Sweet Potato & Carrot Cake - Physio Direct NZ

Sweet Potato & Carrot Cake


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


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.

Focus On Hamstring Tears - Physio Direct NZ

Focus On Hamstring Tears

What are they?

The hamstrings are a large group of muscles, located at the back of the thigh. Their job is to bend the knee, move the hip backwards and stabilise the leg. The muscles can be injured at any point but are most vulnerable where the tendon and muscle fibres join together. This is a common injury for players of all sports that involve running, but particularly those that involve quick movements and kicking. 

What are the causes?

As the hamstrings cross two large joints, they need to perform complicated movements, often activating suddenly and with great force. They are often stretched during a fall, large kick or sudden take-off. Factors that increase the chance of a tear, include poor flexibility and neural mobility. Other factors that contribute to hamstring injuries are muscle imbalances, abnormal lower limb biomechanics, fatigue, and inadequate warm-up. It seems, however, the biggest predictor of a future hamstring tear is a previous hamstring injury.

What are the symptoms?

The most common symptom of a torn hamstring is a sharp pain at the back of the thigh, often immediately after intense activity. There may also be swelling, bruising, difficulty walking and pain with knee movements. The symptoms of a hamstring tear are similar to many other conditions, as the lower back often refers pain to the back of the thigh, mimicking a hamstring tear. 

Your physiotherapist can confirm that the pain is due to a torn hamstring and tell you how bad the tear is. Although not usually required, diagnosis can be confirmed by having an MRI or real-time ultrasound scan.

How can physiotherapy help?

Once a diagnosis has been made, the first step is to follow the R.I.C.E protocol (Rest, Ice, Compression, Elevation). During the first 48 hours, you should apply ice for 20 minutes every hour to reduce swelling and bruising. Consultation with your physio will include advice about your recovery, and when it is appropriate to return to sport. Your physiotherapist has many techniques that can promote healing and reduce scar tissue formation, which may include ultrasound, deep tissue therapy, laser, TENS and dry needling.

They will also prescribe an exercise program to return strength, flexibility and control to the muscle, getting you back to your sport quickly and safely. Due to the high chance of recurrence, rehabilitation is very important and usually takes 6-12 weeks. If the muscle is completely torn, surgery may be required before rehabilitation can start. Your physiotherapist will work with you to help you set goals to get you back to your favourite activities as soon as possible.

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. 

Making The Most of Your Physio Treatment - Physio Direct NZ

Making The Most of Your Physio Treatment

Seeing a physiotherapist is an important investment in healing and recovery from injury. Here are a few tips to help get the best outcomes from your treatment time.

Know what your goals are and ask questions.

If you are clear on what you hope to achieve through physiotherapy, this can help you and your therapist to work together to target treatment towards these goals.

Understanding your condition also plays an important part in recovery, it means that you can make better choices to protect and allow your body to heal, plus you will know better how to prevent future injuries. Before each treatment, it can help to take a few moments to prepare some questions and consider what your short and long-term goals might be. 

Do your exercises.

Targeted home exercises are an essential part of your recovery as they help your body to support itself through healing and recovery. Strengthening weak muscles is one way to correct biomechanical imbalances and reduce excess stress on body structures, as well as helping tissues to strengthen as they recover.

Follow your therapist’s recommendations.

Throughout your recovery, your therapist will guide you as to which activities you should avoid and how much rest to take. Return to sport and activity should be gradual, so as not to stress the body too hard when it is still healing. 

Rest is just as important a part of recovery as strengthening. Following the advice given by your therapist can ensure that you don’t injure yourself again and get the most out of your body.

Be patient with your progress.

It can be frustrating waiting for your body to heal. Returning to sport too early or giving up on treatment are common errors that lead to further injury or impaired healing. Recovery takes time, a general rule is that the longer a condition has been present, the longer it will take to resolve. 

If there is a part of your condition or injury that you are struggling to understand, be sure to seek clarification with your physiotherapist. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your condition.

Cauliflower & Blue Cheese Soup - Physio Direct NZ

Cauliflower & Blue Cheese Soup

Cauliflower & Blue Cheese Soup


1 large Cauliflower

2 Tbsp. Butter

4 cups Vegetable Stock or water

100g Blue Cheese

3 Tbsp. chopped Parsley

2 cloves Garlic

2 cup Milk

Salt and Pepper

½ cup Cream

Sliced Almonds

  1. Cut cauliflower into small pieces and place into a roasting dish, drizzle melted butter over top.
  2. Spread pieces in a single layer, add garlic season with salt and pepper and pour 1 cup of stock or water into the base of the dish.
  3. Roast at 180˚C for about 40 minutes until tender and just starting to brown.
  4. Blend cauliflower and juices until smooth then transfer to a large saucepan on medium heat; add the rest of the stock or water, blue cheese, parsley, milk and cream. 
  5. Reduce to low heat, simmer and stir occasionally until the soup is thick and creamy.

Serve while hot and garnish with sliced almonds.

Focus on Ankylosing Spondylitis - Physio Direct NZ

Focus on Ankylosing Spondylitis

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS) is a type of inflammatory, autoimmune arthritis that primarily affects the spine. It is characterised by intermittent pain and progressive stiffness due to the inflammation and eventual hardening of the ligaments that surround the spine. The classic early symptoms of Ankylosing Spondylitis are pain and stiffness of the sacroiliac joints, the large joints connecting the pelvic bones to the sacrum in the lower back. In the final stages of the disease, the entire spine can become fused and rigid, often in a flexed, forward posture.

As this is an inflammatory disorder, many other systems and joints are often also affected. A significant number of people with AS also suffer from irritable bowel syndrome and inflammation of the eye.

What causes it?

The cause of Ankylosing Spondylitis is not clear, however, there are markers and predisposing factors that may contribute to the development of the condition. Genetics, chronic stress and frequent gastrointestinal infections are among the predisposing factors. Men are affected more often than women and symptoms usually begin between the ages of 17 and 45 years.

What are the signs and symptoms?

Intermittent back pain and progressive stiffness are the two most common symptoms of Ankylosing Spondylitis. Other tendons and ligaments may be affected, including those in the hands, feet and ribs. Symptoms tend to be worse following periods of rest, particularly first thing in the morning and improve following periods of activity. It is common for people to experience “flare-ups” and “remissions” of symptoms.

Some people with Ankylosing Spondylitis may experience mild discomfort in the spine from time to time, while others may experience severe and debilitating symptoms at frequent intervals with minimal time in remission from symptoms. Long term issues with AS include breathing difficulties due to thoracic and rib cage stiffness and severe spinal pain and immobility. Medical treatment focuses on reducing inflammation and slowing the disease process.

How can physiotherapy help?

Physiotherapy treatment aims to manage pain during flare-ups and maintain optimal posture as the disease progresses. Your physiotherapist will assess your spinal movement and posture as well as strength. If your hands, feet, hips or shoulders are affected, they will also provide you with specific exercises to help maintain mobility and strength in those joints. Many studies have proven the positive benefits of exercise for those with Ankylosing Spondylitis, such as improved rib cage expansion when breathing, and improved posture of the upper back and neck.

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

5 Reasons to Stay Active - Physio Direct NZ

5 Reasons to Stay Active

The benefits of keeping active may seem obvious, yet it can’t hurt to be reminded of the many ways exercise can improve your life. Here are a few of our favourite reasons to get moving. 

  • Exercise improves energy levels. 

Improving your fitness means your body is capable of achieving more for the same energy expenditure. While doing exercise can make you tired in the short term, regular improvements to your fitness will help you get more out of your body each day.

  • Exercise can help to reduce stress.

If you are stuck in a state of stress or panic, exercise can help you move out of it into a calmer and more relaxed state, improving your mood, concentration and sleep.

  • Exercise and hobbies can help you build connections and community. 

Making new friends as an adult can be surprisingly difficult and the importance of connection and community is being recognised more as being essential for overall wellbeing. Being part of a team, or club is a great way to build confidence, meet friends as well as keeping active. 

  • Exercise keeps your muscles, tendons, joints and bones healthy.

Our bodies are often compared to machinery or car parts. However, there are some crucial differences between our bodies and machines, including the fact that our bodies respond to exercise by becoming stronger and healthier, rather than being worn out. One of the best ways to prevent osteoporosis is through regular high impact activity, which stimulates bone growth. 

  • Exercise can help to reduce injuries.

Similar to the previous point, tissues that are used regularly are stronger, more elastic and are less likely to tear or break when under stress. Regular exercise is the best way to keep your body in a healthy state and prevent injuries.

Finding the right exercise for you can be tricky, your physiotherapist can help you with suggestions based on your ability and skillset. 

Blueberry & Coconut Muffins - Physio Direct NZ

Blueberry & Coconut Muffins


1 Egg

1/2 Coconut Milk

1/2 Cup Coconut Cream

4 Tbsp. Melted Butter

1/2 Cup Sugar or Honey

2 tsp Baking Powder

1 Cup Frozen Blueberries

2 1/2 Cup Flour

  1. Preheat oven to 200 degrees Celsius. Lightly oil a muffin tin and set it aside.
  2. Add eggs, coconut milk, coconut cream and butter into a large bowl and mix well. 
  3. Add sugar or honey, baking powder and flour and blend until a smooth consistency is achieved.
  4.  Gently fold blueberries through the batter and scoop into muffin tins, filling each to 2/3rds. Bake for 15-20 minutes

Makes 12 Muffins

Is Surgery The Right Decision For You? - Physio Direct NZ

Is Surgery The Right Decision For You?

The decision to have surgery following an injury is a serious and complicated one. It can be difficult when navigating the minefield of information you receive to know what is the right pathway for you.

Unfortunately, the answer is not always obvious which can be very confusing. To ensure that surgery is right for you, here are a few questions it pays to ask yourself and your medical team before making a decision. 

How much will surgery cost and will I need to take time off work?

One of the major downsides of surgery is that you will often need to take time off work to recover, resulting in lost income. The cost of the surgery itself may not be completely covered, particularly for elective procedures and you will often need to visit physiotherapy afterwards. The cost of surgery can really add up, and if you can achieve similar results with physiotherapy, you might find yourself in a much better financial situation.

What are the potential complications and success rates for your surgery?

All surgeries come with risks and potential complications, the probability of these will vary depending on the type of surgery, your age and general health. It is also important to compare the success rates of surgery with a period of physiotherapy treatment. Optimal surgical outcomes still often depend on effective post-surgery physiotherapy treatment, which can be an argument for considering physiotherapy first. In some cases, however, healing simply will not occur without surgical intervention and physiotherapy will have little success in resolving the issue.

What are your post-surgical goals?

Not everyone wants to ski down a mountain, but for some, being able to push and trust their bodies is important for both their income and quality of life. Surgery that aims to repair instability might be the right decision for someone who has high athletic demands on their body, but not for another person who isn’t very active. Setting your goals for your body can help to guide your decision making process.

Before making any major decisions, it is important to consult your medical team to ensure you are well educated in all the risks and benefits of choosing surgery. 

Focus on Carpal Tunnel Syndrome - Physio Direct NZ

Focus on Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

The carpal tunnel is a small space base of the hand. This tunnel is covered by a thick ligament and creates a small tunnel where various nerves, arteries and tendons pass through from the forearm into the hand. If anything causes this space to be reduced, these structures can become compressed and damaged, particularly the median nerve. This common condition is referred to as Carpal Tunnel Syndrome (CTS). 

What are the symptoms?

The hallmark symptoms of carpal tunnel syndrome are pain, numbness and weakness in the hand, usually following a typical pattern over the thumb, index and middle finger. There can also be a reduction in grip strength and wasting of the thumb muscles. Symptoms are usually worse on waking or with repetitive hand movements. Patients might also report difficulty holding items, writing or doing up their buttons.

How does it happen?

Carpal tunnel syndrome can be caused by anything that reduces the space in the carpal tunnel, including arthritis, the growth of a cyst or compression from everyday activities. The median nerve is particularly vulnerable to compression and is of the most concern as prolonged compression can cause nerve damage and permanent weakness of the hands. 

How is it treated?

There are a few different treatment options for CTS. Non-surgical treatment is often recommended first, which includes physiotherapy, wearing a splint, cortisone or plasma rich platelet injections to promote nerve healing. The effectiveness of physiotherapy will depend on the cause of your carpal tunnel. If the space of the tunnel has been reduced permanently, such as with arthritis, then surgery is likely to be the most effective treatment. Carpal tunnel surgery is an operation to widen and release the carpal tunnel allowing decompression. This is a common surgery but is not without its risks or complications and requires a period of time off work for recovery.

For non-surgical cases, altered biomechanics of the arm, the mobility of the median nerve and muscle tightness may all be contributing to symptoms. In this case, physiotherapy can be highly effective, along with a period of rest, splinting and a change in daily habits.

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

Why Do Tendon Injuries Take So Long To Heal? - Physio Direct NZ

Why Do Tendon Injuries Take So Long To Heal?

If you have ever suffered from a tendon injury you will know that the recovery can be frustratingly long. Tendons are important tissues of the body, connecting muscles to bones and come in many different shapes and sizes. There are many reasons why tendon injuries can be difficult to treat, as we explain below.

Tendon injuries often develop gradually.

Tendons need to be able to transmit forces from muscles to the bones that they attach, however they respond to changes in strength more slowly than muscles do. As muscles become stronger or take on more load, the tendons can fail to keep up with this increased demand becoming painful and damaged. This process can take a while to occur and often changes to tendon tissue has begun long before the pain is noticed. This means that there are likely to be multiple factors to be assessed, including biomechanics and training regimes before the problem can be resolved.

Tendons have limited blood supply

Tendons do have their own blood supply, however, it is not abundant as muscles and this can be a factor with healing as all tissues require nutrients for health and to heal. Any condition that compromises circulation, such as diabetes, can predispose tendons to injury and delayed healing.

Rest and stretching may not necessarily help.

Our instincts in response to tendon pain may not help with recovery. In some cases, stretching can aggravate symptoms and while rest may reduce symptoms, it will not necessarily help with recovery. The best evidence for promoting healthy tendon growth is through addressing poor biomechanics and a tailored strength and loading program.

Recovery often relies on adherence to a specific rehab program.

One of the biggest barriers to healing tendon pain is that exercises can be easy to do in theory, but hard to do in practice. They can take time and discipline. Your physiotherapist can also help you to find strategies to fit your exercises into your daily routine if you are finding this difficult.Ask your physiotherapist for more information about tendon pain.

A Wrist Injury: Scaphoid Fractures - Physio Direct NZ

A Wrist Injury: Scaphoid Fractures

What is it?

The scaphoid is a small bone in the wrist that connects the radius to the hand, and it is situated near the thumb. Scaphoid fractures are a relatively common wrist injury and are commonly misdiagnosed as the pain can be quite mild even when the bone has been broken. 

Scaphoid fractures are notorious for their high incidence of complications healing due to low blood supply to the area and how easily their diagnosis can be missed. 

How does it happen?

A scaphoid fracture is often caused by a fall on an outstretched hand or a direct blow to the wrist. It is more common in young adults than in children and the elderly.

What are the symptoms?

Symptoms of a broken scaphoid include wrist pain, swelling, bruising or discolouration of the skin over the injured area and difficulty moving the wrist or hand. As the swelling subsides you might notice pain at the base of the thumb when opening jars or gripping objects. There may also be a deep, dull ache in the wrist that doesn’t settle easily.

How is it diagnosed?

If you suspect that you have a scaphoid fracture, you should consult your physiotherapist or GP who will refer you for an X-ray to confirm if the bone is broken. Occasionally scaphoid fractures will not show up on an X-ray, so if the findings are negative yet your medical team still suspect a fracture, they may wait a week then X-ray again or send you for an MRI or CT to double-check. Though these fractures can often be treated without surgery, doctors may recommend surgical intervention for more severe cases. 

How can physiotherapy help?

If you have a scaphoid fracture, your doctor will likely prescribe a splint or cast to ensure the wrist is kept still until healing is complete, usually for a minimum of six weeks. Healing times will vary depending on which part of the bone has been broken. Following the removal of the cast or splint, there is often residual pain, stiffness or muscle weakness. Your physiotherapist can help you restore any deficits as well as resolve any shoulder pain or headaches that may have resulted from altered biomechanics. 

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

Avocado Chocolate Mousse - Physio Direct NZ

Avocado Chocolate Mousse


2 Large Avocados

1/2 cup Cacao Powder

1/2 cup Coconut Milk

1/2 cup Honey

2 tsp Vanilla Extract

1/2 tsp ground chilli

1 tsp Cinnamon

1/2 tsp Cardamom

Fresh Blueberries

Fresh Mint

  1. Peel and pit avocados and scoop flesh into a bowl.
  2. Add cacao powder, coconut milk, vanilla, chilli, cardamom, cinnamon and honey and combine ingredients.
  3. Using either a cake mixer or food processer, blend ingredients until smooth and slightly fluffy.
  4. Put into small containers, sprinkle with berries and coconut. Allow to chill for at least 20 minutes.

Serve chilled with coconut cream.

Strawberry & Parmesan Salad - Physio Direct NZ

Strawberry & Parmesan Salad


4 cups Mixed Salad Greens 

8 Medium Strawberries 

1 Medium Avocado 

4 Tbsp. Roasted Sunflower Seeds 

2 tsp. glazed Balsamic Vinegar 

2 Tbsp. Coconut Oil

1 tbsp. Lemon Juice

50g shaved Parmesan Cheese 

  1. Place greens in a large mixing bowl. Slice strawberries and avocados and add to the bowl along with roasted sunflower seeds. 
  2. Mix coconut oil and lemon juice and spread over salad. Sprinkle Parmesan cheese on top. 
  3. Drizzle balsamic oil over the salad, serve immediately.

Serves two.

Focus: Can Stress Affect My Pain? - Physio Direct NZ

Focus: Can Stress Affect My Pain?

A common fear for patients when discussing pain is the idea that their symptoms are ‘all in their head’ or that they won’t be believed either by friends, family, therapists or workplace. This fear can be worse when there appears to be no obvious cause for their pain or it has been present for a long time.

What is pain?

Many of the models used in the past to explain pain lead us to believe that the intensity of pain will always be proportional to the severity of an injury. The experience of pain is always real and usually distressing. However, pain is a warning system used by our nervous system to alert us to danger, not a direct indicator of damage done. This is a subtle, yet important distinction meaning that the experience of pain can be influenced by many different factors and not exclusively tissue damage.

How can stress impact pain?

Part of the role of your nervous system is to sort through a huge amount of sensory input and interpret it in a meaningful way. When pain is considered to be a serious threat to the body, the intensity of the pain will be worse.

This can happen in many situations, for example:

-The source of the pain is not well understood, leading to fear that the pain might be something very serious.

-The nervous system is in a state of hyper-arousal, such as when you are stressed or tired.

-The pain or injury could have a significant impact on your quality of life, career, relationships or hobbies.

-The injury occurred through a traumatic event such as a car accident.

What does this mean for my treatment?

Along with all our more traditional treatments, we also know that stress reduction strategies, mindfulness and addressing any emotional trauma associated with pain can all help to aid recovery and improve quality of life. Your physiotherapist is a great person to speak to about pain management strategies so you can get the most out of your life while dealing with long-term pain.

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.

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.