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Sever’s Disease

Is your active child complaining of heel pain? Have they started walking more on their toes? They may be suffering from a common paediatric condition called Sever’s disease.

Sever’s is an overuse condition many 8-14 year old children suffer from, being most common at 8-10 years old for girls and 10-12 years old for boys. It occurs when the Achilles tendon pulls on the growth plate at the base of the heel and becomes inflamed. The calcaneus bone is not fully developed until around 14 years of age. Until then the pressure put on the growth plate, particularly with high levels of running and jumping can cause it to become inflamed and painful.

Sever's Disease


Luckily there are some easy things that can be done to help manage this condition. 

  • load management and rest, your osteopath or physiotherapist can help to guide you with what is appropriate. 
  • cold therapy 20 minutes on 10min off 20 minutes on, particularly after activity. 
  • foam rolling the calf muscles
  • spending less time barefoot or using heel cups and cushioning shoes.

If this sounds like your child could suffer from Sever’s Disease, our team is here to help! Book in with our Osteopath or one of our Physiotherapist’s for treatment now.

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Come and see what an osteopathic approach can do for you or your child. Natalie is available for appointments Monday, Tuesday and Thursday at The Body Refinery.

Book today to experience the benefits of Osteopathy through our App or on 07 3358 3915.

Pilates For Bone Health – Osteoporosis

bone health

While bones feel solid, the inside of the bone is actually filled with holes like honeycomb. Our bones are constantly being remodelled – old bone is removed and new bone is formed. As we age, we begin to lose more bone than we build. This can result in a condition called osteoporosis. The tiny holes within the bones get bigger, and the solid outer layer becomes thinner. In other words, our bones get less dense. This makes them more prone to fracture, even from a minor bump or fall. The most common fracture sites are the spine, wrist and hips. Fractures in the spine reduce the height of the vertebrae and can lead to a stooped or hunched posture called kyphosis, reduced mobility, pain, balance problems and increased risk of falls.

What are the symptoms?

Osteoporosis is often described as a ‘silent disease’ because there are no symptoms. Often people aren’t diagnosed or treated for osteoporosis until they sustain a fracture.

Who is at risk?

There are certain risk factors for developing osteoporosis. These include:

  • Female sex
  • Certain medical conditions and medications (e.g. thyroid problems, rheumatoid arthritis)
  • Family history of osteoporosis
  • Calcium and/or vitamin D deficiency
  • Sedentary lifestyle
  • Smoking
  • Excessive alcohol consumption

If you are over 50 and have any of these risk factors, speak to your doctor about having a bone density scan.

bone health

How is it treated?

Medication and lifestyle changes are the main forms of treatment for osteoporosis. Exercise is also very important. Current guidelines recommend a combination of weight-bearing exercise, resistance training and balance training. Exercise programs should be performed regularly (at least three times per week), challenging, progressive, varied and individualised to the person.


Pilates for osteoporosis.

People often overlook Pilates as an exercise option for the management of osteoporosis, probably because they are only thinking of traditional mat exercises. However, Pilates can also be performed on specialised equipment such as the Trapeze Table and Reformer. This type of equipment-based Pilates incorporates weight-bearing and impact activities which can improve bone mineral density. A recent study in postmenopausal women with osteoporosis found a significant increase in bone mineral density in the lumbar region following a clinical Pilates program.

Equipment Pilates can also help to build muscle strength by adding resistance in the form of springs. Other benefits of Pilates include correction of postural changes, reduced pain and improved mobility, balance and coordination.

If you have been diagnosed with osteoporosis or low bone density, make an initial physiotherapy appointment at the Body Refinery today. Our physiotherapists will perform an assessment and design a safe, effective and individualised clinical rehab program incorporating both Pilates informed exercises and traditional rehabilitation exercises to improve bone density, strength, posture, balance, coordination and reduce the risk of falls.


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Book today to experience the benefits of Pilates through our App or on 07 3358 3915.

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Pelvic girdle pain

Pelvic Girdle Pain (PGP) is a specific form of lower back pain that arises during pregnancy, usually between 14 and 30 weeks. The pain is located around the SIJ/buttock area and may radiate to the back of the thigh. PGP is very common during pregnancy, affecting approximately 56% to 70% of women. 

It is thought to be caused by hormonal changes during pregnancy which increases the laxity of pelvic ligaments in preparation for birth. This increased mobility of the pelvis can increase strain on the muscles and cause irritation or inflammation of the joints. In some cases, the pelvis may even be slightly ‘out of alignment,’ especially after a fall. 

Pregnant women with Pelvic girdle pain will experience pain with sitting, standing or walking for long periods and have difficulty with asymmetrical movements such as stairs and turning in bed. 

pregnancy massage The Body Refinery New Farm Brisbane

Some tips for helping to manage Pelvic Girdle Pain include:

  • Avoid prolonged sitting – get up at least every 30 minutes
  • Stand with weight through both legs evenly 
  • Avoid walks for hours at a time
  • Avoid stairs – take the lift or escalator where possible
  • Roll in bed with knees together
  • Shorten stride length
  • Avoid walking on soft surfaces like sand 

It is important to remember that your pelvis is supposed to be more mobile during pregnancy to make birth easier. It does not mean your pelvis is ‘unstable’, it just means you have to learn to control that increased mobility. 

If you think you are experiencing PGP, please book in for an appointment with one of our women’s health physiotherapists.

In the initial consultation, our physiotherapists will take you through a detailed history and physical examination to ensure an accurate diagnosis and develop an individualised treatment plan. This may include:

  • Advice and education 
  • Hands-on treatment such as massage or joint mobilisation to relieve muscle tension and restore alignment 
  • Fitting for a pelvic belt to help reduce movement of the pelvis
  • Stabilising exercises to help manage your pain and improve your day to day function

Depending on your goals, our physiotherapists may also recommend clinical rehab or pregnancy conditioning classes. 

To make an appointment at our New Farm studio, call our reception staff on 07 3358 3915 or click the link below. Please, be sure to request one of our Women’s Health physiotherapists.: Courtney and Charmion

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Calcification in your shoulder – shockwave can help

Calcific tendonitis is a common cause of shoulder pain. It occurs when calcium deposits in or around the rotator cuff tendons, most commonly the supraspinatus. It usually affects people aged 40 to 60 years and is more common in women than in men.

People with calcific tendonitis will generally have shoulder pain, stiffness, difficulty sleeping on the affected side and problems with activities of daily living such as dressing and work. Diagnosis is confirmed with imaging such as ultrasound or Xray. Calcific tendonitis of the shoulder is typically treated with rest, anti-inflammatories, physiotherapy, corticosteroid injections and if all else fails, surgery.

calcific tendonitis shockwave The Body Refinery New Farm

More recently, shockwave therapy has emerged as an alternative treatment option. Shockwave delivers acoustic waves to the affected area with the intent of breaking up the calcification. Studies have shown shockwave can help to reduce pain, increase shoulder function and dissolve calcifications in people with calcific tendinitis of the shoulder. These improvements are also long-lasting with patients showing improvement in symptoms and resorption of calcifications at 6 months follow up.

The Body Refinery’s shockwave machine is made by EMS Swiss DolarClast, the world leader in Shockwave therapy and technology.

If you have been diagnosed with rotator cuff calcifications, please talk to your physiotherapist, myotherapist or massage therapist about Shockwave. The initial appointment is 45 minutes long and will include a full assessment and a minimum of 15 minutes of treatment. Following sessions can go from 15 to 60 minutes depending on the type of injury. Shockwave appointments are only performed once a week to allow the injured area to rest.

Book today to experience the benefits of Shockwave Therapy. Call 07 3358 3915 or follow the link below.

Achilles tendinopathy

achilles tendinopathy shockwave therapy the body refinery new farm

The Achilles tendon is the largest and strongest tendon in the human body. However, it is prone to injury, with Achilles Tendinopathy being one of the most common overuse injuries.

How does it occur?

It was previously thought that Achilles pain was due to inflammation. However, recent studies show that Achilles Tendinopathy involves little or no inflammation. We now understand that Achilles Tendinopathy occurs when the Achilles tendon is overloaded, either in a single episode or gradually over time. It has been described as a continuum with three phases: reactive tendinopathy; tendon disrepair; and degenerative tendinopathy.

Reactive tendinopathy is usually seen in younger people and results from an acute overload such as a burst of unaccustomed physical activity or a direct blow to the tendon. In response, the tendon thickens but if the load is reduced, the tendon will return to normal. If the tendon is not allowed to rest however, it will progress to the next phase – tendon disrepair. In this stage, the collagen fibres that make up the tendon become disorganised but it is still possible to reverse these changes with treatment. Things become more difficult in the final stage – degenerative tendinopathy. This stage generally affects middle-aged, recreational athletes who have a history of Achilles pain. At this stage, there are degenerative changes in the tendon that are difficult to reverse.


What are the symptoms?

People with Achilles tendinopathy will report pain, stiffness and swelling in the Achilles region. There are two types of Achilles tendinopathy depending on the location of pain– mid portion and insertional Achilles tendinopathy. Pain in the middle region of the Achilles tendon is typical of midportion Achilles tendinopathy whereas pain, where the Achilles inserts onto the heel bone, suggests insertional tendinopathy.


What are the risk factors?

There are certain factors that can increase the likelihood of developing Achilles tendinopathy. These include: 

  • male sex
  • age >30
  • diabetes
  • high BMI
  • calf weakness and/or tightness
  • foot/ankle stiffness.


Other common causes of Achilles tendinopathy include:

  • change of footwear
  • poor, unsupportive footwear
  • change of training surface (e.g. grass to road)
  • increase inactivity


How is it managed?

Physiotherapy is highly effective for the management of Achilles tendinopathy. Your physiotherapist will usually provide advice about reducing the load on the tendon and use manual therapy, massage and taping techniques to help relieve your pain. They will also prescribe a specific type of exercise called eccentric exercise. With eccentric exercise, the muscle is lengthening as it contracts. For example, when you do a calf raise over a step. Eccentric training has been shown to not only reduce pain but also improve the structure of the tendon.

Shockwave Therapy The Body Refinery new Farm Brisbane


If you experience ongoing Achilles pain despite these treatments, please talk to your physiotherapist about shockwave therapy.

Shockwave therapy has been investigated as a potential adjunct to physiotherapy treatment. Studies have shown that shockwave can help to improve pain and function in people with Achilles tendinopathy, especially if it is combined with eccentric exercise. Shockwave uses an acoustic wave which increases blood flow to the injured tendon and stimulates healing.

The Body Refinery’s shockwave machine is made by EMS Swiss DolarClast, the world leader in Shockwave therapy and technology.

The initial appointment is 45 minutes long and will include a full assessment and a minimum of 15 minutes of treatment. Following sessions can go from 15 to 60 minutes depending on the type of injury. Shockwave appointments are only performed once a week to allow the injured area to rest.

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Book today to experience the benefits of Shockwave Therapy. Call 07 3358 3915 or follow the link below.

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My Pain in the butt – Coccydynia

Coccydynia, or pain in the coccyx (tailbone), is commonly experienced by women after a traumatic childbirth.  Symptoms generally include (sometimes excruciating) pain around the tailbone and hip when sitting or standing, especially after certain exercises.  It can be very unwelcomed by new mothers, who are often already looking after one or more young children and sometimes returning to work.

Pilates and general physio treatments can help to relieve pain, however, they are not likely to provide a complete and lasting solution.  However, more specific treatments by a Women’s Health Physiotherapist can provide life-changing results and eliminate the symptoms.


Coccydynia treatment includes manual therapy to release the gluteal muscles and pelvic floor – externally at first and, if indicated, internally.  Treatment may also include mobilization of the sacrum and correction of muscle imbalances through stretching and muscle strengthening. Women’s Health Physiotherapists are trained to treat a range of pregnancy-related matters and to undertake internal examinations, which are sometimes required for the assessment and treatment of certain conditions.

Women suffering from the pain of coccydynia can experience dramatic pain relief after only one or two treatments with an experienced Women’s Health Physiotherapist.  We understand the pain and frustration that conditions such as coccydynia can cause and the relief that is experienced when new mums are correctly diagnosed and successfully treated.  To ensure our clients don’t have to endure a long search for a solution, The Body Refinery team includes Women’s Health Physiotherapists.

Coccydynia treatment women's health physiotherapist brisbane

If you are experiencing pain in your tailbone, hips or buttocks that isn’t improving, especially if you are a new mum, we recommend seeing our Women’s Health Physio.  Internal exams may not be the preferred course of action you are seeking, but many consider this a small inconvenience to have an accurate diagnosis and relief from the pain of coccydynia. Our Women’s Health Physio is considerate and will talk you through any courses of action they consider may be appropriate help you.

Book your appointment today by calling 07 3358 3915. Make sure to request our Women’s Health Physiotherapist, Charmion Bevan.

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What is a pre-pointe assessment and why do I need one?

pre-pointe assessment

Starting to dance en pointe is one of the most exciting times in a young ballet dancer’s life. However, it is important to remember that dancing on the toes is not a typical function of the human foot. If a dancer does not have adequate range of motion, strength and or/stability, it can place excessive stress not only on the foot and ankle, but also on the leg, pelvic girdle, and trunk. A pre-pointe assessment is designed to assess a dancer’s readiness for pointe in order to prevent pain and lifelong injury.

At the Body Refinery, our physiotherapist Courtney has been trained to conduct in-depth pre-pointe assessments and prepare dancers for the demands of pointe work.

The Initial Pre-Pointe Assessment is one hour long. This allows our physiotherapist time to obtain a detailed history and assess posture, ballet technique, range of movement, strength and core stability in a friendly environment. Courtney will then develop an exercise program for the dancer to take home to address any weaknesses in these areas and ensure a safe progression onto pointe.

Dance Pre-pointe assessment physiotherapy The Body Refinery Brisbane

Clients will also have time to ask questions so that they understand every step of the program that our physiotherapist will tailor for them. After the assessment, a report will be provided to the dancer’s teacher outlining the results and exercises prescribed.

Follow up sessions may be required to monitor the dancer’s progress and ensure all of the requirements are met prior to going en pointe.

Depending on each dancer’s goals (and whether there are any existing injuries), Courtney may recommend clinical exercise sessions including Pilates. Clients may choose between private sessions, where they will have 100% of Courtney’s attention, or experience the benefits of joining one of our classes.

Whether you are training to be a professional dancer or taking dance classes for fun, we can help you reach your goals.

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Book your pre-pointe assessment today with physiotherapist Courtney. Create your profile to book through our online system or call 07 3358 3915!

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Plantar Fasciitis

The Plantar fascia is a crucial length of tissue playing an important role in foot structure and biomechanics in weight bearing. Plantar fasciitis or Plantar Fasciopathy results from repetitive excessive tensile loading of the plantar fascia that can gradually build up over a long period of time or arise from a sudden increase in weight-bearing activities.

This can occur both within the athletic population such as long distance runners and dancers, however, obesity is also a risk factor due to increased load through the foot with comparably less activity. The pathophysiology of plantar fasciitis is similar to tendinopathy with evidence of collagen disarray in the absence of inflammation, increasing the thickness of the tissue and regional loading during gait.


What are the symptoms and who is the most touch?

The incidence and prevalence of plantar fasciitis are unclear. However, it has been estimated that 7% of people aged over 65 years report tenderness in the region of the heel and that in the USA plantar heel pain accounts for a quarter of all foot injuries relating to running. Over 1 million people per year in the USA present to their Doctor for the treatment and diagnosis of Plantar heel pain. The condition affects both athletic and sedentary people and does not seem to be influenced by gender.


A recent review into the clinical practice guidelines for Plantar Fasciitis stated patients are likely to present with the following:

  • Plantar medial heel pain, worse in weight bearing, especially initial steps after periods of inactivity, as well as prolonged activity in weight bearing
  • Sudden increase in long-term weight bearing activities especially on a surface with minimal shock absorption
  • High body mass index (non-athletic population)
  • Tenderness/pain on palpation of the proximal attachment of the plantar fascia
  • Positive windlass test
  • Decreased active/passive dorsiflexion range of motion
  • Decreased longitudinal foot arch height


The most notable risk factors for the development of plantar fasciitis are decreased ankle dorsiflexion range, a high percentage of their daily activities/work on their feet and a BMI greater than 30kg/m2.

Plantar Fasciitis


What treatment for Plantar Fasciitis?

Plantar Fasciitis is commonly described as a self-limiting condition. A systematic review, in which heal pain resolved within 12 months regardless of treatment strongly supports this. However, clinically plantar Fasciitis is a painful, disabling condition which severely impacts the quality of life.

Ultrasound-guided corticosteroid injection for Plantar Fasciitis is increasingly popular in the medical treatment of plantar fasciitis. Studies show that ultrasound-guided corticosteroid injection reduces abnormal swelling and pain however significant pain relief did not last longer than four weeks. Some studies are showing that corticosteroid injections do cause degenerative effects for tissue in animal studies if used more than once.

Physiotherapy treatment of plantar fasciitis is dependent on its acuteness or chronicity and level of pain/discomfort but is generally directed at decreasing tensile load on the plantar fascia, increasing foot and ankle mobility, pain management and activity/lifestyle modification.


Physiotherapy treatments include:

  • Education on activity modification
  • Deloading by anti-pronation taping or foot orthoses (either over the counter or customised), along with shock absorbing footwear and gel heel inserts
  • Increasing the extensibility of the musculotendinous units and associated connective tissue of the plantar fascia;
    – Soft tissue release of gastrocnemius, soleus, toe flexors, tibialis posterior, plantar fascia itself using dry needling and trigger point therapy. Dry needling provided statistically significant reductions in plantar heel pain.
    – Mobilisations of talocrural joint, inferior tibiofibular joint,
  • Addressing biomechanics of aggravating activities

In addition to rehabilitation exercises, Pilates can be used effectively to increase the extensibility of the musculotendinous units and soft tissue along with mobilization for the talocrural and tibiofibular joints. Pilates can address poor biomechanics and establish new movement patterns in a non-weight bearing environment making it an ideal choice of exercise to rehabilitate plantar fasciitis, in addition to a home management program.


At The Body Refinery, our physiotherapists are extensively trained in Pilates and dry needling, along with the traditional musculoskeletal physiotherapy skills making them an ideal choice to rehabilitate plantar fasciitis.

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Book an appointment with one of The Body Refinery’s Physiotherapists today on 07 3358 3915 or at info@thebodyrefinery.com.au

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Movements and Activity: a pathway to improve


It is generally believed that when our body hurts we should stay still and avoid any painful movements to avoid worsening the symptoms. This is true only after an acute injury so that our body can heal the damaged tissue. However, excessive rest can have an adverse effect and make things worse in patients with musculoskeletal disorders.


Movement to treat your pain/injury

Not only because the body suffers from the effects of a de-conditioning process, but also because some people may become scared of moving and lose the awareness of the motion of the affected area. So consequently we move less, get stiffer, our muscle weakens and we have secondary pain due to inactivity.

In addition, it has been shown that pain-related fear has an important role in the transition from an acute injury to chronic pain in low back patients. Some patients perceive movements or stimulus as a threat, increasing the stress/anxiety towards specific activity and as a result, creating a fear-avoidance behaviour which leads to further misuse of the body and long-term disability.

Furthermore, the pain experience can be influenced by stress, excessive attention to pain and unhelpful believes. Consequently, the pain of that initial injury has become bigger and bigger due to other factors even though the healing time of the injury has been already finished.


So how can we break down this vicious loop?

A good start is moving, recovering that lost awareness of your body and re-learning how to move adequately, improving the confidence during activities, breaking down the pain-movement association in our brain and decreasing that perceived threat.

You may think “but how if it’s hurting?” The answer is pacing, little by little with the help of health professionals to support you and reassure you through this process. You cannot win a marathon if you didn’t train it before, so after prolonged inactivity due to pain is similar, it is important to build up the strength and movement little by little, to promote the tissue adapt to the new activity, settling goals to finish your own race to get out of such loop.

At the Body Refinery, you can find physiotherapists to help manage your discomfort and start getting active in a safe way, with small movements. Start decreasing the threat of movement with progressive exercises, safe environment and reassurance to recovering progressively the normal motion of your body.

When you feel ready, Pilates is an unparalleled, whole body-conditioning program. The Body Refinery offers a variety of different Pilates classes to help build:

  • Flexibility
  • Muscle strength
  • Endurance throughout the whole body
  • Postural alignment
  • Core strength and stability
  • Healthy breathing patterns, and
  • Improved coordination

If you want to move with strength, flexibility, power, vitality and ease, join our Brisbane Pilates studio. Going on holidays? Take your Pilates Instructor with you anytime… anywhere with The Body Refinery Online’s Studio – www.thebodyrefineryonline.com


HIIT Express Reformer pilates


New to Pilates and our Studio?

Take advantage of our intro offer: $200, 1 Month Trial. It includes:

To register your interest, contact us at info@thebodyrefinery.com.au or call 07 3358 3915

Make use of your physio or instructor


How your physiotherapist or Pilates instructor can assist you to achieve your goal.


Movement is a skill

We often forget that movement is a skill and that we have ‘learned’ it. Along with internal focus, external feedback is an important component of how we learn. One of the primary roles of your physio or instructor is to provide feedback. Beyond the instruction of ‘what’ to do they can often provide valuable feedback on ‘how’ to do something. An experienced physio or instructor would have accumulated hundreds if not thousands of hours studying, teaching, practising and observing movement. Why not take advantage of it?


One instructor vs. a variety of instructors

As a general rule, we recommend finding somebody that you connect with and have some consistency initially. The benefit is it allows a relationship to develop. The instructor will get a better idea of your body, movement and tendencies. You will get a deeper understanding of their teaching style and process. This helps reduce confusion while learning the foundations.

Once you have established a foundation (focusing on the principles) go experience other instructors and be open to their different perspectives and experience their different styles. You may find another favourite!

Pilates Principles


Group versus private sessions

Group settings are more economical and provide some social interaction. Private sessions allow for individual attention throughout the entire session.

Through our experience, nothing works well for ‘everybody’. In a group setting, we instruct for what works for ‘most’ people. We will try to make corrections for the individual as much as possible but by the nature of the class environment, our attention has to be divided. If you are finding you need a bit more attention a private session is a great option.


Some great times to consider working one-on-one with your physio or Pilates instructor would be:

– Pain*
– New to Pilates
– Specific goals
– Performance & technique

* The presence of pain especially if increased during Pilates needs to be discussed with your physio or pilates instructor.

At The Body Refinery, our physiotherapists or Pilates instructors are here to ‘guide’ you and help with technique. It is important that you combine the external feedback with your internal experience to get the most out of your Pilates. The more you understand your body, the more likely you will be able to apply this knowledge to activities and goals beyond the Pilates setting.


Some key ways to make good use of your physio or Pilates instructor:

– Find an instructor you connect with and have some consistency initially
– Listen to their feedback and apply it to your inward experience
– Private or small group sessions are available if more individual attention is required
– If you have a question ask!

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