an existing problem causing pain and injury. Your physiotherapist can guide you on what style of shoe will best suit you. 

Don’t neglect your upper body:

While running can appear to be a purely leg based activity, increasing the strength and mobility of your upper body can have a surprisingly large impact on your posture, running style, breathing and overall performance. 

Find time to train strength as well as endurance:

Your body is great at finding ways to compensate for weak muscles, however, over time this can lead to overuse injuries of tendons and muscles. Identifying any areas of weakness early and specifically strengthening these muscles can both improve your running and help keep you injury-free.

Pace your progress: 

Entering an event is a great way to set a specific goal and keep you motivated. While trying to increase distances and speed, it is easy to forget to include rest days as a part of your routine. Your body needs time to recover and restore itself, just as much as the active portions of your training program.

Increasing your speed and distances gradually also allows your body to adapt to new demands without breaking down. 

Enjoy your training and listen to your body:

Your body will guide you as to when you need to rest and when you can push a little further. Training will be more enjoyable when you are well-rested and pain-free. Most importantly, if you are able to enjoy your runs, this will help you maintain motivation over a longer period of time, so you can continue for many years to come.

Ask your physiotherapist for more tips on how to reach your running goals while staying injury-free. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for assessment of your individual condition.

Focus on Shin Splints - Physio Direct NZ

Focus on Shin Splints

What is it?

Shin splints, are a painful condition of the lower leg, also known as Medial Tibial Stress Syndrome, it is an overuse injury that causes pain along the inside of the tibia or shin bone. It is a common condition in runners, hikers and soldiers who march long distances.

What are the symptoms?

Shin splints are typified by persistent leg pain, usually the inside of the shin, halfway down the lower leg. The pain might be felt during exercise or directly after. Some people experience a dull ache over their shin that lasts for quite a while after exercise stops, while for others the pain may be sharp and fade quickly. The pain is often progressive, becoming worse with shorter distances. Eventually, shin splints can severely impact activity levels as the pain becomes too severe to continue exercising.

Shin splints can be extremely painful and very disruptive to activity levels. As the pain usually starts gradually and progresses many people find themselves unable to continue

training, shin splints may also progress to stress fractures if not diagnosed early and managed effectively.

How does it happen?

Shin splints are predominantly seen in runners who increase their distances quickly, often while training for an event. Activities that require repetitive weight-bearing of any kind, such as marching or high impact sports have also been shown to cause shin splints. Although the pathology of shin splints is unclear, studies have been able to identify certain risk factors that may predispose someone to shin splints. These include;

·An abrupt increase in activity level

·Improper footwear and support

·Higher BMI

·Training on hard or uneven surfaces

·Tight calf muscles

·Flat feet

·Increased external rotation range of the hips

·Females are more likely to develop shin splints than males.

·Prior history of shin splints

·Wearing or having worn orthotics

How can physiotherapy help?

The first step for your physiotherapist will be to address any contributing factors and help to adapt your training program to a level that is optimum for you. A period of relative rest may be recommended along with a targeted strengthening and stretching program for any tight or weak muscles. Switching to low-impact activities such as swimming, cycling and yoga may also help to maintain fitness during recovery. Your running technique will be analyzed and any training errors may be corrected. When getting back into your training routine, it is usually recommended that distances are not increased by more than 10% per week as this allows the tissues of the body to react to the increased demands and adapt accordingly.

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

Sweet Potato & Carrot Cake - Physio Direct NZ

Sweet Potato & Carrot Cake

Ingredients: 

 2 cups Plain Flour

1 tsp. Baking Powder

1 cup Sugar

1 Egg

1 Sweet Potato, roasted and mashed

2 Carrots, grated

1 cup Milk

1 tsp. Ground Cinnamon

3 Tbsp. Butter

Icing

1/2 cup Icing Sugar

1 cup Plain Greek Yoghurt, strained 

1 tsp. Vanilla Essence

  1. Preheat oven to 180d ℃ and grease a medium-sized cake tin.
  2. Combine butter, cinnamon, carrots, sweet potato, eggs, milk, sugar and baking powder in a medium-sized mixing bowl and mix thoroughly.
  3. Add flour and stir into the mixture until a smooth batter forms.
  4. Add mixture to cake tin and bake for 35-40 minutes. Use a skewer to check when the centre of the cake is cooked.
  5. To make the icing, take strained yoghurt, vanilla essence, butter and sugar and mix with an electric hand mixer until the icing is thick and smooth with no lumps. Place in fridge to set while the cake is baking. 

Allow to cool, cover with icing and serve when ready.

Four Surprising Reasons Why Your Pain Is Not Improving - Physio Direct NZ

Four Surprising Reasons Why Your Pain Is Not Improving

Most tissues in the body have healed completely in six to 12 weeks following an injury, however, many people have severe pain that lasts much longer than this. We know that the intensity of the pain you feel is not always associated with a similar amount of damage. In some cases, there can be a severe amount of pain with almost no detectable damage. With this in mind, we explore some reasons why your pain might not be getting better, long after the tissues have healed.

You’re afraid of the pain.

Pain can mean many different things, for some of us pain can affect our ability to work or can be a symptom of a serious disease. What you believe about your pain can either amplify or reduce the symptoms you experience. If you feel that every time you experience pain you are causing more damage, you will naturally pay more attention to this and your nervous system will amplify the signals in an attempt to keep you safe.

If you understand the cause of your pain and know that while there is discomfort, you are not in danger of causing more damage, often the pain will feel less severe. This is one of the benefits of seeing a physiotherapist after your injury as they can help you to understand your pain, giving you more control over your recovery.

You started moving differently after the injury. 

Immediately after an injury, it’s natural to change the way you move to avoid painful movements. After a while, these changed movement patterns can become maladaptive and actually begin to cause pain and discomfort on their own due to the altered stress patterns placed on your body.

Correcting these adaptive movement patterns can often go a long way in reducing pain after an injury. You might not have noticed these changes and might need a physiotherapist to identify and help you to return to your usual movement pattern.

You have lost muscle strength since the injury.

While a certain amount of rest following an injury is always helpful, if we stop moving altogether, our muscles can lose strength. This can mean that our posture changes, we fatigue easier during our usual activities and that we are more susceptible to further injury. Less movement also means we actually focus on the pain more when it does happen. Physiotherapists are able to advise you on the right types and amounts of excercise for you in the period following your injury.

The pain has affected your lifestyle.

When pain affects your ability to sleep, work and even concentrate, it’s not surprising that this can have a negative affect on your overall wellbeing and mental health. This can create a negative cycle of anxiety and depression that perpetuates and increases the experience of pain. If your pain is really getting you down, speaking to a mental health professional can actually be a valuable part of your physical recovery. 

Focus: The Broken Collarbone - Physio Direct NZ

Focus: The Broken Collarbone

What is it?

A broken collarbone, also known as the clavicle, is one of the most commonly broken bones in the body.

The collarbone connects the front of the ribcage to the shoulder and is the only bony connection the arm has to the rest of the body. Many muscles attach to the collarbone, including the Deltoid and Pectoralis Major.

How does it happen?

The most common way for this injury to occur is through a fall onto the shoulder. This can happen from a simple fall or sports such as mountain biking or rugby. It is a very common childhood injury but can happen at any age.

What are the symptoms?

Usually, a broken collarbone will cause moderate to severe pain over the broken area. The patient may have heard or felt a popping or cracking at the time of the injury and there may be an ongoing grinding or creaking with movements of the upper arm. If the skin is not broken there may be bruising and swelling over the painful area.

What is the treatment?

While very severe cases can be surgically fixed, more often a broken collarbone will be allowed to heal naturally with rest and monitoring. By supporting the arm in a sling and providing pain relief the arm will mend on its own. As with most fractures, there are also often other injuries that may need to be dealt with at the same time. There are many important structures near the collarbone that can also be damaged

including muscles, nerves and blood vessels. In very severe cases, the lung tissue under the collarbone can be damaged causing the lung to collapse. 

Physiotherapy and recovery:

Once a treatment plan has been decided by your medical team, your physiotherapist can help you to return to your pre injury strength and mobility with a full 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.

Mixed Seed Pumpkin Bread - Physio Direct NZ

Mixed Seed Pumpkin Bread

Ingredients:

½ cup of coconut oil

2 cups of plain flour

1 tsp. baking soda

½ tsp. baking powder

1½ tsp. ground cinnamon

¼ tsp. grated nutmeg

¼ tsp. ground cardamom

½ tsp. salt

1 cup brown sugar

2 large eggs

1 cup pumpkin puree

1/3 cup coconut cream

2 tsp. pure vanilla extract

¼ cup coarsely chopped walnuts

¼ cup roasted pumpkin seeds

2 Tbsp. salted sunflower seeds

1. Preheat an oven to 180 degrees Celsius or 350 degrees Fahrenheit. Prepare a medium sized cake tin by greasing with butter (or coconut oil) and a small amount of flour.

2. Mix the spices, flour, baking soda, baking powder and salt together in a medium sized bowl and set aside.

3. In a larger bowl, beat coconut oil and brown sugar until they are well mixed. Continue to beat mixture, slowly adding eggs one at a time, waiting a minute before adding the second egg. Once well combined, add the pumpkin puree, coconut cream and vanilla and continue mixing. Finally add flour mixture and beat on low speed until combined.

4. Spoon the mixture into the greased cake tin. Cover with walnuts, pecans, and seeds.

5. Bake mixture for 45-55 minutes until a golden brown colour. To test the inside, insert a wooden skewer, if it comes out clean it is ready. Set bread on a cooling rack and allow to cool for 15 minutes before serving.

10 Facts About Tendons - Physio Direct NZ

10 Facts About Tendons

Tendons are found all over the body and while you may know a little about them, you might be surprised to learn a few of these facts.

1. Tendons can be found at the ends of muscles. Tendons are simply connective tissues that attach muscles to bone and help them move our joints when they contract.

2. Tendons come in many shapes and sizes. While the most recognizable shape is the long thin kind (such as the Achilles tendon), they can also be flat and thin or very thick, depending on the shape of the muscle and attachment of the bone. A thin flat tendon is also known by the name aponeurosis.

 3. Tendons are able to act like elastic bands, they can stretch and bounce back into shape. Like elastic bands, if too much force is applied they can stretch or tear.

4. Unlike elastic bands, tendons are living tissue and their properties are affected by many different factors. Seemingly unrelated things such as hormonal changes, autoimmune disorders and nutrition can all affect a tendon’s ability to withstand load.

5. Tendons don’t only attach muscles to bone, they can attach to other structures as well such as the eyeball.

6. Tendons can tear however; more often they are injured through overuse. Healing of tendons can be quite slow as they have less blood supply than other tissues of the body, such as muscles.

7. Tendons are mostly made of organized collagen fibres. Areas of tendon degeneration have been shown to have collagen fibres that are disorganised, with this area having less strength and elasticity.

8.The Achilles tendon is the strongest tendon in the body. This connects the large calf muscles to the back of the heel to point the ankle away from the body. Most tendons are simply named for the muscle they attach to, however the Achilles has it’s own name, named for the mythical Greek character who’s heel was his only point of weakness.

9. The smallest tendon is located in the inner ear, attaching to the smallest muscle in the body.

10. Tendons and muscles work together to move your joints and are called a contractile unit.

Tibialis Posterior Tendinopathy - Physio Direct NZ

Tibialis Posterior Tendinopathy

The tibialis posterior muscle sits just inside the shin, halfway up the lower leg. The muscle travels downwards and runs along the inside of the heel, with the tendon attaching at the base of the arch of the foot.   

The role of the tibialis posterior muscle is to move the foot and ankle downwards and towards the midline of the body. The tibialis posterior also helps to support and maintain the arch of the foot. Tendinopathy is a broad term that refers to painful pathologies of the tissues in and around a tendon, usually related to overuse.

What are the symptoms?

Signs and symptoms of tibialis posterior tendinopathy can include pain and/or stiffness over the tendon, clicking or ‘crepitus’ sounds with movement and swelling. Pain can be felt both when you touch the tendon or with movements that involve contraction of the tibialis posterior muscle, such as when going up on to your toes, hopping or running. 

As the condition progresses, the tendon might be come weaker and elongated, providing less support to the arch of the foot. This might become more noticeable over time as the lack of support in the foot further aggravates the damaged tendon.  

Pain may become so severe that eventually running becomes too painful to continue and even walking may be sore. In some cases, the affected tendon may be weakened but painless. For some, a complete tear of a weakened tendon can be the first sign that anything is wrong.

What are the causes?

Like most tendinopathies, overuse and biomechanical errors are the main cause of tendon pathology. Prolonged or repetitive activities that place excessive strain on the tibialis posterior tendon can cause degeneration and disorganization of collagen fibres within the tendon.  

Excessive pronation or rolling in of the foot while walking can place the tendon under extra stress as it acts to support the arch. Unsupportive footwear can exacerbate this process as it allows the foot to roll inwards. Often, a person may not have any issues until they begin to increase their training. If tendons are subjected to too much load too quickly, they can begin to breakdown, developing into a tendinopathy.

Being overweight, muscle weakness or tightness, poor warm up and insufficient recovery periods can all contribute to the development of tendinopathy. As you might expect, runners are most affected by this condition, along with other athletes of sports that require lots of running. Non- athletes can also be affected with day-to-day activities causing tendinopathy. 

How can physiotherapy help?

Your physiotherapist can help by making an accurate diagnosis in clinic, which can be confirmed by MRI or ultrasound. Your physiotherapist can also identify which factors may be involved in the development of this condition, helping to address them and reduce pain as quickly as possible.

For most tendinopathies, a period of relative rest is required and a graded training program to help strengthen the tendon has been shown to have the best evidence for recovery. Other interventions such as ultrasound, ice or heat treatment, soft tissue massage, stretching and joint mobilization may be used. Arch support taping, biomechanical correction, bracing and footwear advice may also be added. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Kale & Brussel Sprout Salad - Physio Direct NZ

Kale & Brussel Sprout Salad

Ingredients: 

12 Brussel Sprouts

3 Tbsp. Sliced Baking Almonds

1 cup chopped Kale

¼ cup shaved Parmesan Cheese

2 cloves of Garlic, Crushed

Dressing: 

2 Tbsp. White Wine Vinegar

2 Tbsp. Olive Oil

Salt & Pepper

  1. Preheat your oven to 180º Celsius. Slice brussel sprouts in half and place on a baking tray lined with baking paper. Sprinkle sprouts with olive oil, salt and pepper, add garlic and cover with almonds. 
  2. Roast brussel sprouts in the oven for 20-30 minutes until slightly brown. Prepare kale by chopping into small pieces, washing and placing in a medium sized salad bowl. 
  3. Prepare salad dressing by whisking together olive oil, white wine vinegar, salt and pepper. Mix brussel sprouts, almonds, kale and dressing together gently in the salad bowl. 
  4. Sprinkle thin slices of Parmesan cheese over salad and serve. 

Serves Two.

Where is your pain really coming from? - Physio Direct NZ

Where is your pain really coming from?

Have you ever been to see a physiotherapist for pain in one part of your body and when they treated you, they focused on a completely different area? While this can be a strange experience, it can be even more puzzling when the treatment actually works. So what is going on, shouldn’t pain be treated where it is being felt?

When pain is felt at a different location from where the pain is being caused, this is called ‘referred pain’ and is actually more common than you think. Exactly why this happens is a little complicated, and in fact, we don’t yet understand everything about the way that pain is processed.

Pain is usually felt when something causes damage to the body, sending an electrical impulse to the brain. The brain receives this information and process it to make sense of which part of the body the signal is coming from and what kind of pain it is. When the brain thinks that the pain is coming from a different area than where the damage or signal is actually coming from, this creates the phenomenon of referred pain.

Sometimes referred pain is easy to explain, such as when a nerve becomes injured or irritated, causing the pain to be felt along the length of the nerve. This often feels like a sharp, burning pain that runs in a strip, along the skin. Other examples of referred pain are more difficult to explain and in some cases seem to defy explanation. Perhaps you have heard about the strange phenomenon of phantom pain where amputees continue to feel pain as though it was in the place where their limbs used to be.

Muscular trigger points can also cause referred pain. The mechanism behind this is a bit trickier to understand, but is thought to be explained by tight bands of muscle tissues that cause pain to be felt in predictable patterns around the body.

Adding to this, we know that other tissues of the body can cause pain to be felt in a different location, including discs of the spine and internal organs. Many times the internal organs can refer pain in peculiar patterns and this can actually lead to serious illnesses being mistaken for muscular aches and pains. Kidney pain can be felt in the lower back and tragically, some people fail to recognize that they are having a heart attack because they feel pain in their neck and arm, not in their chest.

We also know that not understanding or being afraid of pain can make pain feel stronger. In rare cases, people who have pain in one hand can feel pain just by seeing their other hand moving in a mirror. There are many other fascinating aspects to pain, and understanding how it works is an important part of managing your symptoms. 

To understand how referred pain may be affecting you, chat to your physiotherapist who can help with any questions. None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Spinal Stenosis - Physio Direct NZ

Spinal Stenosis

What is spinal stenosis?

The spinal cord, nerves and arteries are housed by the spine, which acts as a hard electrical casing to support and protect these vulnerable structures. The spine has a hollow column that allows the spinal cord to run from the brain to the rest of the body. At each spinal segment, nerves exit the spine and supply the tissues of the body. There is also an intricate network of small veins and arteries that provide blood to the spinal cord and vertebrae, providing them with the nutrients needed to operate.

Spinal stenosis is characterized by a narrowing of the spaces that house the spinal cord, nerves and blood supply. A variety of factors can cause spinal stenosis, however overwhelmingly it is caused by degenerative changes to the spine as we age. Many people over the age of 60 will have spinal stenosis; however, not all will have pain. Clinically, spinal stenosis is used to describe the painful symptoms of this condition rather than just the narrowing itself.

What are the symptoms?

Pain with walking or standing that radiates into the hips, thighs and even feet is the hallmark of spinal stenosis. Usually, this pain will be reduced with rest and forward movements of the spine. Spinal stenosis is a progressive condition and symptoms will gradually increase over time. The pain is often described as a deep radiating ache and can be associated with fatigue, heaviness, weakness and numbness. It can affect just one leg, however more often will be felt in both legs.  There will often be associated back pain; however, leg pain is usually the most severe complaint.

How can physiotherapy help?

There are many conditions that need to be excluded before a diagnosis can be made. Your physiotherapist is able to conduct a thorough examination and accurately diagnose this condition. In some cases, imaging may be requested. As mentioned earlier, many people have stenotic spinal changes without symptoms. Surgery to decompress the restricted nerves and stabilize the spine are used in very severe cases. 

For mild to moderate cases of spinal stenosis, physiotherapy can be extremely beneficial.  Your physiotherapist can help you manage your pain through hands-on techniques and by providing a targeted exercise program based on biomechanical assessment. They are also able to help you to understand and manage your day in a way that helps to reduce flare-ups and maintain muscle strength.

If surgery is the right choice for you, your physiotherapist is able to guide you through this treatment pathway, helping you to prepare and recover from surgery to get the best outcome possible.

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

Sweet Potato & Cheese Fritters - Physio Direct NZ

Sweet Potato & Cheese Fritters

Ingredients:

2 Medium Sweet Potatoes

1/2 cup grated Cheddar Cheese

2 Large Eggs, lightly beaten

1 clove of crushed Garlic

2 Tbsp. Olive Oil

½ Tbsp. Cumin Powder

1 Tbsp. Salt & Pepper

1 Tbsp. fresh chives

Tomato salsa for dipping

  1. Peel sweet potatoes and grate them into small pieces. Preheat the oven to 200 °C and line a baking tray with foil and spray.
  2. Place grated sweet potatoes and cheddar cheese in a bowl along with eggs, salt, garlic and pepper and mix together gently.
  3. When mixed thoroughly, use a tablespoon to scoop out small amounts and roll into to small balls.
  4. Place the balls onto the baking tray and brush over or spray with olive oil. Bake for 15-20 minutes or until golden brown.
  5. Garnish with chives and add salsa for dipping.

Allow to cool and serve while still warm.

Move More, Sit Less – 5 Tips From Your Physio - Physio Direct NZ

Move More, Sit Less – 5 Tips From Your Physio

More movement in your day can improve mental, physical health and even workplace productivity. Physiotherapists know that one of the most significant contributors to pain and injury is simply lack of physical activity. Getting more movement in your day doesn’t need to be about high-intensity exercise, all movement can be beneficial. Here are a few tips to help increase the amount of motion in your day. 

1. Try the Pomodoro Technique at work or when studying

The Pomodoro Technique, developed in the late 1980s, recommends breaking work into intervals, usually 25 minutes at a time interrupted by short rests. Studies’ have shown that by creating small time limits, you can focus more intently and the breaks can be useful motivators. 

Use these intervals as prompts for a short walk, some squats or stretches. Not only will you have made your day more productive, but you will also have added some movement to your day. 

2. Challenge a friend to match your steps

A little healthy competition is a great way to keep you motivated to move more. You can set daily, weekly and monthly targets and compare progress to keep you on track. You can use an app like ‘Habitica’ to help track and create movement habits in a game format. 

3. Park further away 

This is an oldie, but a goodie. If you can’t ride or walk to your daily destinations, try parking further away and using the opportunity to walk. Taking the stairs instead of the elevator and getting up and walking while taking phone calls are also great ways to increase your daily movement. 

4. Have a kettle boiling exercise routine.

The time spent waiting for the kettle to boil can feel like an eternity. Use this time to undertake a mini exercise routine. Try fitting in two sets of five squats, five lunges; five heel nurses or try to balance on each leg for two minutes. 

5. Stretch before bed

Gentle stretches before bed are a great way to relax and keep your joints mobile. Create a routine and make it part of our nightly ritual for better sleep and a healthier body. 

Our physiotherapists are happy to help you find strategies to create more movement throughout the day. Come and have a chat with us to see what might work for you.  

Femoroacetabular Impingement - Physio Direct NZ

Femoroacetabular Impingement

What is it?

When the two surfaces of the hip joint move over each other, they usually move freely without any friction. If there is an alteration to either the socket part of the joint (the acetabulum) or the ball (the head of the femur), irritation may occur as the two surfaces move over each other. This is known as Femoroacetabular impingement, a common disorder of the hip, characterized by pain and stiffness.

Femoroacetabular impingement can be classified as cam, pincer or mixed. A cam FAI occurs when the femoral head junction is flattened or a small bump is present. Pincer type of impingement occurs when the acetabular rim extends slightly, causing the femur to be impacted. Cam impingement is more common in men while pincer impingement is more common in women. However, most cases of FAI (about 85%) are mixed, meaning they both have cam and pincer types of impingement.

What are the symptoms?

The most common symptom of FAI is pain located in the hip or groin when resting in certain positions or with specific movements. Some patients also report pain in the back, buttock or thigh. Other symptoms include stiffness, loss of movement range (particularly of the hip), locking, clicking or a feeling that the hip is about to give way.

Activities that cause the incongruous surfaces to move over each other repeatedly are naturally the main culprits for causing symptoms. These can include prolonged sitting, twisting, sitting with crossed legs, squatting and climbing stairs can all aggravate the pain caused by femoroacetabular impingement.

What are the causes?

There are many factors that may cause an individual to develop femoroacetabular impingement including;

  • Hip dysplasia or malformation during infancy/childhood
  • Repetitive stress on the hip
  • A femoral neck fracture that did not heal properly (malunion)
  • Small bony growths around the joint called osteophytes.
  • Normal anatomical variation

How can physiotherapy help?

Femoroacetabular impingement is a complex condition and researchers are still determining the best possible treatment. It is thought that untreated FAI can lead to osteoarthritis of the hip down the track and there are both surgical and non-surgical options for treatment.  Conservative (non-surgical) management for FAI involves core stability training, strengthening exercises for the lower limb specifically the hip and postural balance exercises. This program aims to improve the hip’s neuromuscular function. A hydrotherapy program can also helpful as it reduces weight through the joint, making movements more comfortable. Lastly, a home exercise program is made for patients, so they can continue treatment at home. For many people, physiotherapy is enough to resolve their symptoms and prevent future problems, however others may require surgery.

With surgery, hip arthroscopy is the most common procedure for this disorder and is used to change the shape of the joint slightly so that there are no points of irritation with movement. After surgery, patients are usually referred to physiotherapy for rehabilitation.

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

Grilled Avocado Guacamole - Physio Direct NZ

Grilled Avocado Guacamole

Ingredients:

4 Avocados

3 Roma Tomatoes

1 Small Red Onion

2 Limes

¼ cup Coriander, chopped

1/2 tsp. Salt

1/2 tsp. Black Pepper

¼ tsp. Cumin

¼ tsp. Paprika

  1. Lightly grease a grill or pan with olive oil and place on medium-high heat
  2. Cut avocados in half, remove the seed, keeping the skin intact. Place avocados face down on the grill for a few minutes, allowing them to brown slightly. Remove from heat and allow to cool. Cut tomatoes into halves and grill face down for 2 to 3 minutes. Remove from pan and allow them to cool. Cut onions into large rings and place on grill for 2 to 3 minutes, each side. Repeat this process with halved limes, grilling for 1 to 2 minutes. 
  3. Once cooled, remove the skins of the avocados. Cut all vegetables into small pieces and mix into a bowl. Mash the ingredients together, adding chopped coriander, seasonings and the juice of the grilled limes, until completely combined.

Serve with tortillas or corn chips.