Comprehensive and specialised physiotherapy services

Interpreting Scans and Imaging Results

What does a baseball player’s shoulder look like on MRI? It’s probably not what you’d expect…

A study back in 2002 looked at a small group of professional baseball players’ shoulders. The purpose of the study was to use an MRI to image the players shoulders and see what types of changes might be occurring with this highly active group. 


14 players were included in the study which meant 28 shoulders in total were scanned. The MRI’s were performed and each players Rotator Cuff Tendons (the important muscle group that creates a lot of the function and movement around the shoulder) and Labrum (the capsule that houses the shoulder and provides stability) were assessed, along with numerous other local shoulder structures.

The findings of the MRI’s showed –

  • In their non throwing shoulders 86% of the players had abnormal changes to their Rotator Cuff Tendons.
  • In their throwing shoulders 79% of players had abnormal changes to their Rotator Cuff Tendons.
  • In both their throwing and non throwing shoulders 79% of players had abnormal changes to their Labrums.


Like many, your first thought is probably something along the lines of – Wow… those numbers seem high, their shoulders must be toast. Or, you must need to be super lucky to not ruin your shoulders playing baseball at that level.

Now here’s the really interesting caveat – All the players included in this study were ‘asymptomatic’. Meaning, none of the 14 players reported shoulder pain, in either shoulder, or were dealing impaired function or performance. So I would suggest re-reading the above findings again, and knowing what you know now, how does it change your interpretation of the above?

So what should the take away be from a study like this? I think the moral of the story is that scan findings don’t represent the full picture. If you analyse these players based on their scans, you would assume they would be in some kind of trouble. If you analyse the findings in the context of the person, their shoulders are as healthy and functional as they have ever been. That’s why it’s super important to discuss your scan findings with a medical professional that explains your findings within the context of you as a person, not that what the scan shows because based on the above, we know that can be misleading.


Reference –

Miniaci, A, Mascia, AT, Salonen, D & Becker, EJ 2002, ‘Magnetic resonance imaging of the shoulder in asymptomatic professional baseball pitchers’, The American Journal of Sports Medicine, vol. 30, pp 66-73.


Understanding Pain

Pain, the overprotective warning system

Picture, if you will, that pain is like an over protective guard dog. When the dog barks, it’s warning you of potential intruder to your house, much like how pain is warning you of potential damage to your body. A well trained dog knows the difference between what is a threat and who is your lovely Auntie Pam coming to visit, but if your house has been broken into a couple of times and traumatised your dog, they might start barking at anyone that evens walks past the front door! 

Similarly, your past experiences with pain and injuries can influence the sensitivity of your warning system, and increase your pain when it might not be advantageous to you. How is Auntie Pam supposed to come visit if your dog is getting in the way? How are you supposed to engage in life if pain is limiting your function? 

The trick is to start slow. Pick something that is uncomfortable, but tolerable, and slowly get used to it over time and build up your tolerance to it. Retraining your pain system can be as difficult as teaching an old dog new tricks, but the key is to practice consistently.

Graded exposure is one of the many tools we like to use at PhysioWest, as it helps people to re-engage with life again! If this intrigues you, come in to have a chat about it with any one of our knowledgeable physios. 


Low Back Pain

Coming back from back pain

Low back pain is one of the worlds most prevalent health conditions, with around 1 in 6 (16%) Australian’s experiencing back pain each year, and up to 90% of people experiencing it at some stage of their life. 

Here are some tips on how to overcome your low back pain.


Don’t be put off by medical jargon

Some terms we hear a lot within the clinic are that patients have ‘slipped a disc’ or have ‘put there back out of place’. These phrases sound very harmful and scary, and are a highly inaccurate representation of what’s going on in the spine. The truth is that our spine and intervertebral discs are an extremely strong, robust structure that are so securely attached, that they simply CAN NOT slip out of place. 

Remember that your back is a strong, stable structure built to bend, twist and move with your body. If you experience a severe, sudden episode of back pain after lifting, remember that nothing has slipped out of place.


Don’t be put off by your MRI results

All too often when you’ve had scans, it will come back with some kind of ‘abnormality’, ‘disc degeneration’ or ‘disc protrusion’. For someone who doesn’t understand these terms, it can be quite frightening. The truth is that these changes are a normal part of aging and just like our skin, our joints can show wrinkles or grey hairs as well.


The key is to remain active and avoid bed rest

For back pain that has come on recently, it is often tempting to rest and lie in bed all day until it gets better. Research now shows that those who remain active and avoid bed rest (even when in pain) recover quicker and are less likely to have chronic pain and disability. We suggest that you find a balance between allowing your back to settle, and performing gentle exercise.


Exercise and strengthening helps prevent re-occurrences

Exercise is very healthy for our backs and living a physically active lifestyle is the best approach to preventing re-occurrences. You may be wondering what forms of exercise is safe, and quite simply, it can be any form of exercise that you enjoy. Whether it’s walking, running, cycling, swimming, yoga, pilates, hiking, gym.. The list goes on! Even running that was once deemed to be damaging to our spine has no link to the development of low back pain. 

To find out more information about low back pain, book in and come speak to the team at PhysioWest.




Proprioception: Prevention or Performance?

Many of us have gone out to sports training, thrown on our runners or boots, done a light jog around the oval, a couple of static stretches and called it a “warm up”. 30 years ago this was the status-quo and widely accepted approach to preparing for exercises, however more and more emerging evidence suggests otherwise.

Whether it be at elite, semi-professional or amateur levels, the importance of a dynamic and sports specific warm up have never been clearer, however it remains poorly adopted among the sporting community. 

Participating in proprioceptive neuromuscular training drills has been shown to reduce injury risk in the lower limb by 22% (Finch 2016). Despite this, prevention unfortunately isn’t quite “sexy” enough, and these programs can be neglected. Maybe we should be re-framing their value?

Not only can these drills reduce injury risk, they also have been shown to improve performance in balance, jumping and sprinting outcomes (Ayala 2017).

In a performance driven industry, where even at grass roots level everyone loves to perform at their best, encouraging dynamic warm ups to improve performance as well as reduce injury may be a better way to get the buy in required for them to be widely accepted. 

If you are a player, coach or parent – come into the clinic for a chat, and spread the word to create a safer and more enjoyable sporting community for all.



The Stereotypes, Common Misconceptions & Benefits of Pilates

I’m sure we’ve all seen the stereotypical audience that Pilates attracts on American TV shows; Women in their tight fitting activewear, with their almond milk lattes, having a juicy gossip sesh. So, I’m not surprised when I hear my patients expressing concerns that they don’t think they are suited to Pilates or the pilates ‘crowd’. BUT, pilates does not exclude, it is for everyone!


When offering Pilates as an option for treatment to my male patients, I often get a smirk or laugh as a reply because the majority view it as an exercise for women only. But, that is the furthest from the truth. Pilates was actually developed by a male, Joe Pilates, in an attempt to improve his own health and physical fitness. He then implemented it in camps during World War I to help rehabilitate injured soldiers. Joe, born and raised in Germany, originally created a series of 34 mat based exercises which soon developed into a number of different exercises, incorporating a range of different equipment. In 1925 Joe emigrated to the US where he opened his own studio, broadening his audience to both men and women.

Times have evolved and since, Pilates is now commonly assumed to be a Women’s form of exercise with only 25% of participants being Men.

But what you maybe didn’t know… David Beckham, football star and legend took up pilates, practising it for one hour a day. He reaped the benefits – improved mobility, flexibility, coordination, balance but he also experienced a loss in body fat, in which he expressed that he was “in the best shape in years”. So, there you have it men… if you want a supple muscular body like Beckham, come give Pilates a crack! We can learn a lot through Pilates and definitely improve our performance throughout other daily activities in doing so.


Pilates is a great form of exercise and unlike most other types of exercise, it targets the whole body (with particular emphasis on the deep core muscles). Pilates works to improve flexibility, stability, control and strength. Attention is drawn to technique, postural alignment, body awareness, control and breathing. A number of studies have even shown its effectiveness in reducing pain and disability in those suffering from Chronic Low Back Pain.

These are all great, yes, but my favourite thing about Pilates is that it can be tailored to any individual, no matter what age, gender or skill level. There are a number of exercises that can be performed either on a mat, reformer, trapeze table or using additional equipment. Each exercise can be as gentle or physically demanding as you want it to be.

One of the reasons I love taking our Body Reform class is because of the variation, fun and laughs had. In a class I can have a middle aged male increasing his intensity with some 7kg dumbbells, a teenager pumping out some leg work on the reformer, a 70+ year old woman doing a single leg press on the trapeze table or a mum doing some gentle core and stretching mat work.

Each class is like a family, inclusive of all and with a common goal to improve physical and mental well-being.

Come tone up, improve your control, strength and perform at your peak every day!


Interested yet? Click the link below to book in with our Pilates guru Soph and she’ll help create a pilates program fit for you, whether that be a home program or program to follow along in one of our classes.