the-addison

Running Shoes and Injury Prevention: Does Your Shoe Choice Really Matter?

Tue, 20 Oct 2026 23:43:21 GMT

Walk into a running store and it's easy to feel like choosing the wrong shoe will ruin your knees.

The reality is more nuanced.

There isn't one perfect running shoe

Different runners prefer different levels of:

cushioning
stiffness
heel-to-toe drop
support
weight
responsiveness

There isn't one shoe that is universally best for preventing injuries.

Comfort matters

A shoe should generally feel comfortable and appropriate for the type of running you're doing.

If you are comfortable in a particular shoe and running well, you don't necessarily need to change because someone tells you your foot “needs” a completely different type.

What about pronation?

Pronation is a normal part of running.

Seeing someone's foot pronate does not automatically mean it needs to be corrected.

Footwear decisions should be based on the individual rather than one movement characteristic.

When can shoes contribute to problems?

A rapid footwear change can alter loading.

For example, suddenly changing:

heel-to-toe drop
cushioning
shoe stiffness
plated versus non-plated shoes
while maintaining the same training load may expose tissues to unfamiliar demands.

Training load still matters

A runner who rapidly increases from 20km to 50km per week isn't necessarily injured because they chose the wrong shoe.

Often the more important question is: Was the body prepared for the amount of running being asked of it?

Returning to Running After Injury: A Step-by-Step Guide

Tue, 20 Oct 2026 23:40:11 GMT

One of the biggest mistakes after injury is treating return to running as an on/off switch.

You are injured.

Then you're “cleared”.

Then you go back to your normal 5km.

A better approach is to think of running as another progressive rehabilitation exercise.

Step 1: Build enough capacity

Before running, we may assess:

walking tolerance
strength
calf capacity
single-leg control
hopping
impact tolerance

The exact criteria depend on the injury.

Step 2: Introduce running gradually

For some people this starts with run/walk intervals.

For example: 2 minutes running / 1 minute walking × 6

That allows us to introduce running load without immediately asking the body to tolerate 30 continuous minutes.

Step 3: Increase duration

Once the body is tolerating running consistently, we can progressively increase total running time.

Step 4: Build continuous running

The next goal may be moving from intervals towards uninterrupted easy running.

Step 5: Add intensity

Speed, hills and harder sessions generally place different demands on the body.

They don't necessarily need to return at the same time as easy running.

Step 6: Return to normal training

Eventually, running needs to look like the activity you're preparing for.

A recreational 5km runner, marathon runner and footballer will require different end-stage programs.

Watch the response

The mo st important information often comes from what happens after the run and the following morning.

A good return-to-run program adapts based on this response rather than blindly progressing because a spreadsheet says it's time.

Marathon Recovery: What Should You Do After a Marathon?

Tue, 20 Oct 2026 23:38:21 GMT

You've spent months preparing for 42.2km.

You finish the marathon.

Then comes the question: What now?

The first few days

Your priority is recovery.

That means:

sleep
adequate food and hydration
gentle movement
allowing soreness to settle
avoiding the temptation to immediately “train through” recovery

Walking and normal daily movement are generally useful as tolerated.

When can you run again?

There isn't one mandatory number of rest days for every runner.

Consider:

how hard you raced
your training history
muscle soreness
any injuries or niggles
sleep and general fatigue
whether another event is approaching

Don't confuse fitness with recovery

Your cardiovascular fitness doesn't disappear immediately after a marathon.

You do not need to rush back into training because you're worried about losing everything you built.

Allowing adequate recovery may make the next training block more productive.

Your first runs back

Start easy.

The first few sessions are not the time to test your fitness with intervals or a hard tempo.

Gradually rebuild easy running before layering intensity back into the program.

Persistent pain isn't normal recovery

General muscle soreness is expected.

A specific area that remains painful, particularly with walking or impact, deserves closer attention.

SIJ Pain and Running: Can You Keep Running?

Tue, 13 Oct 2026 23:35:55 GMT

Pain around the back of the pelvis is often described as “SIJ pain”.

The sacroiliac joint sits where the pelvis meets the sacrum. However, pain in this area does not automatically mean the SIJ itself is the source.

What else can cause pain there?

Symptoms around the posterior pelvis can potentially relate to:

lumbar spine
SIJ
gluteal structures
proximal hamstring
referred or neural pain

That is why location alone isn't enough for a diagnosis.

Can running aggravate it?

Yes. Running repeatedly transfers force through the trunk, pelvis and lower limbs.

Symptoms can sometimes emerge following changes in running volume, speed, hills or overall training load.

Do you need to stop?

Not always.

If running produces mild symptoms that remain stable and settle appropriately afterwards, training may sometimes continue in a modified form.

If symptoms progressively worsen, alter your running mechanics or start producing neurological symptoms, further assessment is appropriate.

Rehab is rarely just about “putting the pelvis back in”

Modern rehabilitation generally focuses more on function, strength, load tolerance and symptom behaviour than repeatedly trying to correct tiny positional differences in the pelvis.

Depending on the presentation, rehabilitation may involve trunk, hip and lower-limb strengthening alongside graded running exposure.

Hip Pain When Running: What Could Be Causing It?

Tue, 13 Oct 2026 23:34:38 GMT

Hamst“Hip pain” can mean very different things depending on where you actually feel it.

A runner pointing to the outside of their hip may have a completely different problem from someone describing deep groin pain.

Pain at the front of the hip

Potential contributors include hip joint irritation, hip flexor-related problems and other structures around the anterior hip.

Deep groin pain, catching or restriction may warrant closer assessment of the hip joint itself.

Pain on the outside of the hip

Lateral hip pain may involve the gluteal tendons or surrounding structures.

Running volume, hills and lower-limb loading can all influence symptoms.

Pain at the back of the hip

Posterior hip or buttock pain can originate from several sources.

Sometimes the lumbar spine or neural structures can refer symptoms into this region, meaning the painful area isn't necessarily the source.

Should you keep running?

That depends on the diagnosis and symptom response.

Some hip problems tolerate modified running very well. Others - particularly when a bone stress injury is suspected - require more caution.

Why assessment matters

Rather than simply diagnosing “tight hips”, a good assessment should determine:

where the symptoms are coming from
what loads aggravate them
whether strength or mobility is relevant
whether running load has changed
whether imaging or medical review is indicated.

Hamstring Strains: How to Rehab Properly and Reduce Re-Injury Risk

Tue, 13 Oct 2026 23:33:23 GMT

Hamstring strains have an annoying habit of coming back.

One reason is that rehabilitation often stops once someone can jog and perform basic exercises without pain.

But being able to jog is very different from being ready to sprint.

Hamstring rehab needs progression

A comprehensive program may include:

progressive hamstring strengthening
loading at longer muscle lengths
hip-extension exercises
single-leg strength
trunk and pelvic control
progressive running
exposure to high-speed running

Why sprinting matters

Hamstrings experience high demands during faster running.

If your rehabilitation never exposes the hamstring to increasing running speeds, there can be a large gap between what you have prepared for and what sport requires.

Is it always just the hamstring?

No.

Assessment may also consider the lumbar spine, neural system, glutes, running history and previous injuries.

This is particularly relevant if symptoms don't behave like a straightforward muscle injury.

Our existing Addison hamstring material takes the same broader approach rather than treating the hamstring in isolation.

The goal

Good hamstring rehab isn't simply about getting you pain-free.

It's about restoring enough capacity that sprinting, acceleration, running and sport are no longer unexpected demands.

Calf Strains: How Long Until You Can Run Again?

Wed, 07 Oct 2026 00:26:28 GMT

One of the first questions after a calf strain is: “When can I run again?”

Unfortunately, the calendar alone doesn't give us the answer.

A minor calf strain and a significant calf tear are very different injuries.

What matters before returning?

Rather than simply waiting a certain number of weeks, we want to see whether the calf has regained enough capacity.

That may include assessing:

walking tolerance
calf raise strength
single-leg calf endurance
hopping
jumping
power
ability to tolerate faster contractions

Why calf raises matter

Running places repeated demands through both the gastrocnemius and soleus.

Someone may feel completely normal walking around but still have a considerable strength deficit when tested.

Returning to running without restoring this capacity can expose the calf to more load than it is ready for.

Your first run back shouldn't be your old 5km

Return to running is usually progressive.

Depending on the injury, that might initially involve run/walk intervals before progressing duration, continuous running, speed and hills.

The final stages should reflect what you actually want to return to - particularly if that includes sprinting or field sport.

Don't just wait for pain to disappear

Pain settling is important.

But pain-free does not automatically mean fully rehabilitated.

Restoring strength, endurance and running exposure gives you a much better foundation for returning confidently.

Stress Fractures in Runners: Early Warning Signs You Shouldn’t Ignore

Wed, 07 Oct 2026 00:24:46 GMT

Stress fractures rarely happen from one bad step.

More often, there is a gradual progression where bone is repeatedly exposed to more stress than it can recover from.

Early warning signs

Be particularly cautious about running pain that:

is very localised
worsens with impact
is tender directly over the bone
starts earlier as training continues
progresses from running pain to walking pain
doesn't behave like your usual muscular soreness

Where do runners develop stress fractures?

Common sites include the:

tibia
metatarsals
navicular
femur/femoral neck
pelvis

The location matters because some bone stress injuries are considered higher risk and require more conservative management.

Why do they happen?

Training load is important, but it isn't the whole story.

Assessment may also consider:

recovery
sleep
previous stress fractures
strength
nutrition
energy availability
menstrual health where relevant
training surfaces and footwear

Don't keep testing it

One of the biggest mistakes runners make is repeatedly going for “a little run to see how it feels.”

If a bone stress injury is suspected, early load modification and appropriate assessment are important.

Catching the problem earlier on the bone stress continuum can potentially prevent a smaller stress reaction progressing into a more significant injury. This distinction is also emphasised in our existing bone-stress content.

IT Band Syndrome: Why Does the Outside of My Knee Hurt When Running?

Wed, 07 Oct 2026 00:23:01 GMT

What does typical shin splint pain feel like?

You start your run feeling fine.

A few kilometres later, a sharp or burning pain develops on the outside of your knee.

You stop and it settles.

Then the next run, it happens at almost exactly the same distance.

This is a common presentation of iliotibial band syndrome , or ITBS.

Is my IT band just tight?

Probably not in the way you think.

The IT band is a thick piece of connective tissue. Simply trying to stretch or foam-roll it into becoming “looser” usually doesn't address why symptoms developed.

Instead, we want to understand why the tissues around the outside of the knee are becoming irritated during repeated running.

Common contributors

These may include:

sudden increases in running volume
downhill running
rapid increases in long-run distance
inadequate recovery
hip strength or control deficits
running mechanics in some individuals

Why does it appear at the same distance?

Running involves thousands of repeated loading cycles.

An irritated structure may tolerate the first few thousand cycles before reaching its current threshold.

That is why someone might say: “I'm completely fine for 5km, then it starts hurting.”

That information is useful because it helps us set an initial running load below the point where symptoms escalate.

What does rehab look like?

Rather than simply resting and foam rolling, rehabilitation usually focuses on improving lower-limb capacity and progressively restoring running volume.

For some runners, temporary modifications to cadence, hills or stride characteristics may also help.

Shin Splints: When Should You Stop Running?

Tue, 29 Sep 2026 02:19:39 GMT

“Shin splints” is a term runners use for pain along the inside of the shin, often associated with medial tibial stress syndrome.

But there is an important catch:

Not every painful shin is shin splints.

Sometimes shin pain can represent a bone stress injury, and distinguishing between the two matters.

What does typical shin splint pain feel like?

Medial tibial stress syndrome commonly produces pain along a broader area of the inner border of the tibia. Symptoms may initially occur during running before settling afterwards.

Common contributors include sudden changes in:

weekly kilometres
running frequency
speed
hills
training surfaces
recovery

When are we more concerned?

Pain deserves greater attention when it becomes:

very localised to one small area
progressively worse
painful with hopping
painful during normal walking
present at rest
consistently appearing earlier during runs

These features may increase suspicion of a bone stress injury.

Should you run through shin splints?

It depends.

Mild symptoms may sometimes be managed by modifying training while improving calf and lower-limb capacity.

Progressively worsening or highly localised pain should not simply be repeatedly “tested” with another run.

What should rehab focus on?

Management may include:

adjusting running load
calf strengthening
soleus strengthening
hip and lower-limb strength
reviewing recent training changes
gradual return to impact
reviewing nutrition and recovery where appropriate

The important part is identifying why your shin has become overloaded rather than simply waiting for the pain to disappear.

Achilles Tendinopathy: Why Your Achilles Hurts When Running

Tue, 29 Sep 2026 02:17:55 GMT

You wake up, take your first few steps and your Achilles feels stiff and sore.

After walking around it loosens up.

You run and it might even feel better - only to become sore again afterwards or the following morning.

That pattern is extremely common with Achilles tendinopathy.

What is happening to the tendon?

The Achilles tendon connects the calf muscles to the heel and deals with substantial forces during running.

Problems often develop when the tendon is exposed to more load than it currently has the capacity to tolerate.

This might follow:

increasing kilometres
adding speed work
increasing hills
returning after a break
changing sports
suddenly increasing gym or plyometric training

Why is it so stiff in the morning?

Morning stiffness is one of the characteristic features of Achilles tendon problems.

It is also useful for monitoring your response to training. If morning pain and stiffness are progressively increasing, it may indicate that your current running and rehabilitation load needs adjusting.

Should I stretch my Achilles?

Stretching is not necessarily the main answer.

For most Achilles tendinopathy presentations, the priority is improving the strength and load tolerance of the calf-Achilles complex.

That usually means progressive calf strengthening rather than endlessly stretching the painful area.

Can I still run?

Often, yes.

Some runners can continue with modified training while completing rehabilitation. Others need a temporary reduction in running load.

The decision depends on symptom severity, function and how the tendon responds over the following 24 hours.

Achilles rehab takes time

Tendons adapt slowly.

Good rehabilitation typically progresses from controlled calf strengthening towards heavier loading, single-leg work, faster contractions, plyometrics and eventually the demands required for running.

The goal isn't simply to make the pain disappear. It is to make the tendon capable of handling running again.

Runner’s Knee: Why Does My Knee Hurt When I Run?

Tue, 29 Sep 2026 02:16:12 GMT

Runner’s knee is one of the most common problems we see in runners. The term usually refers to patellofemoral pain - pain felt around or behind the kneecap.

It can appear during a run, afterwards, when walking downstairs, squatting or even after sitting for a long period.

Importantly, it does not necessarily mean there is something structurally wrong with your knee.

Why does runner’s knee develop?

Often, it comes down to a mismatch between the amount of load going through the knee and how much load the knee is currently prepared to tolerate.

Common contributors include:

a sudden increase in running volume
adding hills or speed sessions
returning to running after time off
reduced quadriceps or hip strength
changes in running frequency
inadequate recovery between sessions

Sometimes running mechanics are relevant, but there is rarely one single “bad” running technique responsible for knee pain.

Why does it hurt running downhill?

Downhill running increases demand through the patellofemoral joint. That is why runners with an irritated knee will often tolerate flat running reasonably well but notice symptoms quickly on descents.

Do I have to stop running?

Not necessarily.

For many runners, the better approach is to modify running rather than completely stop it.

That could mean temporarily reducing distance, slowing the pace, avoiding hills or increasing recovery between sessions.

At the same time, rehabilitation should improve the knee’s ability to tolerate load.

What does rehabilitation involve?

Strengthening commonly targets:

quadriceps
glutes
calves
hamstrings
single-leg strength and control

Your running program then needs to be progressively rebuilt alongside this

The key point

Runner’s knee is usually a load and capacity problem, not a sign that running is damaging your knees.

If knee pain is repeatedly limiting your running, a physiotherapy assessment can help determine what needs to change and give you a structured way forward.

At The Addison in Marrickville, we work with runners across the Inner West to assess strength, running load and movement before building an individual return-to-running plan.

Running Assessment

Best Shoulder Exercises for Shoulder Pain

Wed, 23 Sep 2026 00:28:33 GMT

The best shoulder exercises aren't necessarily the hardest—they're the ones that match your injury, your current strength and your stage of recovery. Choosing the right exercises at the right time is one of the most important factors in recovering from shoulder pain.

Whether you've developed shoulder pain from the gym, swimming, work or everyday activities, exercise is one of the most effective treatments. However, doing the wrong exercises too early can make symptoms worse.

At The Addison Physiotherapy, we prescribe shoulder exercises based on your individual diagnosis, goals and stage of recovery. Our aim is to help you build a stronger, more resilient shoulder—not simply reduce pain.

Key Takeaways

Exercise is one of the most effective treatments for shoulder pain.
The best exercises depend on your diagnosis and stage of recovery.
Progressive strengthening produces better long-term outcomes than complete rest.
Technique is often more important than lifting heavy weights.
Rehabilitation should prepare you to return to work, sport or the gym.

What are the best shoulder exercises?

There isn't one exercise that's best for everyone.

The most effective rehabilitation programs usually include a combination of exercises that improve shoulder movement, strengthen the rotator cuff and build stability around the shoulder blade.

Exercises are generally progressed as your symptoms improve.

Early Stage Exercises:

When pain is more irritable, the focus is on maintaining movement without excessively aggravating symptoms.

Examples include:

Pendulum exercises
Assisted shoulder elevation
Isometric shoulder exercises
Gentle range of motion exercises

The goal during this stage is to keep the shoulder moving while allowing symptoms to settle.

Strengthening Exercises:

As pain improves, strengthening becomes the priority.

Common exercises include:

External rotation with resistance bands
Side-lying external rotation
Scaption raises
Cable rows
Serratus anterior strengthening
Lower trapezius strengthening

These exercises improve the shoulder's ability to tolerate everyday activities and reduce the likelihood of future flare-ups.

Advanced Exercises:

Once strength has improved, rehabilitation progresses towards more demanding movements.

Examples include:

Dumbbell shoulder press
Landmine press
Push-ups
Pull-ups
Overhead carries
Medicine ball exercises
Plyometric drills for overhead athletes

The aim is to prepare the shoulder for the demands of your work, sport or gym training.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain has persisted for more than one to two weeks.
Exercises found online are making your symptoms worse.
Your shoulder feels weak or unstable.
You're unable to return to normal activities.
Pain keeps returning despite exercising.

A physiotherapist can determine which exercises are appropriate for your specific injury and ensure you're progressing safely.

Do I need imaging?

Usually, no.

Most shoulder conditions can begin rehabilitation without an MRI or ultrasound.

A physiotherapy assessment is often enough to identify the source of your symptoms and prescribe an appropriate exercise program.

Imaging may be recommended if there has been significant trauma, substantial weakness or if symptoms aren't improving as expected.

How should I progress my exercises?

Successful rehabilitation isn't about constantly changing exercises - it's about progressively increasing your shoulder's capacity.

Progression usually involves:

Increasing Resistance

Gradually lifting heavier weights as symptoms allow.

Increasing Repetitions

Building muscular endurance before increasing load.

Increasing Range of Motion

Progressively restoring full shoulder movement.

Returning to Functional Activity

Gradually reintroducing work tasks, gym exercises and sporting movements.

Small, consistent improvements are usually more effective than progressing too quickly.

Can I keep going to the Gym?

Usually, yes.

One of the biggest myths surrounding shoulder pain is that you need to stop exercising completely.

Most people recover better by modifying their program rather than avoiding exercise altogether.

Your physiotherapist may recommend temporarily reducing overhead pressing, adjusting bench press depth or selecting alternative exercises while your shoulder recovers.

Maintaining overall strength and fitness is an important part of rehabilitation.

How long before exercises start working?

Recovery varies depending on your diagnosis, but most people notice gradual improvement over several weeks.

Consistency is far more important than finding the "perfect" exercise.

Ready to Strenthen Your Shoulder?

If shoulder pain is limiting your movement or training, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and an individual exercise program designed to get you moving with confidence.

Frequently Asked Questions

Do I Need an MRI for Shoulder Pain?

Wed, 23 Sep 2026 00:26:15 GMT

Most people with shoulder pain don't need an MRI straight away. In many cases, a thorough physiotherapy assessment provides enough information to diagnose the problem and begin effective treatment without waiting for imaging.

It's common to think that a scan is needed to identify what's causing shoulder pain. However, research shows that many people have tendon tears, arthritis or bursitis on MRI despite having no pain at all. For this reason, MRI findings should always be interpreted alongside your symptoms and physical examination.

At The Addison Physiotherapy, we perform comprehensive shoulder assessments to determine whether imaging is necessary or whether treatment can begin immediately.

Key Takeaways

Most shoulder pain can be diagnosed without an MRI.
MRI findings don't always explain why your shoulder hurts.
Many tendon tears and arthritic changes are painless.
Physiotherapy is often the best first step.
Imaging is recommended when it will change treatment decisions.

Is an MRI Helpful?

An MRI provides detailed images of the muscles, tendons, ligaments and cartilage around the shoulder.

Your doctor or physiotherapist may recommend an MRI if:

You suffered a significant traumatic injury.
A full-thickness rotator cuff tear is suspected.
There is significant weakness after an injury.
Symptoms haven't improved despite appropriate rehabilitation.
Surgery is being considered.
Another serious shoulder condition needs to be excluded.

In these situations, an MRI can provide valuable information to guide your management.

When is an MRI usually NOT needed?

For many common shoulder conditions, treatment can begin without imaging.

Examples Include:

Rotator cuff tendinopathy
Shoulder bursitis
Shoulder impingement
Mild AC joint irritation
Biceps tendinopathy

These conditions are often diagnosed accurately through your history, movement assessment and strength testing.

Starting physiotherapy early is usually more important than waiting for a scan.

What if my MRI shows a tear?

This is one of the most common concerns we hear.

Finding a tear on MRI doesn't automatically mean it's the source of your pain.

Research has shown that many adults, particularly over the age of 40, have partial rotator cuff tears or tendon degeneration without experiencing any symptoms.

Your MRI should always be interpreted alongside:

Your symptoms
Your strength
Your shoulder movement
Your functional limitations

Treating the scan rather than the person can sometimes lead to unnecessary concern or treatment.

Can physiotherapy diagnose shoulder injuries?

Yes.

Physiotherapists are trained to assess shoulder pain through:

A detailed history
Movement assessment
Strength testing
Special clinical tests
Functional assessment

In many cases, this provides enough information to confidently diagnose the problem and begin treatment immediately.

If imaging is required, we'll explain why and refer you back to your GP or specialist where appropriate.

How is shoulder pain treated without an MRI?

Treatment is based on your symptoms and physical assessment rather than relying solely on imaging findings.

Treatment usually includes:

Education

Helping you understand your diagnosis and recovery expectations.

Load Management

Modifying activities that aggravate your shoulder while maintaining movement.

Progressive Strengthening

Improving the strength of the rotator cuff and surrounding muscles to restore shoulder function.

Return to Activity

Gradually progressing back to work, sport or the gym as your shoulder improves.

Most people notice significant improvement with this approach regardless of whether imaging has been performed.

Can I recover without knowing exactly what's on my MRI?

Absolutely.

For many shoulder conditions, rehabilitation focuses on improving how your shoulder functions rather than trying to change what appears on a scan.

Many people recover completely despite ongoing MRI findings.

The goal is improving your pain, movement and strength—not achieving a "normal" scan.

Most people notice gradual improvement as shoulder strength and function improve.

Not Sure Whether You Need a Scan?

If you're experiencing shoulder pain and wondering whether an MRI is necessary, our experienced physiotherapists can help.

Book an appointment with The Addison Physiotherapy for a comprehensive shoulder assessment and an evidence-based treatment plan tailored to your goals.

Frequently Asked Questions

Why Does My Shoulder Click?

Wed, 23 Sep 2026 00:24:13 GMT

Shoulder clicking is very common and, in most cases, isn't something to worry about. However, if clicking is accompanied by pain, weakness or a feeling of instability, it may indicate an underlying shoulder problem that should be assessed.

Many people notice clicking, popping or cracking when lifting their arm, reaching overhead or rotating the shoulder. Sometimes it's completely painless, while other people experience discomfort during certain movements.

At The Addison Physiotherapy, we regularly assess people experiencing shoulder clicking. Our role is to determine whether the clicking is a normal movement of the joint or whether it's being caused by an injury requiring treatment.

Key Takeaways

Painless shoulder clicking is usually normal.
Clicking with pain may indicate an underlying shoulder injury.
Rotator cuff injuries, bursitis and labral tears can all cause painful clicking.
A thorough assessment is often more useful than imaging alone.
Physiotherapy can address the underlying cause and improve shoulder function.

What causes shoulder clicking?

The shoulder is a complex joint made up of muscles, tendons, ligaments and cartilage working together. Clicking can occur when one of these structures moves over another during shoulder movement.

Common causes include:

Tendons moving over bony structures
Rotator cuff tendinopathy
Shoulder bursitis
Labral injuries
Shoulder instability
Tight muscles around the shoulder
Shoulder arthritis

In many people, clicking occurs simply because of normal movement within the joint and isn't associated with any damage.

What are the symptoms of shoulder clicking?

People commonly experience:

When lifting the arm overhead
During bench press or overhead press
While swimming or throwing
Reaching behind your back
During shoulder rotations

If the clicking is painless and doesn't affect your strength or movement, it's often considered a normal finding.

However, clicking associated with pain, catching, locking or a feeling that the shoulder is slipping should be assessed.

When should I see a physiotherapist?

It's worth booking an assessment if:

Clicking is accompanied by pain.
Your shoulder feels unstable.
You're losing strength.
The shoulder catches or locks.
Symptoms developed following an injury.
Clicking is affecting your ability to exercise or work.

A physiotherapy assessment helps determine whether the clicking is harmless or related to an underlying shoulder condition.

Do I need imaging?

Usually, no.

Many people with shoulder clicking don't require imaging.

An MRI or ultrasound may be recommended if:

A labral injury is suspected.
The shoulder repeatedly dislocates or feels unstable.
There is significant weakness.
Symptoms fail to improve with rehabilitation.

Imaging should always be interpreted alongside your symptoms and clinical examination.

How is shoulder clicking treated?

Treatment depends on the cause of the clicking.

If the clicking is painless, treatment may not be required.

Treatment usually includes:

Education

Understanding why your shoulder is clicking and whether it's something that requires treatment.

Load Management

Temporarily modifying aggravating activities while symptoms settle.

Progressive Strengthening

Improving rotator cuff strength and shoulder blade control helps improve shoulder stability and often reduces painful clicking.

Return to Activity

Gradually returning to work, sport and gym exercises as shoulder strength and confidence improve.

The goal is to improve how the shoulder functions rather than simply eliminating the clicking.

Can I keep exercising?

Usually, yes.

If your shoulder clicks without pain, it's generally safe to continue exercising.

If clicking is painful, certain exercises may need temporary modification while rehabilitation is underway.

Your physiotherapist will advise which movements are appropriate and how to safely progress your training.

How long does recovery take?

Recovery depends on the underlying cause of your symptoms.

Most people notice gradual improvement as shoulder strength and function improve.

Concerned About Your Clicking Shoulder?

If your shoulder is clicking and causing pain, weakness or instability, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive shoulder assessment and an individual rehabilitation plan tailored to your needs.

Frequently Asked Questions

Shoulder Instability: Causes, Symptoms & Treatment

Wed, 16 Sep 2026 00:50:50 GMT

Shoulder instability occurs when the shoulder joint moves more than it should, causing pain, weakness or a feeling that it may slip out of place. Physiotherapy plays a vital role in improving stability and reducing the risk of future dislocations.

Some people experience instability after a traumatic shoulder dislocation, while others develop symptoms gradually because the muscles supporting the shoulder aren't providing enough control. With the right rehabilitation, many people return to work, sport and the gym without ongoing instability.

At The Addison Physiotherapy, we regularly assess and rehabilitate shoulder instability in athletes, gym-goers, swimmers and people recovering from shoulder dislocations. Our goal is to restore stability, improve confidence and reduce the risk of future episodes.

Key Takeaways

Shoulder instability occurs when the shoulder doesn't remain securely centred in the joint.
It often develops after a shoulder dislocation but can also occur gradually.
Strengthening the muscles around the shoulder is essential for recovery.
Not every unstable shoulder requires surgery.
Early rehabilitation reduces the risk of recurrent instability.

What causes shoulder instability?

The shoulder is the most mobile joint in the body, allowing you to move your arm in almost every direction. This mobility also means it relies heavily on muscles, ligaments and the joint capsule for stability.

Shoulder instability may develop because these structures have been injured or are no longer providing enough support.

Common causes include:

Shoulder dislocation
Previous shoulder subluxation (partial dislocation)
Contact sports
Falls onto an outstretched arm
Generalised joint hypermobility
Repetitive overhead sports

Young athletes participating in rugby, AFL, basketball, volleyball and swimming are particularly at risk.

What are the symptoms of shoulder instability?

People commonly experience:

A feeling that the shoulder may "pop out"
Pain during overhead movements
Apprehension when throwing
Repeated shoulder dislocations
Clicking or slipping sensations
Weakness during pushing or lifting
Loss of confidence using the shoulder

Some people describe the shoulder as feeling loose or unreliable rather than painful.

When should I see a physiotherapist?

It's worth booking an assessment if:

You've experienced a shoulder dislocation.
Your shoulder repeatedly feels unstable.
You avoid certain movements because you're worried it will slip.
You're returning to contact or overhead sport.
Your shoulder feels weaker following an injury.

Early rehabilitation is important to restore strength and improve shoulder control.

Do I need imaging?

Sometimes.

X-rays are commonly performed immediately after a shoulder dislocation to confirm the joint has relocated correctly and to exclude fractures.

MRI may be recommended if:

A labral injury is suspected.
You've experienced repeated dislocations.
Surgery is being considered.
Significant soft tissue injury is suspected.

Your physiotherapist can help determine whether further imaging is appropriate.

How is shoulder instability treated?

Treatment focuses on restoring stability by improving the muscles that support the shoulder.

Treatment usually includes:

Education

Understanding how instability develops and what activities should be modified during recovery.

Load Management

Gradually reintroducing shoulder movements while avoiding positions that place excessive stress on healing tissues.

Progressive Strengthening

Strengthening the rotator cuff, shoulder blade muscles and surrounding stabilisers to improve dynamic shoulder control.

Return to Sport

A structured rehabilitation program progressively restores strength, power and confidence before returning to contact or overhead sport.

Objective strength testing and functional assessment help determine when it's safe to return to higher-level activities.

Can I keep exercising?

Usually, yes.

Following a dislocation, there may be a short period where movement is restricted while healing occurs. Once appropriate, rehabilitation focuses on restoring movement and strength.

Many lower body and cardiovascular exercises can continue throughout rehabilitation, while upper body exercises are progressively reintroduced under guidance.

Returning too quickly to heavy overhead lifting or contact sport can increase the risk of another dislocation.

How long does recovery take?

Recovery depends on the severity of the injury and whether surgery is required.

Return to contact sport should always be guided by strength, shoulder function and your treating clinician.

Ready to Trust Your Shoulder Again?

If your shoulder feels unstable, keeps slipping out or you're recovering from a dislocation, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised rehabilitation plan designed to restore shoulder stability and get you back to doing what you enjoy.

Frequently Asked Questions

Shoulder Arthritis: Symptoms, Causes & Treatment

Wed, 16 Sep 2026 00:48:33 GMT

Shoulder arthritis occurs when the smooth cartilage within the shoulder joint gradually wears away, leading to pain, stiffness and reduced movement. Although arthritis cannot be reversed, physiotherapy can significantly improve your function, reduce pain and help you stay active.

Many people worry that an arthritis diagnosis means they'll eventually need surgery. In reality, most people manage their symptoms successfully with education, exercise and sensible activity modification for many years.

At The Addison Physiotherapy, we help people with shoulder arthritis remain active by improving strength, maintaining movement and developing practical strategies to reduce pain during everyday activities.

Key Takeaways

Shoulder arthritis is caused by gradual wear of the shoulder joint.
Pain and stiffness usually develop slowly over time.
Exercise is one of the most effective treatments.
Physiotherapy helps improve movement and shoulder function.
Many people avoid or delay surgery with appropriate management.

What causes shoulder arthritis?

Shoulder arthritis develops when the cartilage lining the shoulder joint gradually wears down. As the cartilage becomes thinner, the joint surfaces no longer glide as smoothly, leading to pain and stiffness.

Common causes include:

Age-related wear and tear
Previous shoulder injuries
Previous fractures
Rotator cuff tears
Repetitive heavy manual work
Family history of osteoarthritis

Unlike the knee or hip, arthritis of the shoulder is less common, but it can still have a significant impact on daily activities.

What are the symptoms of shoulder arthritis?

People commonly experience:

Deep aching shoulder pain
Stiffness, particularly first thing in the morning
Difficulty reaching overhead
Pain reaching behind your back
Reduced shoulder movement
Clicking or grinding sensations
Pain after heavier activity

Symptoms usually develop gradually and slowly worsen over time if left unmanaged.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain has persisted for several weeks.
Stiffness is affecting everyday activities.
You're avoiding exercise because of pain.
Your shoulder movement is gradually reducing.
You're struggling with work or recreational activities.

Early treatment can help maintain movement and reduce the impact arthritis has on your lifestyle.

Do I need imaging?

Sometimes.

X-rays are the most common investigation used to diagnose shoulder arthritis and may show narrowing of the joint space or bone spurs.

However, it's important to remember that imaging findings don't always match your symptoms. Some people have significant arthritis on X-ray with minimal pain, while others experience considerable symptoms despite relatively mild changes.

A physiotherapy assessment helps determine whether arthritis is actually responsible for your shoulder pain.

How is shoulder arthritis treated?

Treatment focuses on improving your shoulder's function and helping you remain active.

Treatment usually includes:

Education

Understanding your diagnosis and learning how to manage flare-ups confidently.

Load Management

Modifying activities that excessively aggravate the joint while encouraging regular movement.

Progressive Strengthening

Strengthening the muscles surrounding the shoulder improves joint support and can reduce pain during everyday activities.

Maintaining Mobility

Gentle mobility exercises help reduce stiffness and preserve shoulder movement over time.

The aim is to improve your quality of life, not simply reduce pain.

Can I keep exercising?

Absolutely.

Exercise is one of the most effective treatments for shoulder arthritis.

While some movements may need temporary modification during painful flare-ups, remaining active helps maintain strength, reduce stiffness and improve long-term shoulder function.

Low-impact strengthening exercises are generally encouraged.

How long does recovery take?

Shoulder arthritis is a long-term condition rather than an injury that completely heals.

However, symptoms often improve within weeks of beginning an appropriate rehabilitation program.

The goal is long-term symptom control and maintaining shoulder function.

Ready to Move More Comfortably?

If shoulder arthritis is affecting your everyday life, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised management plan designed to reduce pain, improve movement and keep you active.

Frequently Asked Questions

Gym Shoulder Pain: Causes, Symptoms & Treatment

Wed, 16 Sep 2026 00:46:06 GMT

Shoulder pain is one of the most common injuries experienced in the gym, but it doesn't mean you have to stop training. Most gym-related shoulder pain develops gradually from overload and responds well to the right rehabilitation and exercise modifications.

Whether your shoulder hurts during bench press, overhead press, pull-ups or lateral raises, understanding why it's happening is the first step towards recovery. In many cases, continuing to train with appropriate modifications is not only possible, but beneficial.

At The Addison Physiotherapy, we regularly help lifters of all levels recover from shoulder pain without losing their progress. Our focus is on identifying the source of your symptoms, modifying aggravating exercises and helping you return to lifting stronger than before.

Key Takeaways

Gym shoulder pain is usually caused by overload rather than a major injury.
Rotator cuff tendinopathy, shoulder bursitis and AC joint irritation are common causes.
Most people don't need to stop training completely.
Exercise modifications are often more effective than prolonged rest.
Progressive strengthening reduces the risk of future flare-ups.

What causes gym shoulder pain?

The shoulder is one of the most mobile joints in the body, allowing a wide range of movement but also relying heavily on muscles and tendons for stability.

Gym shoulder pain often develops when training demands exceed what the shoulder can currently tolerate.

Common causes include:

Increasing training loads too quickly
Poor lifting technique
Excessive training volume
Inadequate recovery
Rotator cuff weakness
Poor shoulder blade control
Returning to lifting after time off

Certain exercises place greater stress on the shoulder, particularly when performed with poor control or excessive weight.

What are the symptoms of gym shoulder pain?

People commonly experience:

Pain during bench press
Pain with overhead press
Pain during lateral raises
Pain performing dips
Weakness during pressing movements
Pain after training
Difficulty sleeping on the affected shoulder

The exact location of your pain often helps determine which structure is involved.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain lasts longer than one to two weeks.
You're modifying every workout because of pain.
Your lifting strength is decreasing.
Pain is affecting your everyday activities.
Symptoms continue to worsen despite reducing your training.

Addressing shoulder pain early usually allows you to continue training while preventing a more significant injury.

Do I need imaging?

Usually, no.

Most gym-related shoulder injuries can be diagnosed through a detailed physiotherapy assessment.

Imaging may be recommended if:

There has been a traumatic injury.
Significant weakness is present.
Symptoms fail to improve despite rehabilitation.
A large tendon tear or another serious injury is suspected.

Scans are only one piece of the puzzle and should always be interpreted alongside your symptoms and physical examination.

How is gym shoulder pain treated?

Treatment focuses on identifying why your shoulder has become overloaded and improving its ability to tolerate lifting.

Treatment usually includes:

Education

Understanding which exercises are contributing to your symptoms and why.

Exercise Modification

Adjusting your training program so you can continue exercising without unnecessarily aggravating your shoulder.

Progressive Strengthening

Strengthening the rotator cuff, shoulder blade muscles and surrounding structures to improve shoulder stability and resilience.

Return to Full Training

Gradually increasing lifting loads while ensuring the shoulder continues to tolerate training.

The aim is not simply to reduce pain but to improve your shoulder's capacity so you can continue progressing in the gym.

Can I keep training?

In most cases, yes.

Completely stopping the gym is rarely necessary. Instead, your physiotherapist may recommend temporary modifications such as:

Reducing bench press depth
Using dumbbells instead of a barbell
Lowering overhead pressing loads
Replacing painful exercises with suitable alternatives
Reducing overall training volume

As your shoulder improves, these exercises can usually be progressed back to normal.

How long does recovery take?

Recovery depends on the underlying condition and how consistently rehabilitation is completed.

Most lifters return to full training with a structured rehabilitation program and sensible progression.

Ready to Get Back to Training?

If shoulder pain is affecting your workouts, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised rehabilitation plan designed to get you back to lifting with confidence.

Frequently Asked Questions

Shoulder Pain After Swimming: Causes & Treatment

Wed, 09 Sep 2026 00:51:58 GMT

Shoulder pain after swimming is one of the most common overuse injuries seen in swimmers. Fortunately, it usually isn't caused by a serious injury and most people recover well with the right rehabilitation and technique modifications.

Swimming places thousands of repetitive overhead movements through the shoulder during a single session. If the muscles and tendons aren't able to tolerate these loads, pain can gradually develop. Whether you're a recreational swimmer, triathlete or competitive athlete, early treatment can help you recover and prevent symptoms from becoming persistent.

At The Addison Physiotherapy, we regularly assess swimmers with shoulder pain. Our goal is to identify why your shoulder has become overloaded, restore strength and mobility, and help you return to swimming with confidence.

Key Takeaways

Shoulder pain after swimming is usually an overload injury.
Rotator cuff tendinopathy and shoulder bursitis are common causes.
Poor technique and sudden increases in training often contribute.
Most swimmers recover without surgery.
Physiotherapy helps improve strength, technique and training load.

What causes shoulder pain after swimming?

Swimming requires the shoulder to repeatedly move through a large range of motion while generating force through the water.

Over time, this repetitive loading can irritate the tendons and muscles that stabilise the shoulder.

Common causes include:

Rotator cuff tendinopathy
Shoulder bursitis
Poor stroke technique
Weakness around the shoulder blade
Sudden increases in swimming volume
Fatigue during longer sessions

Although it's often called "swimmer's shoulder", there isn't one single injury responsible. Instead, several structures can become overloaded depending on your technique, training and shoulder strength.

What are the symptoms of shoulder pain after swimming?

People commonly experience:

Pain during freestyle or butterfly
Pain reaching overhead
Pain at the front or side of the shoulder
Pain after finishing a swim session
Shoulder fatigue earlier than usual
Pain sleeping on the affected side

Some swimmers only notice discomfort after training, while others experience pain during every stroke.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain persists after several swim sessions.
Pain is limiting your training.
You're changing your stroke to avoid discomfort.
You're experiencing weakness.
Symptoms continue to worsen.

The earlier shoulder pain is addressed, the easier it is to modify training before it becomes a long-term problem.

Do I need imaging?

Usually, no.

Most swimming-related shoulder pain can be diagnosed through a clinical assessment.

Imaging may be appropriate if:

There has been a traumatic injury.
Significant weakness is present.
Symptoms don't improve despite rehabilitation.
A larger tendon tear is suspected.

MRI findings don't always correlate with pain, so treatment should be based on your symptoms and physical examination rather than imaging alone.

How is shoulder pain after swimming treated?

Treatment aims to reduce irritation while improving the shoulder's ability to tolerate swimming.

Treatment usually includes:

Education

Understanding why your shoulder became overloaded and what changes are needed during recovery.

Training Modification

Temporarily reducing swimming volume, intensity or certain strokes while symptoms settle.

Progressive Strengthening

Improving rotator cuff strength, shoulder blade control and overall shoulder capacity.

Return to Swimming

Gradually increasing swimming distance and intensity while monitoring symptoms and refining technique where necessary.

Our goal isn't simply to reduce pain - it's to help you return to swimming stronger and reduce the likelihood of recurrence.

Can I keep swimming?

Often, yes.

Complete rest is rarely necessary.

Many swimmers can continue training by reducing total volume, avoiding painful strokes or modifying session intensity while completing a structured strengthening program.

Your physiotherapist can help determine how much swimming is appropriate during your recovery.

How long does recovery take?

Recovery depends on the severity of symptoms and how long they've been present.

Most swimmers gradually return to full training with appropriate rehabilitation and sensible load progression.

Ready to Get Back in the Water?

If shoulder pain is stopping you from enjoying swimming, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and an individual rehabilitation plan designed to get you back in the pool.

Frequently Asked Questions

Shoulder Pain at Night: Causes & Treatment

Wed, 09 Sep 2026 00:50:02 GMT

Shoulder pain that worsens at night is a common complaint and one of the main reasons people seek physiotherapy. Although it can be frustrating, night pain doesn't necessarily mean you've seriously injured your shoulder.

If you're waking because of shoulder pain or struggling to find a comfortable sleeping position, the underlying cause is often related to conditions such as rotator cuff tendinopathy, shoulder bursitis or frozen shoulder. The good news is that identifying the cause and starting the right treatment can significantly improve both your shoulder and your sleep.

At The Addison Physiotherapy, we regularly help people who are unable to sleep comfortably because of shoulder pain. Our goal is to identify the underlying condition, reduce irritation and restore normal shoulder function.

Key Takeaways

Shoulder pain at night is commonly associated with rotator cuff injuries and shoulder bursitis.
Sleeping on the affected shoulder often aggravates symptoms.
Night pain doesn't automatically mean you've torn a tendon.
Physiotherapy can help reduce pain and improve shoulder function.
Most people recover without surgery.

What causes shoulder pain at night?

Several shoulder conditions can become more painful at night.

Common causes include:

Rotator cuff tendinopathy
Shoulder bursitis
Partial rotator cuff tears
Frozen shoulder
AC joint irritation

Pain often becomes more noticeable at night because the shoulder is compressed when lying on your side, muscles relax during sleep, and there's less movement to naturally change positions.

In some cases, inflammation within the shoulder also contributes to increased discomfort overnight.

What are the symptoms of shoulder pain at night?

People commonly experience:

Pain when lying on one side
Waking because of shoulder discomfort
Difficulty finding a comfortable sleeping position
Pain reaching overhead during the day
Pain putting on a shirt or jacket
Morning stiffness

Night pain often develops alongside pain during lifting or reaching activities.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain regularly wakes you at night.
Symptoms have persisted for more than one to two weeks.
You're avoiding normal activities because of pain.
Your shoulder feels weaker or stiffer.
Pain is gradually becoming worse.

Persistent night pain is a good reason to have your shoulder professionally assessed.

Do I need imaging?

Usually, no.

Many conditions that cause shoulder pain at night can be accurately diagnosed through a clinical assessment.

Imaging may be recommended if:

There has been significant trauma.
There is substantial weakness.
Symptoms aren't improving with rehabilitation.
A larger tendon tear is suspected.

Imaging findings don't always explain why pain is occurring, so treatment should always be based on both your symptoms and physical examination.

How is shoulder pain at night treated?

Treatment depends on the underlying cause, but generally focuses on reducing irritation while improving shoulder function.

Treatment usually includes:

Education

Understanding why your shoulder hurts at night and how to avoid aggravating positions.

Load Management

Reducing activities that excessively irritate the shoulder while maintaining comfortable movement.

Progressive Strengthening

Improving the strength of the rotator cuff and surrounding muscles to reduce stress on painful structures.

Sleeping Advice

Simple changes such as sleeping on your opposite side with a pillow supporting your arm or placing a pillow under the affected arm when lying on your back can often improve comfort.

Can I keep exercising?

Usually, yes.

Complete rest is rarely recommended.

Your physiotherapist may suggest temporarily modifying painful overhead exercises while continuing other forms of training.

Maintaining shoulder strength is an important part of recovery.

How long does recovery take?

Recovery depends on the condition causing your symptoms.

Improving night pain is often one of the first signs that your shoulder is recovering.

Ready to Sleep Comfortably Again?

If shoulder pain is waking you at night or limiting your everyday activities, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive shoulder assessment and a personalised treatment plan tailored to your recovery.

Frequently Asked Questions

Biceps Tendinopathy: Causes, Symptoms & Treatment

Wed, 09 Sep 2026 00:48:05 GMT

Pain at the front of your shoulder isn't always coming from your rotator cuff. The long head of the biceps tendon is another common source of shoulder pain, particularly in people who lift weights, play overhead sports or perform repetitive lifting.

If you're experiencing pain at the front of your shoulder when lifting, reaching overhead or carrying heavy objects, you may have biceps tendinopathy. The good news is that most people recover well with physiotherapy and progressive strengthening, without requiring injections or surgery.

At The Addison Physiotherapy, we regularly assess and treat biceps tendon injuries in gym-goers, swimmers, racquet sport athletes and manual workers. Our aim is to reduce pain, restore strength and address the underlying cause so you can return to the activities you enjoy.

Key Takeaways

Biceps tendinopathy causes pain at the front of the shoulder.
It commonly develops due to repetitive overload rather than a single injury.
Rotator cuff weakness and shoulder mechanics often contribute.
Most people recover without surgery.
Progressive strengthening is the key to long-term recovery.

What causes biceps tendinopathy?

The long head of the biceps tendon runs through the front of the shoulder before attaching inside the shoulder joint. It helps stabilise the shoulder during lifting and overhead movements.

Biceps tendinopathy develops when the tendon is repeatedly overloaded and doesn't have sufficient time to recover.

Common causes include:

Heavy gym training
Repetitive overhead lifting
Swimming
Throwing sports
Poor shoulder strength
Rotator cuff dysfunction
Sudden increases in training load

Often, the tendon becomes irritated gradually rather than tearing suddenly.

What are the symptoms of biceps tendinopathy?

People commonly experience:

Pain at the front of the shoulder
Tenderness over the biceps tendon
Pain lifting overhead
Pain during bench press or shoulder press
Discomfort carrying heavy objects
Pain reaching behind your back

Clicking or discomfort during shoulder movement

Symptoms may gradually worsen if the underlying overload isn't addressed.

When should I see a physiotherapist?

It's worth booking an assessment if:

Front shoulder pain persists for more than one to two weeks.
Pain is affecting work or training.
You're noticing shoulder weakness.
Symptoms developed after increasing your training.
Pain is becoming progressively worse.

A thorough assessment helps determine whether the biceps tendon is the primary source of pain or whether another shoulder structure is involved.

Do I need imaging?

Usually, no.

Most cases of biceps tendinopathy can be diagnosed through a clinical assessment.

Ultrasound or MRI may be recommended if:

There has been significant trauma.
A tendon rupture is suspected.
Symptoms fail to improve despite rehabilitation.
Another shoulder injury is suspected.

Imaging findings should always be interpreted alongside your symptoms and physical examination.

How is biceps tendinopathy treated?

Treatment focuses on reducing tendon irritation while gradually rebuilding its ability to tolerate load.

Treatment usually includes:

Education

Understanding why the tendon became overloaded and how to avoid repeatedly aggravating it.

Load Management

Temporarily reducing painful activities while maintaining shoulder function where possible.

Progressive Strengthening

Specific exercises targeting the rotator cuff, shoulder blade muscles and biceps tendon help improve strength and tendon capacity.

Return to Activity

Gradually progressing back to work, sport and gym exercises once symptoms improve. The aim is to build a stronger, more resilient shoulder rather than simply reducing pain.

Can I keep exercising?

Usually, yes.

Most people don't need to stop training completely. Instead, temporary exercise modifications can help reduce irritation while maintaining overall strength.

Depending on your symptoms, your physiotherapist may recommend reducing heavy pressing, pull-ups or overhead lifting until the tendon becomes more tolerant to load.

As rehabilitation progresses, these exercises are gradually reintroduced.

How long does recovery take?

Recovery depends on how long symptoms have been present and how consistently rehabilitation is completed.

Most people experience gradual improvement with a structured rehabilitation program.

Ready to Overcome Front Shoulder Pain?

If pain at the front of your shoulder is limiting your training or everyday activities, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and an individual rehabilitation plan designed to get you moving again.

Frequently Asked Questions

AC Joint Pain: Causes, Symptoms & Treatment

Wed, 02 Sep 2026 00:24:14 GMT

Pain on the very top of your shoulder may be coming from the acromioclavicular (AC) joint. This small joint is commonly irritated by gym training, contact injuries and age-related changes, but most cases improve with the right rehabilitation.

If you're experiencing pain directly on the top of your shoulder, especially during bench press, push-ups, overhead lifting or sleeping on your side, the AC joint may be contributing to your symptoms. Fortunately, physiotherapy is highly effective for most people and surgery is rarely required.

At The Addison Physiotherapy, we regularly assess AC joint pain in gym-goers, athletes, manual workers and active individuals. Our goal is to identify the underlying cause, reduce irritation and help you return to your usual activities without ongoing shoulder pain.

Key Takeaways

AC joint pain is felt on the top of the shoulder.
It commonly develops from heavy lifting, contact injuries or arthritis.
Bench press, push-ups and cross-body movements often aggravate symptoms.
Most people recover with physiotherapy and exercise.
Surgery is only required in a small number of cases.

What causes AC joint pain?

The AC joint is where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion). Although it's a small joint, it plays an important role in allowing your shoulder to move normally.

AC joint pain usually develops because the joint becomes overloaded or irritated.

Common causes include:

Heavy bench pressing
Push-ups and dips
Overhead lifting
Falling directly onto the shoulder
Contact sports
Age-related arthritis

Repeated loading can gradually irritate the joint, while a fall onto the shoulder may cause an AC joint sprain or separation.

What are the symptoms of AC joint pain?

People commonly experience:

Pain directly on the top of the shoulder
Tenderness when touching the joint
Pain reaching across the body
Pain during bench press or push-ups
Pain sleeping on the affected shoulder
Pain lifting overhead

Unlike rotator cuff pain, discomfort is usually very localised to the top of the shoulder.

When should I see a physiotherapist?

It's worth booking an assessment if:

Pain has lasted longer than one to two weeks.
You're unable to train comfortably.
The top of your shoulder remains tender.
Pain developed after a fall.
Symptoms continue to worsen.

Early diagnosis helps determine whether the problem is coming from the AC joint or another structure within the shoulder.

Do I need imaging?

Usually, no.

Most cases of AC joint pain can be diagnosed during a clinical assessment.

An X-ray or MRI may be recommended if:

You sustained a significant fall or collision.
An AC joint separation is suspected.
Symptoms fail to improve with rehabilitation.
Surgery is being considered.

Mild arthritis is commonly seen on imaging and doesn't always explain shoulder pain.

How is AC joint pain treated?

Treatment focuses on reducing stress through the joint while restoring shoulder strength and function.

Treatment usually includes:

Education

Understanding what activities are irritating the joint and how to modify them during recovery.

Load Management

Temporarily reducing exercises that place excessive compression through the AC joint while maintaining overall shoulder function.

Progressive Strengthening

Strengthening the rotator cuff, shoulder blade muscles and surrounding structures helps improve shoulder mechanics and reduce stress on the AC joint.

Return to Activity

Gradually reintroducing gym exercises, work tasks and sporting activities as symptoms improve.

Most people recover successfully without injections or surgery.

Can I keep exercising?

Usually, yes.

Rather than stopping training completely, temporary exercise modifications are often enough to allow the joint to settle.

Examples include:

Reducing bench press depth
Using dumbbells instead of a barbell
Temporarily avoiding dips
Modifying push-ups
Reducing overhead lifting

Your physiotherapist will help determine which exercises you can continue safely while your shoulder recovers.

How long does recovery take?

Recovery depends on the cause of your symptoms.

Most people notice steady improvement once aggravating activities are modified and shoulder strength improves.

Ready to Get Back into Training?

If pain on the top of your shoulder is affecting your work, gym or sport, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive shoulder assessment and an individual rehabilitation plan designed to get you moving again.

Frequently Asked Questions

Frozen Shoulder: Symptoms, Stages & Treatment

Wed, 02 Sep 2026 00:22:22 GMT

Frozen shoulder is a condition that causes progressive pain and stiffness in the shoulder, making everyday activities increasingly difficult. While it can take time to recover, the right treatment can help manage symptoms and restore movement.

If you've noticed your shoulder becoming increasingly stiff, painful or difficult to move, particularly without a significant injury, you may have frozen shoulder. Simple tasks such as reaching overhead, fastening a bra, putting on a jacket or reaching into your back pocket can become frustrating and painful.

At The Addison Physiotherapy, we help people understand each stage of frozen shoulder and provide personalised rehabilitation to reduce pain, improve movement and guide recovery.

Key Takeaways

Frozen shoulder causes pain and significant loss of shoulder movement.
It usually develops gradually without a major injury.
Recovery occurs in stages and may take several months.
Physiotherapy helps improve function and manage symptoms.
Most people recover without surgery.

What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition where the capsule surrounding the shoulder joint becomes thickened and stiff. As the capsule tightens, shoulder movement becomes progressively restricted.

Unlike many other shoulder conditions, frozen shoulder affects movement in almost every direction, even when someone else tries to move your arm.

Although the exact cause isn't fully understood, the condition is generally self-limiting, meaning it improves over time. Physiotherapy aims to help manage symptoms and maximise recovery throughout the process.

What causes a frozen shoulder?

The exact cause isn't always known, but several factors increase your risk.

Common risk factors include:

Age between 40 and 65 years
Diabetes
Thyroid disorders
Previous shoulder injury
Shoulder surgery
Prolonged shoulder immobilisation

Many people develop frozen shoulder without any obvious trigger.

What causes a frozen shoulder?

The exact cause isn't always known, but several factors increase your risk.

Common causes include:

Age between 40 and 65 years
Diabetes
Thyroid disorders
Previous shoulder injury
Shoulder surgery
Prolonged shoulder immobilisation

Many people develop frozen shoulder without any obvious trigger.

What are the frozen shoulder impingement?

People commonly experience:

Increasing shoulder pain
Progressive stiffness
Difficulty reaching overhead
Difficulty reaching behind your back
Pain when dressing
Pain at night
Loss of movement in all directions

What are the stages of frozen shoulder?

Frozen shoulder typically progresses through three stages.

Stage 1 – Freezing

Pain gradually increases and shoulder movement begins to reduce. This stage can last several months.

Stage 2 – Frozen

Pain often settles slightly, but stiffness becomes the main problem. Everyday tasks become increasingly difficult due to limited shoulder movement.

Stage 3 – Thawing

Shoulder movement gradually improves, and function slowly returns. Recovery during this stage may continue for many months.

Everyone progresses through these stages differently, and recovery times vary.

When should I see a physiotherapist?

It's worth booking an assessment if:

Your shoulder is becoming progressively stiffer.
Pain is affecting your sleep.
Everyday activities are becoming difficult.
You cannot reach overhead or behind your back.
Symptoms have continued to worsen over several weeks.

Early assessment helps confirm the diagnosis and rule out other causes of shoulder pain.

Do I need imaging?

Usually, no.

Frozen shoulder is primarily diagnosed through a clinical assessment. Imaging is sometimes used to exclude other shoulder conditions if the diagnosis is unclear.

Your physiotherapist may recommend imaging if:

Your symptoms don't fit the typical pattern.
There has been significant trauma.
Another shoulder condition is suspected.

How is frozen shoulder treated?

Treatment depends on which stage of frozen shoulder you're experiencing.

Treatment usually includes:

Education

Understanding the condition and knowing what to expect can reduce anxiety and help guide appropriate activity levels.

Pain Management

During the painful stage, treatment focuses on reducing discomfort and maintaining as much movement as possible without significantly aggravating symptoms.

Mobility Exercises

Gentle exercises help maintain available movement and reduce stiffness where appropriate.

Strengthening

As pain settles and movement begins returning, strengthening exercises help restore shoulder function and confidence.

Treatment is always individualised based on the stage of recovery.

Can I keep exercising?

Usually, yes.

Although some movements may be uncomfortable, completely avoiding shoulder movement often leads to further stiffness.

Exercises should be modified according to your symptoms, with an emphasis on maintaining mobility rather than forcing painful stretches.

Your physiotherapist will guide you on what is appropriate during each stage.

How long does recovery take?

Frozen shoulder often takes longer to recover than many other shoulder conditions.

Recovery varies considerably between individuals, but most people regain good shoulder function over time.

Ready to Get Your Shoulder Moving Again?

If shoulder pain and stiffness are limiting your everyday activities, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised treatment plan designed to support your recovery.

Frequently Asked Questions

Partial Rotator Cuff Tear: Symptoms, Recovery & Treatment

Wed, 02 Sep 2026 00:20:43 GMT

A partial rotator cuff tear doesn't always require surgery. In fact, many people recover successfully with physiotherapy, progressive strengthening and the right rehabilitation program.

Hearing you've torn a tendon in your shoulder can be worrying, especially if it's mentioned on an MRI report. However, a partial tear doesn't mean the tendon has completely ruptured, and many people return to work, the gym and sport without needing an operation.

At The Addison Physiotherapy, we regularly assess and treat partial rotator cuff tears. Our goal is to reduce pain, restore strength and help you confidently return to the activities you enjoy while reducing the risk of ongoing shoulder problems.

Key Takeaways

A partial tear means only part of the tendon has been injured.
Most partial tears improve without surgery.
MRI findings don't always match the amount of pain you're experiencing.
Progressive strengthening is the foundation of rehabilitation.
Early physiotherapy can improve recovery and restore shoulder function.

What causes rotator cuff tear?

The rotator cuff is made up of four muscles and their tendons, which help stabilise and move the shoulder.

A partial tear occurs when some of the tendon fibres are damaged, but the tendon remains attached to the bone. This differs from a full-thickness tear, where the tendon is completely torn through.

Partial tears most commonly affect the supraspinatus tendon, particularly where it attaches to the top of the arm bone.

What causes a partial rotator cuff tear?

Partial tears may develop gradually over time or occur following a specific injury.

Common causes include:

Repetitive overhead activity
Heavy lifting
Gym training
Falls onto the shoulder
Age-related tendon changes
Long-standing rotator cuff tendinopathy

In many people, the tendon has gradually weakened before the tear develops.

What are the symptoms of shoulder impingement?

People commonly experience:

Pain lifting the arm overhead
Pain reaching behind your back
Weakness during pressing or lifting
Pain sleeping on the affected shoulder
Pain during throwing or swimming
Shoulder pain that lingers after activity

Some people have surprisingly little pain despite a tear, while others experience significant discomfort with relatively small tears.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain persists for more than one to two weeks.
You're noticing increasing weakness.
Pain is affecting sleep.
You struggle with work, sport or gym activities.
Symptoms began after a fall or lifting injury.

Early assessment helps determine whether your symptoms are likely to respond well to rehabilitation or whether further investigation is appropriate.

Do I need imaging?

Not always.

Many partial tears are first suspected during a physiotherapy assessment.

An MRI or ultrasound may be useful if:

There was a significant traumatic injury.
There is considerable weakness.
Symptoms aren't improving after rehabilitation.
Surgery is being considered.

It's important to remember that many people have partial rotator cuff tears on MRI without experiencing any shoulder pain. Imaging findings should always be interpreted alongside your symptoms and clinical examination.

Imaging may be recommended if:

You experienced a significant traumatic injury.
There is substantial weakness.
Symptoms aren't improving despite rehabilitation.
A larger rotator cuff tear is suspected.

MRI findings don't always match symptoms, so scans should always be interpreted alongside a thorough clinical assessment.

How is partial rotator cuff tear treated?

Most partial tears can be managed successfully without surgery.

Treatment usually includes:

Education

Understanding your diagnosis and what activities are safe during recovery.

Load Management

Temporarily reducing activities that significantly aggravate your shoulder while maintaining comfortable movement.

Progressive Strengthening

Improving the strength of the rotator cuff and surrounding muscles helps reduce pain, restore function and improve the tendon's ability to tolerate load.

Return to Activity

Gradually progressing back to work, gym, sport or overhead activities with a structured rehabilitation program.

The goal isn't simply to reduce pain—it's to rebuild a stronger, more resilient shoulder.

Can I keep exercising?

Usually, yes.

Most people don't need complete rest. Instead, exercises are modified to avoid excessive pain while maintaining shoulder strength.

For example, overhead pressing may be temporarily reduced, while rowing, lower body training and other pain-free exercises can usually continue.

Your physiotherapist will guide you on which movements are appropriate throughout each stage of recovery.

How long does recovery take?

Recovery varies depending on the size of the tear, your symptoms and how consistently rehabilitation is completed.

Improvement is often gradual, and rebuilding shoulder strength usually takes longer than pain relief.

Ready to Get Your Shoulder Moving Again?

If you've been diagnosed with a partial rotator cuff tear - or suspect you may have injured your shoulder - our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and an evidence-based rehabilitation plan tailored to your goals.

Frequently Asked Questions

Shoulder Impingement: Causes, Symptoms & Treatment

Wed, 26 Aug 2026 04:17:35 GMT

Shoulder impingement is a common cause of shoulder pain, particularly when lifting your arm overhead. While the term is widely used, the problem is usually related to an overloaded rotator cuff rather than something simply being "pinched".

If you're experiencing pain when reaching overhead, lifting weights or putting on a shirt, shoulder impingement may be contributing to your symptoms. Fortunately, most people recover well with physiotherapy and progressive rehabilitation without needing injections or surgery.

At The Addison Physiotherapy, we assess shoulder pain by identifying why your symptoms have developed rather than simply focusing on the painful area. This allows us to create an individual rehabilitation program that gets you back to work, the gym or sport safely.

Key Takeaways

Shoulder impingement commonly causes pain when lifting the arm overhead.
Rotator cuff weakness and overload are often contributing factors.
Most people improve without surgery.
Strengthening and activity modification are the cornerstones of treatment.
Early physiotherapy helps prevent ongoing shoulder problems.

What causes shoulder impingement?

Shoulder impingement occurs when the tissues within the shoulder become irritated during movement, particularly when lifting the arm overhead.

While it was once thought that structures were simply being "pinched", we now understand that shoulder impingement is usually influenced by several factors.

Common causes include:

Rotator cuff tendinopathy
Shoulder bursitis
Repetitive overhead activities
Poor shoulder blade control
Weakness around the shoulder
Sudden increases in gym or sporting load

Rather than there being one single cause, shoulder impingement often develops because the shoulder is no longer tolerating the demands being placed upon it.

What are the symptoms of shoulder impingement?

People commonly experience:

Pain when lifting your arm above shoulder height
Pain reaching into cupboards
Pain during overhead gym exercises
Pain putting on a shirt or jacket
Shoulder pain at night
Weakness when lifting overhead

Many people notice a "painful arc", where lifting the arm becomes painful between approximately shoulder height and overhead before easing again.

When should I see a physiotherapist?

It's worth booking an assessment if:

Shoulder pain has lasted longer than one to two weeks.
Pain is limiting work, gym or sport.
You're avoiding overhead activities.
Your shoulder feels weaker than usual.
Symptoms continue to worsen.

Early assessment can identify whether shoulder impingement is the primary issue or whether another shoulder condition is contributing.

Do I need imaging?

Usually, no.

Most cases of shoulder impingement can be diagnosed through a detailed history and physical examination.

Imaging may be recommended if:

You experienced a significant traumatic injury.
There is substantial weakness.
Symptoms aren't improving despite rehabilitation.
A larger rotator cuff tear is suspected.

MRI findings don't always match symptoms, so scans should always be interpreted alongside a thorough clinical assessment.

How is shoulder impingement treated?

Treatment focuses on improving how your shoulder functions rather than simply reducing pain.

Treatment usually includes:

Education

Understanding why your symptoms developed and how to modify aggravating activities.

Load Management

Reducing excessive overhead loading while maintaining as much normal movement as possible.

Progressive Strengthening

Strengthening the rotator cuff and shoulder blade muscles to improve shoulder stability and reduce irritation.

Return to Activity

Gradually returning to work, sport and the gym once strength and confidence improve.

Research consistently shows that exercise-based rehabilitation provides excellent outcomes for most people with shoulder impingement.

Can I keep exercising?

Usually, yes.

Rather than stopping exercise completely, most people benefit from temporarily modifying painful movements.

For example:

Reduce overhead pressing loads.
Modify the range of motion.
Substitute painful exercises with shoulder-friendly alternatives.

As your shoulder becomes stronger, these exercises can usually be progressed back to normal.

How long does recovery take?

Recovery varies depending on the severity of the injury and how long symptoms have been present.

Most people notice gradual improvement with a consistent rehabilitation program.

Ready to Get Your Shoulder Moving Again?

If shoulder pain is limiting your training or everyday life, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised rehabilitation plan designed to get you moving again.

Frequently Asked Questions

Shoulder Bursitis: Causes, Symptoms & Treatment

Wed, 26 Aug 2026 04:17:31 GMT

Shoulder bursitis is a common cause of shoulder pain, but it often occurs alongside other shoulder conditions rather than on its own.

If you're experiencing pain when reaching overhead, lifting your arm or sleeping on one side, an irritated bursa may be contributing to your symptoms. The good news is that shoulder bursitis usually responds very well to physiotherapy, activity modification and progressive rehabilitation.

At The Addison Physiotherapy, we commonly see shoulder bursitis in gym-goers, swimmers, tradespeople and active individuals. Our focus is on identifying why the bursa has become irritated and addressing the underlying cause, rather than simply treating the inflammation.

Key Takeaways

Shoulder bursitis is irritation of the fluid-filled sac that cushions the shoulder.
It commonly develops alongside rotator cuff tendinopathy.
Most people recover without injections or surgery.
Progressive rehabilitation is more effective than prolonged rest.
Early treatment helps prevent persistent shoulder pain.

What causes shoulder bursitis?

A bursa is a small fluid-filled sac that reduces friction between tissues. In the shoulder, the subacromial bursa sits between the rotator cuff tendons and the roof of the shoulder.

Shoulder bursitis develops when this bursa becomes irritated, usually because of repeated overload rather than a single injury.

Common causes include:

Repetitive overhead lifting
Increasing gym training too quickly
Swimming or throwing sports
Rotator cuff weakness
Poor shoulder mechanics
Falls or direct impact to the shoulder

In many cases, the bursa isn't the primary problem. Instead, it's reacting to excessive load caused by an underlying rotator cuff issue.

What are the symptoms of shoulder bursitis?

People commonly experience:

Pain when lifting your arm overhead
Pain reaching away from your body
Pain lying on the affected shoulder
Pain when putting on a shirt or jacket
Aching after activity
Difficulty sleeping due to shoulder pain

Many people notice a painful arc, where lifting the arm becomes sore between shoulder height and overhead before easing again.

When should I see a physiotherapist?

It's worth booking an assessment if:

Your shoulder pain has lasted longer than one to two weeks.
Pain is affecting your sleep.
You're avoiding work, sport or the gym.
Shoulder movement is becoming restricted.
Symptoms continue to worsen despite resting.

Early assessment can help determine whether the bursa is the primary source of pain or whether another shoulder condition is contributing.

Do I need imaging?

Usually, no.

Ultrasound and MRI commonly show bursal thickening, but these findings don't always explain your symptoms. Many people have imaging changes without any pain.

Imaging may be appropriate if:

You experienced significant trauma.
Symptoms aren't improving with rehabilitation.
A larger rotator cuff tear is suspected.
Surgery or an injection is being considered.

Most cases can be diagnosed through a thorough physiotherapy assessment.

How is shoulder bursitis treated?

Successful treatment focuses on reducing irritation while improving the shoulder's ability to tolerate load.

Treatment usually includes:

Education

Understanding why the bursa has become irritated and how to avoid repeatedly aggravating it.

Load Management

Temporarily modifying activities such as overhead lifting while maintaining as much normal movement as possible.

Progressive Strengthening

Improving the strength of the rotator cuff and shoulder blade muscles to reduce stress on the shoulder.

Return to Activity

Gradually returning to work, gym or sport once symptoms and strength improve.

Passive treatments may help reduce discomfort in the short term, but long-term improvement comes from restoring shoulder strength and function.

Can I keep exercising?

Usually, yes.

Completely resting the shoulder often leads to stiffness and weakness. Instead, exercises may need to be modified while the shoulder settles.

For example, reducing overhead pressing or temporarily changing certain gym exercises can often allow you to continue training without significantly aggravating symptoms.

Your physiotherapist will help determine which exercises are appropriate and when it's safe to progress.

How long does recovery take?

Recovery varies depending on the severity of the injury and how long symptoms have been present.

Most people notice gradual improvement with a consistent rehabilitation program.

Ready to Get Your Shoulder Moving Again?

If shoulder pain is limiting your work, training or everyday activities, our experienced physiotherapists are here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive shoulder assessment and an individual rehabilitation plan designed to get you moving again.

Frequently Asked Questions

Rotator Cuff Pain: Causes, Symptoms & Treatment

Wed, 26 Aug 2026 04:17:30 GMT

Rotator cuff pain is one of the most common causes of shoulder pain, but it doesn't always mean you've torn a tendon.

If you're experiencing pain when reaching overhead, lifting weights, putting on a shirt or sleeping on one side, your rotator cuff may be involved. The good news is that most rotator cuff injuries respond very well to physiotherapy and a structured strengthening program, with surgery only required in a small number of cases.

At The Addison Physiotherapy, we regularly assess and treat rotator cuff injuries in gym-goers, runners, tradies, office workers and recreational athletes. Our focus is on identifying the cause of your pain, improving your shoulder's capacity to tolerate load, and helping you return confidently to work, sport and everyday life.

Key Takeaways

Rotator cuff pain is commonly caused by tendon overload rather than a complete tear.
Pain is often worse when reaching overhead, lifting or sleeping on the affected side.
Most people don't need an MRI straight away.
Progressive strengthening is one of the most effective treatments.
Most people recover well without surgery.

What causes rotator cuff pain?

Rotator cuff pain usually develops when the shoulder is exposed to more load than it can currently tolerate. This may happen suddenly after lifting something heavy or gradually after weeks or months of repetitive activity.

Common causes include:

Increasing gym loads too quickly
Repetitive overhead work
Swimming or throwing sports
Returning to exercise after time off
Poor shoulder strength or control
Falling onto the shoulder

In many cases there isn't a single injury. Instead, the tendon gradually becomes irritated as the demands placed on it exceed its current capacity.

What are the symptoms of rotator cuff pain?

People commonly experience:

Pain when lifting the arm overhead
Pain reaching behind your back
Difficulty putting on a shirt or jacket
Pain when lying on the affected shoulder
Weakness during lifting or pressing exercises
Aching after activity rather than during it
Reduced confidence using the shoulder

Pain doesn't always reflect the severity of the injury. Some people with significant tendon changes have very little pain, while others with relatively minor irritation can be quite sore.

When should I see a physiotherapist?

It's worth booking an assessment if:

Your shoulder pain has lasted longer than one to two weeks.
Pain is affecting your sleep.
You're unable to train or work comfortably.
You're noticing weakness or reduced movement.
Symptoms continue to worsen despite resting.
Early assessment helps identify the underlying cause and allows treatment to begin before the problem becomes more persistent.

Do I need imaging?

Usually, no. An MRI isn't always required because many people have rotator cuff changes on imaging without experiencing any pain. Your symptoms, strength and movement are often more important than the scan itself.

Imaging may be recommended if:

You suffered a significant traumatic injury.
There is marked weakness suggesting a larger tear.
Symptoms fail to improve with appropriate rehabilitation.
Surgery is being considered.

For most people, physiotherapy can begin without waiting for imaging.

How is rotator cuff pain treated?

Successful treatment focuses on improving the shoulder's ability to tolerate load rather than simply reducing pain.

Treatment usually includes:

Education

Understanding why your shoulder became painful and how to manage symptoms during recovery.

Load Management

Modifying activities that aggravate your shoulder while maintaining as much normal movement as possible.

Progressive Strengthening

Specific exercises to improve the strength and capacity of the rotator cuff and surrounding muscles.

Return to Activity

Gradually returning to work, sport or the gym with a structured plan that reduces the risk of flare-ups.

Can I keep exercising?

In many cases, yes.

Completely stopping exercise is rarely necessary and may actually delay recovery by reducing shoulder strength. Instead, exercises are usually modified by reducing weight, changing range of motion or selecting alternative movements that place less stress on the shoulder. As your symptoms improve, you'll gradually progress back to your usual training.

How long does recovery take?

Recovery varies depending on the severity of the injury and how long symptoms have been present.

Recovery isn't always linear. Temporary flare-ups are common and don't necessarily mean you've caused further damage.

Ready to Get Your Shoulder Moving Again?

If shoulder pain is limiting your work, training or everyday activities, we're here to help.

Book an appointment with The Addison Physiotherapy for a comprehensive assessment and a personalised rehabilitation plan designed to get you back to doing what you love.

Frequently Asked Questions

Running Assessments: What Is Your Physio Looking For?

Tue, 21 Apr 2026 06:18:28 GMT

A running assessment is often misunderstood. Some people think it is just someone watching how they run and commenting on their foot strike. In reality, a useful running assessment should be broader than that.

At our Marrickville clinic, running assessments are usually done to help understand why someone is getting sore, why a problem keeps recurring, or how to return to running more effectively after injury. For runners across the Inner West, the most useful question is usually not, 'What is the perfect running technique?' It is, 'What is it about my running, loading or capacity that may be contributing to this issue?'

It is not just about how you look on the treadmill

Video analysis can be useful, but it is only one part of the picture. A running assessment often also includes:

training history
recent volume and intensity changes
symptom behaviour
strength and control assessment
previous injuries
footwear and surface considerations

In many cases, the issue is not purely technique. It is a mismatch between load and capacity.

What your physio may be looking at

Cadence

Cadence can influence loading patterns, particularly in runners who are overstriding or spending too much time in a heavier braking pattern.

Stride characteristics

This includes where the foot lands relative to the body, how the runner manages impact, and whether any movement patterns appear to be increasing stress on a specific structure.

Pelvis and trunk control

Control through the trunk and pelvis can influence how load is distributed through the hip, knee and lower leg.

Lower limb loading

Depending on the injury, the physio may be watching for patterns that appear to increase stress at the calf, Achilles, patellofemoral joint, tibia, hamstring or hip.

What a running assessment should not do

It should not assume there is one perfect running style for everyone. It should also not make unnecessary changes just because something looks different.

Good running assessment is about relevance. If a movement pattern is not linked to symptoms, performance goals or injury risk in a meaningful way, it may not need changing.

Why strength still matters

Even if something useful is picked up in running form, the answer is often not just cueing. Capacity still matters. If the calf, hamstring, quads, glutes or trunk are not tolerating load well, changing form without improving strength usually has limited value.

Who may benefit from a running assessment?

It can be useful for:

runners with recurring injuries
people returning to running after injury
those increasing training load
runners preparing for an event who want a clearer plan

The key point

A good running assessment is not about chasing perfect form. It is about understanding your symptoms, your load and your capacity, then working out whether anything in your running pattern is meaningfully contributing to the problem.

If you are a runner in Marrickville, Enmore, Stanmore, Newtown or elsewhere in the Inner West and want a clearer idea of what is driving your symptoms, a proper running assessment can be useful.

Links: Exercise Prescription | Bone Stress | Hamstring Injuries | ACL Rehab

The Impact of the Relaxin Hormone Antenatally and Postnatally and How an MSK Physio Can Help

Tue, 21 Apr 2026 06:11:29 GMT

Pregnancy and the postnatal period involve significant physical change. One of the hormones often discussed in this context is relaxin. It is commonly associated with increased laxity and a feeling that the body is less stable, particularly through the pelvis, hips and lower back.

While relaxin is only one part of a much larger picture, it can help explain why some people feel physically different during pregnancy and after birth.

At our clinic in Marrickville, we see antenatal and postnatal patients from across the Inner West dealing with pain, reduced load tolerance and uncertainty around how to exercise safely. This is where a musculoskeletal physio can be helpful.

What does relaxin do?

Relaxin is a hormone involved in supporting pregnancy-related changes in the body. It is often discussed in relation to ligament laxity and changes in passive stability, particularly around the pelvis.

In practical terms, this can mean some people feel:

less stable through the pelvis
more sore through the lower back
more aware of hip, pubic or sacroiliac region discomfort
less tolerant of positions or loads that previously felt easy

Not everyone experiences these issues, and not every ache in pregnancy is due to relaxin, but it can be part of the broader load and stability picture.

Antenatal considerations

During pregnancy, people may notice discomfort with:

walking
rolling in bed
stairs
single leg tasks
exercise that previously felt straightforward

Common presentations include pelvic girdle pain, lower back pain, hip pain and rib discomfort. As pregnancy progresses, posture, breathing mechanics, abdominal wall demand and general movement patterns also change.

Postnatal considerations

Postnatally, the conversation often shifts to rebuilding tolerance. This may involve:

returning to walking comfortably
lifting and carrying a baby
regaining confidence with exercise
managing pelvic, lower back or abdominal symptoms

Even once pregnancy is over, people do not instantly return to full physical capacity. Load tolerance often needs to be rebuilt gradually.

How an MSK physio can help

A musculoskeletal physio can help by assessing the specific drivers of pain and reduced function, then building a plan that is realistic for the stage you are at.

This may include:

strength and control work
exercise modification
load management advice
guidance around returning to walking, gym or running
hands-on treatment where appropriate

For some patients, broader women's health or pelvic floor input is also appropriate.

The key point

Pregnancy and the postnatal period place different demands on the body. Relaxin may be one part of why the body feels less stable or more physically sensitive, but good management is rarely about simply 'being loose'. It is usually about understanding load, improving muscular support and building back confidence gradually.

If you are in Marrickville, Enmore, Newtown, Stanmore or elsewhere in the Inner West and are dealing with antenatal or postnatal musculoskeletal pain, our team can help guide safe, sensible progression.

Lin ks: Pregnancy Massage | Chronic Pain | Massage Therapy

Top 10 Benefits from Regular Soft Tissue Massage

Tue, 21 Apr 2026 06:04:33 GMT

Soft tissue massage is often seen as either a luxury or a quick fix. In reality, it usually sits somewhere in the middle. It is not magic, and it does not replace good rehab, but it can be a useful part of an overall treatment plan.

At our clinic in Marrickville, massage is commonly used alongside physiotherapy for people dealing with muscular tightness, training fatigue, stress-related tension and general physical overload. For many people in the Inner West, it is simply a useful way to feel and move better while supporting broader recovery.

Temporary pain relief

Massage can help modulate pain, particularly where muscles feel tight, overloaded or generally reactive. While it may not 'fix' the underlying issue on its own, it can reduce symptoms enough to help someone move more comfortably.

Reduction in muscular tension

Where someone feels generally bound up through the neck, shoulders, back, glutes or calves, massage can help reduce the sense of muscular tone and stiffness.

Improved sense of movement

People often feel freer after massage, even if objective flexibility changes are modest. Sometimes that improved sense of ease is enough to make exercise and daily activity feel more manageable.

Recovery support between training sessions

For active people, massage can be a useful recovery tool during heavier training periods, especially when combined with sleep, appropriate load management and sensible nutrition.

Stress reduction

Not all muscular tension is purely physical. Stress often shows up physically through the neck, jaw, shoulders and upper back. Massage can help reduce that load.

A useful adjunct to physiotherapy

Massage is often most useful when it supports a broader plan. For example, reducing symptoms enough to make strength work, movement retraining or return to exercise more manageable.

Better body awareness

Some people do not realise how much tension they are carrying until they actually stop and address it. Massage can help people become more aware of where they are holding tension and how their body is responding to stress and load.

Relief from desk-related tightness

People who sit for long periods often develop upper back, shoulder and neck tightness. While changing work habits still matters, massage can help settle some of the accumulated physical tension.

Improved short-term comfort for exercise and activity

For some people, massage helps them feel more comfortable getting back into walking, gym work or general activity after a flare-up.

It can simply help you feel better

Not every treatment benefit needs to be overcomplicated. Sometimes people book regular massage because it helps them feel less sore, less stiff and more settled. That is a valid reason.

The key point

Massage is best viewed as one useful tool, not the whole answer. It can help with pain, tension, recovery and general wellbeing, particularly when paired with good movement, strength work and load management.

If you are in Marrickville, Newtown, Enmore, Stanmore or elsewhere in the Inner West and are looking for regular soft tissue massage as part of your overall care, our team can help point you in the right direction.

Lin ks: Massage Therapy | Desk Neck Pain | Post-Op Rehab

How Can a Dietitian Benefit Your MSK Injury?

Tue, 21 Apr 2026 05:55:29 GMT

When people think about recovering from a musculoskeletal injury, they usually think about physiotherapy, exercise rehab and perhaps massage. They do not always think about nutrition. That is understandable, but it often means an important part of recovery gets overlooked.

A dietitian can play a meaningful role in injury management, particularly where healing, recovery, energy availability, body composition or bone health are relevant.

At our Marrickville clinic, we see a wide range of injuries across the Inner West, from runners with bone stress issues through to gym-goers managing tendon pain and people recovering from surgery. In many cases, rehab outcomes are not just shaped by the exercise plan. They are also shaped by how well the body is being fuelled.

Why nutrition matters in injury recovery

Injured tissue still needs raw materials to repair. Whether the issue involves muscle, tendon, bone or post-operative healing, the body needs enough energy and adequate nutrient intake to support the process.

If nutrition is poor, recovery may be affected by:

slower healing
lower training tolerance
poor recovery between sessions
loss of muscle mass
reduced bone support

Where a dietitian can help

1. Protein intake and tissue repair

Protein plays a key role in tissue repair and muscle maintenance. During injury, activity levels sometimes change, appetite can fluctuate, and people often end up under-consuming without realising it.

2. Energy availability

If someone is training, rehabbing and working, but not eating enough overall, recovery can stall. This is especially relevant in runners and highly active individuals, and links closely with RED-S and bone stress injuries.

3. Bone health support

For bone stress injuries, recurrent stress reactions, or low bone density concerns, nutrition becomes even more relevant. Calcium, vitamin D, total energy intake and broader dietary patterns may all matter.

4. Body composition during reduced activity

Injury can be a difficult period nutritionally. Some people become overly restrictive because they are moving less. Others struggle to manage appetite or routine. A dietitian can help keep things sensible and performance-focused rather than reactive.

Who may benefit most?

Dietitian support can be especially useful for:

runners with bone stress injuries
people with recurrent injuries
those recovering from surgery
highly active individuals with low energy availability
anyone whose recovery seems slower than expected

Why combined care works well

Physio and dietetics often work well together because they address different parts of the same problem. Physio helps guide loading, movement, strength and function. A dietitian helps make sure the body is appropriately fuelled to adapt to that work.

This is often particularly valuable in return-to-running and bone stress cases.

The key point

If you are dealing with an MSK injury, nutrition may not be the only answer, but it is often part of the answer.

If you are in Marrickville, Enmore, Stanmore, Newtown or elsewhere in the Inner West and want a more rounded approach to injury recovery, our team can help coordinate care between physiotherapy and dietetics where appropriate.

Lin ks: Dietitian | Red-S | Bone Stress Injury

RED-S and Bone Stress Injuries

Tue, 21 Apr 2026 05:48:50 GMT

When a runner or active person develops a bone stress injury, the focus often goes straight to the painful area. That makes sense, but it is not always the full picture. One of the more important underlying contributors can be RED-S, or Relative Energy Deficiency in Sport.

This matters because if RED-S is present and not addressed, bone stress injuries are more likely to occur and more likely to recur.

At our clinic in Marrickville, we see this most commonly in runners and highly active individuals across the Inner West who are training hard but not always meeting the energy demands of that training.

What is RED-S?

RED-S occurs when energy availability is too low to support both exercise and normal body function. In simple terms, the body is not getting enough fuel for everything it is being asked to do.This does not always mean someone is intentionally under-eating. It can simply mean that training load has increased and nutrition has not kept pace.

Why does it matter for bone health?

Low energy availability can affect:

bone health
hormonal function
recovery
immune function
performance

When bone health is compromised, the skeleton becomes less able to adapt to the repeated loads of running and sport. That increases the risk of bone stress injuries.

Common signs that may raise suspicion

Not every person with RED-S will present the same way, but common features can include:

recurrent bone stress injuries
persistent fatigue
poor recovery
drop in performance
low mood or irritability
menstrual irregularity in females
frequent soft tissue injuries

It is important to note that someone can look outwardly healthy and still have low energy availability.

Why runners are commonly affected

Running has a relatively high energy cost, particularly once volume increases. Add gym training, busy work schedules, poor recovery, or a drive to stay lean, and it becomes easier for a mismatch to develop between output and intake.

How it is managed

If RED-S is suspected, management should go beyond just the painful bone. It often involves:

temporary modification of training load
review of nutrition and overall intake
appropriate medical input where needed
physio support with load management and return to running
dietitian involvement

If there is a clear nutrition mismatch, dietitian input can be a particularly useful part of reducing ongoing injury risk.

The key point

If someone keeps developing bone stress issues, there is usually a reason. RED-S is one factor that should not be missed.

If you are a runner or active person in Marrickville, Newtown, Enmore, Stanmore or elsewhere in the Inner West and have had recurrent bone stress injuries, low energy availability may be part of the picture. Identifying it early can make a large difference to both recovery and future injury risk.

Links: Bone Stress Injuries | Dietitian | Sports Injuries

Hamstring Injuries: We Should Be Looking at More Than Just the Hamstring

Tue, 21 Apr 2026 05:42:14 GMT

Hamstring injuries are common in running and field-based sports, and they can be frustratingly recurrent. One reason for that is that hamstring rehab often becomes too narrow. People focus on the sore muscle itself but not enough on the broader factors that may have contributed to the injury.

At our physio clinic in Marrickville, we regularly see hamstring injuries in runners, footballers and active adults across the Inner West. One of the more important parts of assessment is working out whether the hamstring is the whole story, or just the structure that has become symptomatic.

The hamstring does not work in isolation

The hamstring sits within a broader system that includes:

the pelvis
the lumbar spine
the glutes
the calf complex
the ability to tolerate high-speed running

If there is an issue elsewhere in that chain, the hamstring can end up taking more load than it is ready for.

What else should be considered?

1. Lumbopelvic control

The pelvis and trunk provide a base for the hamstring to work from. Poor control here can change how force is transferred and may increase the demand on the hamstring during running and acceleration.

2. Glute strength and contribution

If the glutes are underperforming, the hamstrings often end up doing more work with hip extension. That does not mean the glutes are always 'off', but it can mean the posterior chain is not sharing load well.

3. Sprint exposure

A lot of hamstring injuries occur at high speed. If someone has not been exposed to enough high-speed running, then asks the hamstring to tolerate it suddenly, that is often where trouble starts.

4. Neural contribution

Sometimes posterior thigh pain is not purely a local hamstring issue. Lumbar referral or neural sensitivity can mimic or contribute to symptoms, particularly where there is a history of back pain, pins and needles, or symptoms that feel less like a classic strain.

What rehab should usually include

Good hamstring rehab often involves more than rest and basic curls. It may include:

progressive hamstring strength work
lengthened-position loading
single leg control work
glute and trunk strengthening
running progression
high-speed running exposure where appropriate

For a runner, this may also involve reviewing cadence, training progression and recent load spikes.

Why recurrence is common

Hamstring strains often settle enough for people to jog, gym and function reasonably normally. That does not mean they are ready for sprinting, kicking, fast accelerations or reactive movement. Returning too early or without enough high-speed exposure is one reason recurrence rates remain high.

The key point

If you injure your hamstring, it makes sense to treat the hamstring. But it generally does not make sense to stop there.

A broader assessment often gives a clearer picture of why it happened and what needs to improve to reduce the chance of it happening again.

Links: Running Assessment | ACL Rehab | Sports Injuries

Shoulder Pain: Are We Just Not Strong Enough?

Tue, 21 Apr 2026 05:32:47 GMT

Shoulder pain is common, whether it shows up in the gym, at work, during sport, or just with day to day tasks. A lot of people assume that if their shoulder hurts, something must be torn, pinched or worn out. Sometimes that is relevant. Often, though, the issue is more about load tolerance than structural damage.

In simple terms, the shoulder may not currently have the capacity to handle what you are asking it to do.

At our Marrickville physio clinic, we regularly see shoulder pain in active adults, gym-goers, overhead athletes and office workers across the Inner West. One of the more common patterns is not that the shoulder is incapable of loading. It is that it has become underprepared for the loading being asked of it.

Why strength matters

The shoulder relies heavily on muscular control. Unlike the hip, which has a deep socket and a lot of passive stability, the shoulder depends far more on the surrounding muscles to centre and control the joint.

These include:

the rotator cuff
the scapular muscles
the deltoid
the trunk and upper back muscles

If those structures are not strong enough, not well conditioned enough, or not handling load well, the shoulder can become irritable.

It is not always just weakness

That said, shoulder pain is not solved by randomly strengthening everything. It is usually a combination of factors such as:

reduced strength
poor tolerance to certain ranges
sudden increase in training or workload
loss of conditioning after time off
poor exposure to overhead positions

Common examples

Some common scenarios include:

a gym-goer who ramps up overhead pressing too quickly
a parent repeatedly lifting a child after not doing much upper body training
someone returning to tennis after months off
an office worker with a deconditioned upper back and poor tolerance to sustained postures

In each case, the problem is not necessarily that the shoulder should not be loaded. It may be that it needs to be loaded more appropriately.

What rehab often involves

Good shoulder rehab usually includes a combination of:

rotator cuff strengthening
scapular control work
graduated return to painful or demanding movements
review of training load or work demands
upper back and trunk contribution where needed

Importantly, avoiding all painful movement is usually not the long-term answer. The goal is generally to reload the shoulder in a sensible, progressive way.

Should you worry about scans?

Sometimes imaging is useful. But shoulder scans also often show age-related findings that are not necessarily the reason for pain. A scan result should be interpreted alongside your symptoms and physical assessment, not in isolation.

The key point

So, are we just not strong enough? Sometimes, partly yes. Not because the shoulder is weak in a simplistic sense, but because it may lack the specific strength and capacity needed for the tasks being asked of it.

If your shoulder keeps getting sore with gym work, sport, lifting, or day to day use, it is worth looking at whether the issue is less about damage and more about whether the shoulder is adequately prepared for that load.

Links : Sports Injuries | Neck Pain | Massage Therapy

3 Things to Do When You're Getting Neck Pain Sitting at a Desk Too Long

Tue, 21 Apr 2026 05:25:58 GMT

Neck pain from desk work is common. It is also one of the more frustrating issues because it often builds gradually, feels worse by the end of the day, and then repeats itself the next morning.

The good news is that desk-related neck pain is usually not about one major structural problem. More often, it is a load tolerance issue. In other words, your neck, upper back and surrounding muscles are spending too long doing the same thing.

At our clinic in Marrickville, we regularly see people from office -based jobs around the Inner West dealing with neck pain, upper trapezius tightness, headaches and postural fatigue. Below are three simple things that are usually worth doing.

1. Stop chasing the perfect posture

A lot of people think their neck pain must be because they are sitting 'wrong'. Usually, that is too simplistic.

There is no perfect posture that you can hold all day without consequence. The bigger issue is usually that you have been in one position for too long.

What tends to help more:

changing positions regularly
standing for short periods
walking during calls
breaking up long sitting blocks

Even a quick movement break every 30 to 45 minutes can help reduce how stiff and loaded the area feels by the end of the day.

2. Restore some movement during the day

When the neck and upper back stay still for too long, they often become more sensitive. A few simple movements through the day can help.

Examples include:

gentle neck rotation
chin tuck variations
thoracic extension over the back of a chair
shoulder blade retraction

The goal is not to aggressively stretch everything out. It is just to move enough, often enough, to stop the area from becoming progressively more rigid and irritated.

3. Build your tolerance, not just your flexibility

Desk workers often try stretching, massage or heat, which can all feel good in the short term. The missing piece is usually capacity.

If the neck, upper back and shoulder girdle fatigue quickly, you are more likely to feel sore by the end of the day. That is where some simple strength work can help.

This might include:

rows
face pulls
deep neck flexor endurance work
mid-back strengthening

When to get assessed

Most desk-related neck pain is mechanical and manageable. That said, it is worth getting assessed if:

the pain is getting progressively worse
you are getting frequent headaches
you have pain into the arm
you are noticing numbness, tingling or weakness
your symptoms are not settling with simple changes

The key point

If your neck hurts when you sit at a desk too long, it usually does not mean something is badly damaged. More often, it means the area does not love prolonged static load.

Three useful starting points are:

move more often
restore some movement during the day
build strength and tolerance

If you are based in Marrickville, Enmore, Newtown, Stanmore or elsewhere in the Inner West and desk work is irritating your neck, our physio team can help work out what is driving it and give you a plan that is actually realistic to follow.

Links: Sports Injuries | Shoulder Pain | Massage Therapy

Bone Stress Injuries in Runners: The Continuum and What to Look Out For

Tue, 21 Apr 2026 05:16:34 GMT

Bone stress injuries are common in runners, but they rarely come out of nowhere. In most cases, they develop over time. That is why understanding the continuum matters. If picked up early, a bone stress injury may only require a relatively short period of load modification. If ignored, it can become a much more frustrating and prolonged issue.

At our Inner West clinic, we often see runners who thought they were just dealing with a sore shin, irritated foot, or something that would settle if they pushed through. Sometimes that works with other running aches. Bone stress injuries are not usually one of them.

What is a bone stress injury?

A bone stress injury sits on a spectrum. Bone is a living tissue that responds to load. When training load is appropriate, the body adapts. When load exceeds the body's ability to recover and remodel, the bone can start to become irritated.

The continuum is often described as moving from:

bone stress reaction
bone stress response
stress fracture

The earlier along that continuum you identify the issue, the easier it generally is to manage.

Common areas in runners

Some areas are more commonly affected than others. These include:

the tibia
the metatarsals
the femoral neck
the navicular
the pelvis

Some of these are considered higher risk than others, which is why early assessment matters.

What should runners look out for?

The early signs can be subtle. Common features include:

pain that comes on with running and eases with rest
a specific, localised pain rather than a vague ache
pain that becomes easier to provoke over time
pain with hopping or impact
tenderness over a small, defined area

As the issue progresses, symptoms may start earlier in a run, linger longer afterwards, or appear with walking and daily activity.

A general rule: if the pain is becoming more localised, more predictable, and more reactive to impact, it is worth taking seriously.

Why do bone stress injuries happen?

They are rarely due to one thing alone. Common contributors include:

sudden increase in training volume or intensity
change in running frequency
insufficient recovery
poor energy availability
reduced strength capacity
history of previous bone stress injury
change in surface, shoes or training environment

This is why a good assessment should look at more than just the painful area.

What should you do if you suspect one?

The main mistake is continuing to test it. Most runners want to know whether it is 'just tight' or whether it will warm up. Bone stress injuries often do not behave well when you keep probing them.

Early management usually involves:

modifying or pausing running load
reducing impact exposure
assessing strength and capacity
reviewing training history
considering nutrition and recovery factors

In some cases, imaging may be needed, especially where the site is higher risk or symptoms are progressing.

How physio can help

Physiotherapy is not just about telling you to stop running. The role is to work out why the issue developed, manage it appropriately, and help you return to running with a better plan.

This might include:

load modification and return-to-run planning
calf, hip and lower limb strengthening
review of running history and progression errors
screening for factors such as RED-S

The key point

Bone stress injuries are usually much easier to deal with when picked up early. If your running pain is becoming more localised, more impact-related, or less likely to settle, it is worth getting assessed before it progresses further.

If you are a runner in Marrickville, Newtown, Stanmore, Enmore or the wider Inner West and are worried about a possible bone stress injury, early assessment can make a large difference to how long you are out for.

Links: RED-S | Running Assessments | Dietitian

ACL Rehab and Physio: What a Typical 12 Month Period Looks Like

Tue, 21 Apr 2026 05:05:17 GMT

ACL injuries are one of the more significant injuries we see in sport and active populations. Whether you have had an ACL reconstruction, are preparing for surgery, or are trying to understand what rehab actually involves, it helps to have a realistic picture of the road ahead.

ACL rehab is not a quick process. In most cases, it is better thought of as a structured 9 to 12 month progression rather than a short block of treatment. For many people, the biggest challenge is not the surgery itself. It is the consistency required afterwards.

At our clinic in Marrickville, we regularly help people through different stages of ACL rehab and physiotherapy, from early post-operative management through to strength work, running progressions and return to sport testing. While every case is different, the outline below gives a good sense of what a typical 12 month period can look like.

Months 0 to 3: Settle the knee and restore the basics

The first phase is usually about getting the knee moving well again and settling pain and swelling. Early priorities often include:

reducing swelling
restoring full knee extension
improving knee flexion
regaining quadriceps activation
walking more normally
building confidence with basic daily tasks

For many people, this stage can feel slow. That is normal. Early rehab is not meant to look exciting. It is meant to lay a good foundation. If range of motion, swelling control and basic strength are not addressed early, they tend to create issues later.

Depending on the surgeon's protocol and any associated injuries, this phase may also include crutch use, brace use, and gradual progression of weight bearing.

Months 3 to 5: Build strength and control

Once the knee is settling and movement has improved, rehab becomes more strength focused. This is where people usually start to feel like they are doing more meaningful work, but it is still a relatively controlled phase.

Common priorities include:

quadriceps strength
hamstring strength
glute and calf strength
single leg balance and control
step work, split squat patterns and squat variations

A lot of ACL rehab success comes down to gradually rebuilding the capacity of the entire lower limb, not just the knee. That includes trunk control, pelvis control and confidence through single leg loading.

Months 5 to 7: Running and early power work

One of the most common questions people ask is, 'When can I run again?' The answer depends less on the date and more on whether the knee is ready.

Before returning to running, we are usually looking for:

good strength markers
minimal or no swelling response
acceptable single leg control
good tolerance to gym-based loading

Once those boxes are ticked, return to running usually starts as a graded progression rather than straight back into normal training. This phase often also introduces basic jumping, landing and power development.

Months 7 to 9: Change of direction and higher level loading

At this stage, rehab starts to look more athletic again. For field and court sports, this often means:

change of direction drills
deceleration work
single leg landing progressions
reactive movement drills
higher speed running exposures

This phase matters because many people can look good in straight line strength work but still lack the ability to tolerate unpredictable movement, speed and force.

Months 9 to 12: Return to sport preparation

The final phase is not just about feeling better. It is about being physically prepared for the demands of your sport or activity.

This often includes:

strength testing
hop testing
movement quality assessment
conditioning appropriate to your sport
graduated return to training and competition

This is also the point where many people need guidance around confidence. It is one thing to be medically cleared. It is another to trust the knee again in a fast, reactive environment.

Why ACL rehab should not be based on time alone

One of the more common mistakes in ACL rehab is assuming that if enough months have passed, the knee must be ready. In reality, two people at the same time point can look very different. One may be ready to progress, while the other still lacks strength, confidence or load tolerance.

That is why good ACL rehab should be based on objective progress markers, not just the calendar.

When to get help

If you are preparing for surgery, are early post-op, or feel like you have plateaued later in rehab, it is worth getting a proper plan in place. A structured approach can make a significant difference to how the knee functions long term.

If you are looking for ACL rehab and physio in Marrickville, Enmore, Newtown, Stanmore or the broader Inner West, our team can help guide the process from the early stage right through to return to running and sport.

Lin ks: Sports Injuries | Running Assessments | Hamstring Injuries

the-addison

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