Shin Splints

Shin splints is a general term used to describe pain that arises over the inside border of the shin. It is a common complaint for runners or running-based athletes, however there can be multiple causes for pain in this area, making proper assessment and diagnosis imperative.

Potential sources of pain:

Medial Tibial Stress Syndrome:

          Most common cause.

          Pain with MTSS is thought to arise from irritation where the muscles on the inside of the shin attach to the shin bone.

Stress fracture:

          A sinister cause of pain

          Pain occurs when bone recovery can’t keep up with how the load being placed on it, resulting in damage to the bone that worsens over time.

          There are varying degrees of stress fracture, ranging from ‘stress response’ in the early stages to ‘stress fracture’ in the later stages.

          If not managed correctly stress reactions will progress to stress fractures which result in very long rehabilitation periods.


Common contributing factors:

          Increases in running/training volume

          Change in footwear/poor fitting footwear

          Change in running surface

          Lower leg muscle weakness

          Weakness at the hip and/or knee

          Other systemic causes which impair the bone’s ability to repair


Management of MTSS and stress fractures are completely different. It is important to get assessed by a Physiotherapist who is well trained to help differentiate between them and guide your management appropriately.

MTSS is primarily managed through strengthening the lower limb and improving single leg mechanics. Running load will be reduced to a comfortable level and gradually increased over time as you recover. Your physio will also use massage and/or dry needling to help relax irritated muscles, and ensure your footwear is optimal for the sport you are playing.

Stress fracture management is very different. If a stress fracture is suspected, your physio will likely refer to a Sports Medicine Physician for imaging and to oversee the healing process, as well as investigate underlying reasons for onset. Depending on severity and location, stress fractures have varying time frames for recovery. However, they all involve a period of time spent on crutches, followed by slow and gradual rehabilitation guided by your physiotherapist.


In summary, not all shin pains are ‘shin splints’ and early diagnosis is pivotal to rule out sinister stress fractures as well as to facilitate a speedy recovery.



If you or someone you know would like help with their shin pain, please feel free to contact us on 9245 1011. 

Achilles Tendinopathy

Achilles Tendinopathy


The achilles tendon joins your calf muscle to your heel bone. During running the calf and
achilles complex does a majority of the work. This means it has to withstand very large amounts of force and as a result, the achilles tendon can be often overused. This can lead to achilles tendinopathy, a common running-related overuse injury which results in the tendon becoming painful and stiff, especially during and after exercise as well as first thing in the morning. This makes it difficult to run, walk or play sport.

There are various causes of achilles tendinopathy, but most commonly it is due to a large
increase in the amount of running or training the person is doing. A Physiotherapist can diagnose achilles tendinopathy, but most importantly work with you to work out why it has happened and devise a specialised rehabilitation plan.

Rehabilitation for achilles tendinopathy will vary depending on the individual circumstances,
however largely there is 2 main stages which can often take >8 weeks to complete.

Stage 1: Calm the tendon down with modalities including:

o  Massage

o  Dry needling

o  Shockwave

o  Modified running/training load

Stage 2: Strengthen the tendon through guided rehabilitation exercises:

o  Lower limb strength training

o  Plyometric training (hopping/jumping)

o  Gradual build-up of running distance/training load

As you progress through your rehab it is important to quantify your improvement with
tools such as force plates, strength measures and hop tests, to ensure that your injured side recovers as close as possible to your uninjured side.

If you or someone you know would like help with an achilles problem, please contact our clinic on 9245 1011.

Using TENS machine for labour



Are you pregnant and looking for noninvasive, drug free and alternate ways to manage labour discomforts?

Did you know that a more active labour and drug free options may reduce the length of labour or the need for obstetric invention like epidural, forceps or vacuum delivery.

TENS (transcutaneous electrical stimulation) can be use during labour (1st and 2nd stages) to help manage contraction discomfort.

A couple of the ways it works is to reduce the intensity of uterus discomfort and it can help release pain reducing endorphins.

A recent study has shown it is as effective, like Entonox (gas), in improving labour satisfaction and pain management during labour (Rashtchi et al 2022).

Women should be given options for managing labour. If you are wanting more information, or to RENT a TENS machine from our pelvic health Physiotherapists, please contact @Karrinyup Physio, @Marmion Physio.

Vestibular Physio in Perth

vestibular physio vertigo treatment perth

The vestibular system is small and complex system which is located in the inner ear. You have one apparatus on each side of the head. This system is primarily responsible for helping you to maintain your balance, as well as controlling eye movements and keeping you gaze stable. When there is a problem with the vestibular system, it commonly results in symptoms such as vertigo/dizziness, nausea, feeling off balance and light-headedness. These problems can come from a variety of causes (pathologies) such as BPPV, neuronitis, Meniere’s disease, vestibular migraine and multiple others. It is important that if you have any of these symptoms that you are assessed by an appropriately trained health professional to ensure there is nothing more sinister causing your symptoms.

BPPV is by far the most common cause of dizziness. It occurs when small crystals become displaced within the vestibular system. When you move your head or change positions, these crystals move throughout the vestibular system, causing a brief (and often severe) episode of vertigo and nausea. This often occurs with movements such as sitting up/laying down in bed, rolling over in bed, looking up or bending down to the floor, or turning around too fast. When the head remains still for a period of time, the crystals also stop moving and hence the vertigo subsides until you move again. An appropriately trained Physiotherapist is able to confirm the diagnosis of BPPV and treat it through a range of maneuvers and home exercises. This treatment is highly effective, and aims to re-position the crystals in their correct place, which stops them moving around and causing vertigo.

Neuronitis/labyrinthitis is another pathology which can cause dizziness. It refers to an infection of the inner ear (vestibular system), and it usually only happens on one side. This dizziness is usually sudden onset, with severe and constant spinning. It is often associated with tinnitus (ringing in the ear) or sudden loss of hearing in one ear, as well as pain. Initially medical management from your GP is important to diagnose and help stop the infection/inflammation. Once this has settled, often people are left feeling off-balance and dizzy. This is where an appropriately trained physiotherapist is very helpful. Through a series of exercises which are progressed over a number of weeks, we are able to rehabilitate the vestibular system to improve its function. This improved function then allows your balance to improve, and helps to reduce dizziness with day to day tasks.

There is a high level of evidence supporting the benefits of seeing an appropriately trained physiotherapist for rehabilitation of your dizziness issues. For more information please contact our reception on 92451011

Dry Needling in Perth

dry needing karrinyup
Dry needling is used by qualified physiotherapists as an adjunct to traditional physiotherapy treatments for a variety of musculoskeletal problems including but not limited to tennis elbow, headaches, calf spasm/ tightness, hamstring strains, jaw pain and back pain. Dry needling is a treatment technique similar to acupuncture, in which a thin filament needle is inserted into the muscle sitting underneath the skin surface. The needle is inserted into a myofascial trigger point, which is like a taut band of muscular tissue (similar to a “knot”) that accumulates in areas of mechanical stress. Dry needling is thought to encourage biochemical and mechanical changes, reducing pain and increasing muscle length. Inserting a needle into the trigger point creates a noxious stimulus to the tissue that then reacts by releasing neurochemicals such as endorphins and corticosteroids. The body responds to the chemical change by increasing the flow of oxygen and nutrient rich blood to the site, acting like a healing mechanism.