Facebook Twitter YouTube Google +


Conveniently located on the North Shore at:

Wahroonga Specialist Centre
Suite 4, 176 Fox Valley Road
02 9489 4111

Articles of interest

McKenzie Institute
Australian Physiotherapy Association



What is mindfulness?

You may have heard of a recently popular approach to bring more focus and calmness into our busy lives. This approach, called mindfulness, is promoted by many health and educatory bodies. With all the things around us, all demanding our attention, we often end up navigating through life on autopilot. Dr. Chris Walsh describes mindfulness as one of the most powerful ways in which we can deal with and overcome psychological, emotion and physical stress. He describes it as an open hearted kind of attentiveness to the present moment and focus on the five senses. “Instead of reacting in our automatic pilot habitual ways we become more spacious allowing us to choose different more skilful ways of responding”.

At its core, mindfulness is about turning off autopilot and training ourselves to be active participants in our own lives.1 This involves bringing our attention to bear on each moment, and truly allowing ourselves to experience it. However, as we don´t have unlimited attention spans, this takes some training. And so mindfulness encourages us to put some concrete time aside each day to meditate. The idea of meditation may sound daunting — or even weird — but it´s really very simple. The easiest way for beginners is to draw our attention to something specific, such as our own breathing, and focus on that one thing for a time.

What you may not know is that this approach also has a lot of benefits when it comes to dealing with pain — particularly chronic pain.2 Mindfulness is about bringing your attention to your pain. This might seem counterintuitive, but it acknowledges that it would be pretty impossible not to think about your pain at all. So if we´re going to think about it anyway, we should focus instead on trying not to think about it negatively. This doesn´t mean you have to focus on your pain 24/7. It´s more about finding better ways to deal with it when it does arise. Using mindfulness techniques can help with this in a few ways.3

How can it help my pain?

One of the easiest ways is the breathing meditation mentioned above. Rather than focus on the pain when it arises, focus on your breathing. This helps to change your automatic reaction to pain.4 Accept that you will get distracted (breathing sounds boring, right?), but when you do, gently bring your mind back to your breathing. Don´t reject your distracted thoughts or get frustrated with yourself. Acknowledge them, but gently put them aside for another time and return to breathing.5 This helps us not to get caught up in immediate negative thoughts and, from this calm place, we can then let awareness of our pain in, without judging it. It also helps us to prioritise what needs our attention.6

Breathing meditation also helps your body to relax. This is a useful side effect because stress and tension in the body exacerbate pain, which in turn increases feelings of stress and tension. Becoming relaxed helps to break this cycle.7

The second way is the “body scan”. This involves bringing awareness to each body part individually. Don´t let your brain shy away from confronting painful areas — if you bring your attention to a painful area, you learn that you can actually coexist with it.8 It also helps you to learn more about your pain.9 For example, we might feel like our pain is constant, but if we let ourselves become more aware of it, we might realise there is a lot of time during the day where we have less pain or none at all.10

This method promotes acceptance. Trying to control pain can make us frustrated, because we won´t ever be able to. Acceptance is not about losing hope. It´s about accepting the present moment as it is, with everything it entails, so that we can be more receptive to what might come next. This allows us to be open to more, rather than getting caught up in pain.11

Both of these techniques are forms of meditation, and teach you to experience pain with less distress. Pain experienced in meditation is disconnected from memory, emotion and self-referential thought (thinking about the way this pain impacts me). This makes it less distressing and helps you to change your relationship with your pain.12

At the end of the day, mindfulness is all about making your pain a judgement free zone. It shifts our sense of the situation from something that we have no control over, to an acceptance that, while we may not be able to control the pain itself, we can control how we relate to it.13

Pain doesn´t have to diminish my quality of life!

Finally, when your pain reaches those higher levels, finding something to take your mind off it might actually be a better cause of action. But mindfulness helps us to do this in a calm way. It´s not about running away from the pain in fear. It´s about recognising it, but choosing to do something else.14 Focusing on finding satisfaction in the other aspects of life can result in pain being reduced in importance.15 It teaches us to cope in new ways, and can have really positive effects even when objective measurement of the pain itself doesn´t improve.16

Of course, not being scared of your pain doesn´t mean that you should push yourself too hard, too fast. You should always work with a health professional, such as a physiotherapist, to set safe, realistic goals. Practising mindfulness in the meantime simply helps you to better achieve these goals, and to be more content no matter where you´re at.

1Schütze and Byrne, “Mindfulness and pain.”
2Mindful, “Easing chronic pain with mindfulness.”
3Tartakovsky, “Using mindfulness to approach chronic pain.”
4Tartakovsky, “Using mindfulness to approach chronic pain.”
5Schütze and Byrne, “Mindfulness and pain.”
6Tartakovsky, “Using mindfulness to approach chronic pain.”
7Schütze and Byrne, “Mindfulness and pain.”
8Tartakovsky, “Using mindfulness to approach chronic pain.”
9Schütze and Byrne, “Mindfulness and pain.”
10Tartakovsky, “Using mindfulness to approach chronic pain.”
11Schütze and Byrne, “Mindfulness and pain.”
12Schütze and Byrne, “Mindfulness and pain.”
13Mindful, “Easing chronic pain with mindfulness.”
14Tartakovsky, “Using mindfulness to approach chronic pain.”
15Schütze and Byrne, “Mindfulness and pain.”
16Mindful, “Easing chronic pain with mindfulness.”


Osteoporosis occurs when bones lose minerals, such as calcium, quicker than the body can replace them, resulting in a loss of bone thickness. This causes bones to become brittle, with a higher risk of breaking than normal bones.

Women are at greater risk of osteoporosis due to the rapid decline in oestrogen levels during menopause, which causes bone to lose calcium and other minerals at a much faster rate. From the age of 25 until the time of menopause, bone mass remains relatively stable, but following menopause it declines quickly if there is no intervention.

To limit the development or progression of osteoporosis, strength and balance training is important. Balance training helps change bone mass and limit osteoporosis, while also helping to improve balance and overall function. Balance needs to be practised regularly to maintain improvements and could be as simple as standing on your toes while waiting for the kettle to boil.

Education in risks of falling and awareness of appropriate activities is also essential.

Current research indicates strength or resistance training and/or high impact loading are the most appropriate types of exercises for bone health. As with all exercises, the body adapts, so it is very important to vary, challenge and ensure that exercises are performed correctly. Bone mass accumulates slowly over a long period, so this form of exercise will have an increasing effect over time as well.

Brain Detox- Clear the mind with exercise, meditation, better sleep and diet.

Your habits and lifestyle choices may be to blame for your tiredness, difficulty concentrating, forgetfulness and even your pain. Exercise, balanced diet, sleep and relaxation are essential for our physical and mental well being. It is so easy to not factor these essential elements into our lives as we become busier and lack a healthy work life balance. Technology has made us more connected with the outside world, leaving us less time for the things that our mind and body need to keep us healthy and happy.

Mike Dow in his book The Brain Fog Fix says “people are saying that they don´t function like they used to”. He refers to symptoms of tiredness, difficulty focusing and anxiety as a lifestyle disease. He says that “The brain is the hub of every decision we make. When the brain is not functioning optimally, everything else is affected.”

We should take steps to ensure that our brain is fit as well as our body.

Ways to promote brain fitness:

Mental health and physical health are intertwined. In his book Brain Fog, Dow encourages readers to make a connection between their day to day choices and how they think and feel.

Three habits that are causing your school child's back pain

Mihiri Udabage.    Feb 25 2016 at 11:54 AM


Just two weeks into the new school term and Sarah*, 13, has an appointment with the physiotherapist. Her lower back has been aching on and off for the past couple of weeks and it's not getting better. "It mostly hurts when I'm sitting down," reports Sarah. The Year 8 student can't recall any particular incident when she might have incurred an injury. "It just started to ache and now it feels worse," she tells her physio, Jane Watson.

Watson, a paediatric and spinal physiotherapist, says it's very common for school students to present at her practice complaining of back pain – some of her patients are as young as 10 years old. Peak periods, she says, are during exams, at the end of the school year, and as children return to school.

While Watson sees patients who are typically already experiencing pain, Chetan Khanna, an occupational therapist and workplace ergonomic consultant has clients who are aiming to prevent it. At Ergonomic Solutions Australia he is helping families to establish the correct study set up in the home, so that children are learning good postural habits from a young age.

So what's causing back pain in children and what can parents do to prevent it?

Heavy backpacks

"A lot of students are carrying laptops to and from school and that makes the school bag quite heavy," says Watson. "Also, if the backpack is too heavy and hanging loosely around the shoulders, children tend to lean forward, poke their head forward and round their shoulders. This posture, if adopted too frequently will often lead to neck and upper back pain." And a quick look inside the bag will reveal a myriad of books and other materials that children are lugging every day.

What to do:

For more tips, Queensland Education offers a comprehensive safety fact sheet for heavy school bags.

Poor sitting posture

"Our spine is designed to be upright, in a neutral 'S' position. When children slouch onto desks or sit on their beds to use their digital devices, they are rounding their spine into a 'C' shape which puts stress on bony and soft tissue structures in the back," explains Watson. The feeling of pain that follows is the body's indicator to change positions or reverse the stress on it.

Khanna says the following three ergonomic principles for students seated at desks will help alleviate the majority of ergonomic complaints:

Extended periods in a seated position

"The demands of studying are increasing all the time, especially in years 11 and 12 ... yet we are not designed to sit for as long as we do; our bodies work best when they are moving or standing," says Khanna. Watson has noticed that digital devices often glue children to the one spot for a long time, with their heads down. "Children are spending longer periods sitting in front of their screens because digital devices absorb their attention…at the expense of playing outside and being active."

What to do:

Watson and Khanna agree that poor postural habits from a young age can be a precursor to back pain later in life. But, posture can be re-learnt and new habits put in place. In Sarah's case, sitting in a slouched position on the floor for group activities and maintaining poor posture in a straight backed chair for her 80-minute lessons seems to be the cause of her lower back pain. Using her laptop from her bed instead of at a desk is also contributing to her persistent pain. "There are no other significant symptoms and her back ache is relieved when she stands up and walks around. It's most likely a mechanical problem, which is good news, because we can treat that with some targeted movements," explains Watson. "But nothing beats back care education and prevention."

Watson recommends that parents who are concerned about their child's back pain seek the advice of medical professionals who promote back care education and the prevention of injuries.

Taken from Sydney Morning Herald. Essential Kids insert. 25th February, 2016 http://www.essentialkids.com.au/education/school/primary-school/three-habits-that-are-causing-your-school-childs-backpain-20160221-gmzx8w

Taking a stand on sitting

"Sitting is the new smoking" is a phrase that has taken the internet by storm for some time now. Indeed, most people know that sitting for lengthy periods each day is not ideal - its effect likened to that of smoking in terms of how it can negatively impact our health overtime.

Safe Work Australia (SWA) reminds us that sitting is a sedentary behaviour which slows metabolism and results in the pooling of blood, thereby implicating blood pressure, blood glucose levels and overall cardiovascular health.

While Watson sees patients who are typically already experiencing pain, Chetan Khanna, an occupational therapist and workplace ergonomic consultant has clients who are aiming to prevent it. At Ergonomic Solutions Australia he is helping families to establish the correct study set up in the home, so that children are learning good postural habits from a young age.

Hearing this new health message, some people have begun to avoid sitting entirely. Sales of standing desks have “rocketed” according to Professor Wendy Brown. With some people now standing for the entirety of their 9 to 5 working days, complaints of sore joints and muscles have also begun to skyrocket.

Should we be avoiding sitting entirely?

Brown argues that it is not actually a question of whether standing is better than sitting. Ironically, they are both as detrimental as each other. People have misinterpreted the trending phrase entirely, the message being that we need to break up long periods of static posture no matter what it is. She argues that “the real issue is that we need to move more” and establish a healthy balance between activity and sedentariness in all aspects of our lives.

SWA states that "more than seven hours overall sedentary behaviour per day is likely to be detrimental to health and therefore considered excessive". The importance of regularly taking a break from sitting (or standing statically) is highlighted by the fact that for most office workers, this "excessive" is the norm. Indeed, it is argued that not only is this beneficial for our physical health, but necessary to remain "intellectually healthy" as physical activity "help(s) ideas to flow" (Stern, 2017).

How can we break up the time we spend in the same position?

It is recommended that we take a break from sitting every hour to walk and/or stretch in the opposite direction, such as leaning back a few times in standing. When sitting, it is important to be aware of our posture and to sit in a chair that supports the natural curves of the spine, particularly in the low back. Slouch sitting for long periods is not recommended. Sitting with good posture reduces the amount of stress placed on facet joints and discs in the spine, which can often be a source of pain when the natural curves are reversed over long periods of time.

SWA recommends that as well, regular seated exercises can be performed to promote circulation such as under desk cycling, ankle pumps and shoulder shrugs. They also suggest avoiding unnecessary time spent in sedentary positions where possible such as when travelling to work, walking to the station rather than driving.



knowledge ... self-management ... prevention
Specialising in all suburbs on the North Shore of Sydney Australia, including Wahroonga, Waitara, Turramurra, Pymble, Gordon, Killara, Roseville, Lindfield, Chatswood, Hornsby, Asquith, Normanhurst, Thornleigh, Westleigh, Pennant Hills, Carlingford, Beecroft, Cheltenham, Epping, Eastwood and Denistone.