We’re excited to now stock Tiny Treads at GV Sportscare! Barefoot toddler shoes!




Preparing for pregnancy and childbirth looks different for everyone. We are so lucky to have great access to information in the form of Instagram and podcasts. Deciphering between the information out there obviously becomes the tricky part.
I found the following resources were so helpful for me, I am someone who likes to have a lot of information, listen to different people talk on the same topic, find common themes and then build my own plan.
I learnt a lot as a physio experiencing pregnancy. My pregnancy sickness, that hit early and hard until about 22 weeks, meant I dropped from daily walking and strength work 5 times a week… to a total of 6 walks in the first 16 weeks. I was really stressed about my lack of exercise, but I also believed it was my body telling me to slow down and rest, so I did.
When I got back into short exercise sessions, I could barely do a push up, my core had gotten so weak. I slowly built-up strength again via outside workouts, which were so much better for my nausea, and short stints on the reformer.
However this drop in strength, lots of couch time and my manual job led to pregnancy pelvic girdle pain. I was so disappointed as a physio I had developed this, but you can’t fight hormones and what they will or won’t let you do.
I started seeing the other physios at work and was reminded by our Shepparton women’s health physio Jacinta, that the number one risk factor for pelvic girdle pain in pregnancy, is a standing job. The physios reminded me to wear my pelvic belt (lifesaver) BEFORE my pain started and so many other strategies that my brain had forgot to apply to myself! I was so much better in 3 weeks. Obviously I am still challenged sometimes but my strategies for low back pain and pelvic pain are much better.
Once this was under control I could focus on birth and newborn preparation. They say knowledge is power and who knows which way my birth will go, but the following resources I found so helpful in my preparation and from here.. whatever happens, happens!
Podcast Pregnancy with Physio Laura, 🍎 Pregnancy Nutrition Series with Larissa Telfer:
Nutrition through the trimesters
Podcast: Growing Beth Ryan
EP01: What happens after a positive pregnancy test?
EP02: Early pregnancy ultrasound: The who, the what, the why
EP03: Your incredible body during the first trimester
EP04: Help! I feel soooo sick!!
EP05: Story time! My first trimester
EP06: What if I miscarry? I’m so nervous all the time
EP07: Your first appointment with a midwife or OB
Listed under websites, books, Instagram’s or podcast shows, not in order or relevance 😊
Of course none of this should replace individual advice you get from your care provider!
Amazing content, I specifically liked the episodes with:
Dietician Larissa Telfer; Nutrition through the trimesters: https://podcasts.apple.com/au/podcast/24-nutrition-through-the-trimesters-pregnancy/id1543672102?i=1000511029445
Midwife Beth Ryan;
Creating a beautiful hospital birth environment 🙋🏻♀️ Ask the Midwife Series Ep 2 w/ Beth Ryan:
Asking questions & managing interventions in birth 🙋🏻♀️ Ask the Midwife Series Ep 3 w/ Beth Ryan
Midwide Lauretta, Empowered Birth Series
Birth plans and preferences 🧡 Empowered Birth Series Ep 2 w/ Midwife Lauretta:
Perineal preparation and tearing 🧡 Ep 3 w/ Midwife Lauretta
Optimal maternal and baby positioning 🧡 Ep 4 w/ Midwife Lauretta:
Doula and Physio Elanor Lambert, own your birth series:
How to transfer to hospital well 👑 Own Your Birth Series Ep 1 w/ Eleanor Lambert
Birthing positions 👑 Own Your Birth Series Ep 2 w/ Eleanor Lambert
Empowered induction and C-section births 👑 Own Your Birth Series Ep 3 w/ Eleanor Lambert:
Beth the midwife, short and sweet snippets of info on certain topics.
New born must haves and ‘don’t needs’
10 TIPS: Surviving Week One With A Newborn (Midwife Tells All!)
Podcaster Sophie interviews women about their birth stories in a calm and non judgemental fashion. Gives you some insight into how birth can be so different.
For example: Beth Ryan, Vaginal Physiological Birth, Midwife, Birth Educator, MGP
S1, Ep4 – Rhea Dempsey says “Labour pain has a purpose. Trust it”
S1, Ep3 – Dr Howard Chilton on Evidenced Based Natural Parenting
What To Expect In Your First 6 Weeks Postpartum With Midwife Beth From Birth With Beth
Establishing Breastfeeding with IBCLC Susie Prout
The most common milk supply myths busted, with your host Susie Prout
Sleep and reflux myth busting with Dr Howard Chilton
My favourtie account, if you don’t want to be overwhelmed she would be my one reocmmendation to follow. An amazing midwife, non judgemental posts with cool graphics. She also has both an online birth preparation course and a face to face course which Tom and I attended and LOVED. She has another online course called positive induction and plenty of resources.
physioforwomen_ Go across to reels for free workouts
Susie Prout Lactation consultant
-Sophie Woodhouse
Physiotherapist Shepparton
GV Sportscare
Recently, Physio Emily was invited onto OneFM’s weekday radio with Steve Little to chat about staying fit, active and mobile once hitting the 50’s and 60’s – and that it is never too late to get started!
Here’s the link to the podcast to listen to: https://soundcloud.com/user-570295409/steve-interviews-emily?in=user-570295409/sets/one-fm-interviews-2025
Some key points from the discussion ~
Emily’s top three tips for anyone who wants to stay strong, flexible and pain-free over 50?
One myth about ageing and fitness that you’d love to banish forever?
“No pain no gain!” Exercise shouldn’t cause you so much pain that it stops you from doing exercise again, or stops you from moving well, or stops you from doing your day to day activities. A little bit of muscle soreness during exercise okay and sometimes a bit of joint pain is acceptable, but significant pain does not need to be pushed through (see a physio for guidance!)
– Emily Wiedemann
Physiotherapist
GV Sportscare Shepparton
By Ryan Davey, Podiatrist, Shepparton
Running is one of the most accessible forms of exercise. But behind every stride lies a complex interaction of movement, muscle control, and force absorption that, if not optimised, can lead to performance plateaus or injury.
Whether you’re a weekend jogger, competitive athlete, or someone looking to return from injury, a Running Assessment offers powerful insights to keep you running stronger, safer, and smarter.
At GV Sportscare Shepparton, we’re proud to offer comprehensive running assessments that go beyond just watching you run. Here’s what it’s all about and why it’s worth considering, no matter where you are in your running journey.

Running is incredibly healthy, but it’s also a common source of musculoskeletal injuries. In fact, injury prevalence in runners ranges from 18–92% depending on the population and context. Most injuries stem not from the act of running itself, but from how your body handles the repetitive loads placed on joints, tendons, and muscles (Barton et al., 2016).
Research led by Prof. Christian Barton At Latrobe University suggests that injury is rarely the result of one factor. Rather, it’s the outcome of a mix of load-related, biomechanical, and sometimes psychological contributors (Barton, 2017).
“Running gait” refers to the sequence of movements your body makes when you run, specifically the cycle of your legs during each stride you take while you run.
We don’t assess your running just for the sake of it – we assess to better target our interventions so that we can be confident that they add real value to your training or rehab.

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Depending on the runner and their goals, we may assess:
This means some runners may be assessed at a comfortable jog, while others may run at race pace, uphill, or with a particular shoe or orthotic – whatever best recreates your natural movement and symptoms.

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A subtle change in technique can have a big impact. Research suggests gait retraining should follow motor learning principles, including faded verbal feedback, mirrors or video, and continued progression in practice.
If biomechanical faults are identified, we often prescribe targeted strength and conditioning. These are not generic gym routines – they’re tailored to your specific needs, and might include:
Strength training alone has been shown to improve:
We follow a process supported by strong evidence and led by expert clinical reasoning.

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Running technique is important, but understanding your current training load and how it interacts with your body’s capacity is the cornerstone of injury prevention and rehab.
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Shoe choice can influence mechanics, but it’s rarely the sole factor (pun intended!).
We consider:
Sometimes changing shoes can offload sensitive tissues, but more often, footwear is one piece of a broader plan. Orthotic therapy may be used in cases where there are chronic injuries or other complex issues.

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Everyone.
That’s not a cliché – it’s supported by the literature:
Many runners think gait analysis is only for when you’re injured. That’s simply not true. In fact, many performance gains come from improving neuromuscular control, movement economy, and mechanical efficiency – all of which can be assessed and addressed in a gait assessment session.
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A gait assessment is not about fixing every flaw. It’s about finding meaningful, individualised ways to help you run more efficiently, stay injury-free, or finally break through a plateau.
At GV Sportscare Shepparton, we take a personalised, evidence-informed approach—bridging biomechanics, clinical reasoning, and practical strategies to support every runner’s journey.
📞 Book your assessment today and take the next step in your running performance. Book online or call 03 58977044 to book a Running Analysis.
– Ryan Davey, Podiatrist, Shepparton
BIBLIOGRAPHY
Beattie, K., Kenny, I. C., Lyons, M., & Carson, B. P. (2014). The effect of strength training on performance in endurance athletes. Sports Medicine, 44(6), 845–865.
Nunes, G. S., Barton, C. J., & Serrão, F. V. (2018). Hip rate of force development and strength are impaired in females with patellofemoral pain without signs of altered gluteus medius and maximus morphology. Journal of Science and Medicine in Sport, 21(2), 123–128.
Barton, C. J., Bonanno, D. R., Carr, J., Neal, B. S., Malliaras, P., Franklyn-Miller, A., & Menz, H. B. (2016). Running retraining to treat lower limb injuries: A mixed-methods study of current evidence synthesised with expert opinion. British Journal of Sports Medicine, 50(9), 513–524.
Seitz, L. B., Reyes, A., Tran, T. T., Saez de Villarreal, E., & Haff, G. G. (2014). Increases in lower-body strength transfer positively to sprint performance: A systematic review with meta-analysis. Sports Medicine, 44(12), 1693–1702.
Barton, C. J. (2017). Managing RISK when treating the injured runner with running retraining, load management and exercise therapy. Physical Therapy in Sport, 24, 1–5.
Rendos, N. K., Harrison, B. C., Dicharry, J. M., Sauer, L. D., & Hart, J. M. (2013). Sagittal plane kinematics during the transition run in triathletes. Journal of Science and Medicine in Sport, 16(3), 259–265.
Congrats! You’ve had a baby and want to get your body moving again. Here are some of the things you need to know before getting back into running, sport or high-intensity exercise after pregnancy.
The demands of pregnancy, birth and the postpartum period involves big changes to the musculoskeletal system. The body needs time to recover and this will impact readiness to return to high-intensity or high-impact activity safely. This would be no different for a runner sustaining a non-pregnancy related injury – our advice would be to commence running again only after appropriate progression through rehab and ticking off key strength and loading criteria!

Current guidelines recommend waiting at least 12-16 weeks before returning to running or high-impact exercise. This is to prevent injury to the pelvic floor, abdominal muscles and other joints and muscles.
But this doesn’t mean you can’t be exercising earlier! Low impact or low intensity exercise is safe in the postpartum period from as early as 3 weeks postpartum when directed by a health professional such as a physiotherapist.
Our Shepparton physiotherapists can assess you in the postpartum period, and get you started with your return to exercise at home or the gym, a walking program, or discuss with you our Mums & Bubs Clinical Exercise classes. We recommend a postnatal assessment at the 3-4 week mark to make an individualised plan for returning to exercise.
The pelvic floor undergoes many changes during pregnancy, childbirth and postnatally. Read our blog to learn more about the pelvic floor. The pelvic floor can become weak, which means that it doesn’t function as well as it should – this can lead to pelvic floor symptoms like bladder or bowel leakage, urgency or prolapse.
Running, sport and/or high-intensity exercise are high impact activities that increase pressure in the abdomen, which in turn places more pressure and demand on the pelvic floor.
Symptoms to look out for that may indicate your pelvic floor or core isn’t coping with exercise:

Image source: https://www.continence.org.au/about-continence/continence-health/pelvic-floor
✓ Have already completed at least 6 weeks of low impact cardio exercise, such as walking or swimming
✓ You will have done at least 6 weeks of strength and conditioning in the postpartum period prior to running, to get your muscles strong enough for running/sport/HIIT
✓ Timeline wise, at least 12 weeks postpartum (and even up to 6 months), to allow your body time to heal, improve your strength and prevent pelvic floor dysfunction
✓ A pelvic floor assessment and run/sport/HIIT clearance from a pelvic floor physio
✓ Able to pass a series of pelvic floor loading tests without pelvic floor symptoms above
✓ Able to pass general lower body strength tests – this is the benchmark for all runners/athletes to prevent other non-pregnancy related joint/soft tissue injuries!
How can our Shepparton based Physiotherapists help with your postnatal return to running?
– Complete a post-natal musculoskeletal assessment and pelvic floor screening (as early as 3-4 weeks postpartum), and refer you onto a local pelvic floor physio if indicated
– Develop an individualised exercise program including general strength, mobility, pelvic floor and core exercises
– Facilitate safe return to running, HIIT or your chosen sport by testing you against the criteria above to ensure you are ready to return to this level of exercise
– Work with you to set some short and long term goals!
– Emily Wiedemann
Physiotherapist Shepparton
Osteoporosis is a condition that affects your bone health, causing them to become weak and brittle. This leads to a higher risk of fractures (or breaks) than in normal bone.
Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone density.
Osteoporosis is more common in older females due to reduced estrogen levels after menopause. Estrogen is a hormone that helps to regulate the menstrual cycle, but has an important role in preventing bone loss and keeping bones strong. When estrogen levels drop during menopause, bones break down faster than they can rebuild (this is a normal process, but bone rebuilding matches breakdown rates in healthy bones!).
Osteopaenia is a less severe form of osteoporosis, where the bone density is lower than normal.

Exercise plays an important role in maintaining bone health throughout life. A combination of weightbearing, resistance and balance exercises are recommended for bone health.
Weightbearing and resistance exercises improve bone density by applying controlled stress to the bones, triggering the body’s natural bone-building process. These exercises encourage the bones to become stronger and denser, which is crucial for people with osteoporosis.


Research has demonstrated that when it comes to our bone health, not all exercise is equal.
Bones benefit when a certain amount of impact or strain is placed on them – which cannot be achieved by walking alone.
Walking is a great form of exercise for overall health; however, it primarily provides cardiovascular benefits rather than directly improving bone strength. Weightbearing and resistance training is the most effective way to maintain and improve bone density in individuals with osteoporosis.
Starting new exercise can be daunting, especially if you are concerned about injuring yourself. It is recommended to consult a physiotherapist for guidance on the best type of exercise for you.
Physiotherapists are trained healthcare professionals who specialise in diagnosing and treating musculoskeletal disorders, improving physical function and promoting health through exercise.
Physiotherapists have expertise in prescribing tailored exercise for people with osteoporosis and can accommodate for other medical or physical limitations. This includes considering pre-existing injuries, fitness levels and past exercise experience.
The good news is it’s never too late to start exercising!
Strength exercise provides several other benefits including:
References
Healthy Bones Australia. (2025). About osteoporosis. https://healthybonesaustralia.org.au/your-bone-health/about-osteoporosis/
Healthy Bones Australia. (2024). Exercise and bone health. https://healthybonesaustralia.org.au/wp-content/uploads/2024/11/hba-fact-sheet-exercise-v2-11-24-digital.pdf
Image sources:
https://msfocus.org/Magazine/Magazine-Items/Posted/Prevent-Osteoporosis-with-6-Bone-Health-Boosters
– Zoe Boldiston
Physiotherapist Shepparton
Our ancestors lived in tune with the natural light-dark cycle, and our bodies remain attuned to those rhythms. By understanding how light interacts with biology, we can make informed decisions about sun exposure, protection, and mitigating artificial light’s harmful effects.
Sunlight, which is part of the electromagnetic spectrum shown in Figure 1, is vital for regulating biological rhythms and supporting various bodily functions.
The sun’s light spans a broad spectrum, including ultraviolet (UV) radiation, visible light, and infrared radiation, each influencing the body in unique ways.
Despite the evolutionary significance of sunlight, modern human behaviors — such as the widespread use of sunscreen and sunglasses — have led to an unintended disruption of this natural process, with potential negative consequences for our health.
Figure 1.
This blog by Shepparton Podiatrist, Ryan Davey, delves into the fundamental role of native light frequencies from the sun; specifically UVB light and how it is utilised for the creation of vitamin D in the body.
This blog will explain the various functions of vitamin D, specifically examining its role in the:
It also explores why blocking sunlight, through the use of sunscreen or even indoor living, might be detrimental to health, and how these practices may hinder the body’s ability to produce the necessary quantities of vitamin D.
Then it offers practical recommendations for balanced sun exposure and mitigation of potentially harmful frequencies from indoor living and screen time.
The circadian rhythm is your body’s natural 24-hour internal clock, influenced by light and dark cycles in the environment. This rhythm regulates essential biological processes such as sleep, hormone production, and metabolism, aligning them with the day-night cycle.
Sunlight plays a crucial role in resetting and maintaining this rhythm by signaling the brain to suppress melatonin (the sleep hormone) during the day and increase its release as night approaches.
In the modern world, many start their day by checking a phone or switching on the lights, followed by a commute to indoor, screen-based work under more artificial lighting. After work, we return home, cook and eat dinner under bright lights, and then often unwind in front of the television. This scenario does not allow for an accurate circadian rhythm to be maintained. This may be important for optimal health in ways we are only beginning to understand.
Figure 2.
Vitamin D plays a crucial role in keeping bones strong and healthy. It helps the body absorb calcium, which is essential for building and maintaining bone density. This prevents bone-related conditions like osteoporosis which can weaken bones, especially in older populations. By improving calcium absorption and supporting the natural process of bone repair, vitamin D helps lower the risk of fractures, thus improving falls outcomes which has been shown to be the largest contributor to hospitalisations among the elderly. A large scale research analysis revealed 35% of total hospitalisations of people 60 and over are due to falls. Some research papers report the rates could be as high as 60% in some populations.
Vitamin D also plays a critical role in the immune system by regulating inflammation and enhancing immune cell responses. It helps balance inflammatory processes, which is essential for preventing autoimmune diseases. Low vitamin D levels are linked to higher risks of infections and chronic inflammatory conditions like rheumatoid arthritis.
A study published in early 2022 displayed some striking results regarding vitamin D and severity of Covid19 infections. It was found that people who had above 20 ng/ml vitamin D had 14 times better outcomes in regard to severity and duration of illness. Vitamin D also had a significant impact on reported mortality rates across all demographics of people infected with COVID19.
In the brain, vitamin D receptors are present in regions governing mood, learning, and memory. Deficiencies have been linked to depression and neurodegenerative diseases. While supplementation can help, obtaining vitamin D naturally through sunlight is preferable. See figure 3 for reference on the major differences between the form derived from sunlight vs consumed through the digestive system.
Figure 3: Sunlight vitamin D vs Dietary vitamin D

If you have had general blood work done recently, or intend to have testing done, the normal range for vitamin D are:
The use of sunscreen and sunglasses, though well-intentioned, inadvertently reduces vitamin D synthesis. Sunscreens contain active ingredients like avobenzone, oxybenzone, and octinoxate that block UVB rays. While sunscreen lowers the risk of US skin damage, excessive use—especially combined with limited natural sun exposure—can lead to vitamin D deficiency. Striking a balance between sun protection and vitamin D production is essential.
Furthermore, sunglasses block UV and blue light, altering the sunlight that reaches the retina. This means that although sunglasses are seen as eye protection, they can have a significant negative effect on the body’s circadian rhythm.
One proven function of the retina is regulation of the sleep-wake cycle. Blocking light during the day disrupts this balance, causing sleep disturbances and hormonal imbalances. This means that overusing sunglasses outdoors can have extensive unintended consequences.
See figure 4:

In contrast to sunlight, artificial blue light from LEDs, laptops, and smartphones disrupts circadian rhythms and melatonin production. Blue light overexposure, especially at night, suppresses melatonin (our sleep hormone), leading to insomnia, daytime fatigue, and increased risks of chronic diseases like obesity, type 2 diabetes, and cardiovascular issues.
Disrupted circadian rhythms impact metabolism and hormone levels, throwing off essential processes and contributing to chronic health problems. While sunlight supports our biology, the prevalence of artificial light at inappropriate times poses serious risks to health and longevity.
While sunlight is fundamental to human biology, artificial light—particularly blue light—presents significant challenges. Not all light is created equal. Sunlight provides essential light frequencies for vitamin D production, circadian rhythm regulation, and other physiological processes.
Balancing your sun exposure and mitigating exposure to artificial light is undeniably important. This practice can also amplify other health practices in your current routine.
Balancing sun exposure while protecting against harm can optimize vitamin D levels and overall health. Here are practical strategies:
Sunlight is the primary source of vitamin D, responsible for 80-90% of production, while food provides only 10-20%.
Sunlight and vitamin D play an integral role in health and wellbeing, interacting with almost all bodily systems.
Excessive sunscreen use can hinder vitamin D synthesis, so strategic application is essential to balance protection with the proven health benefits of sun exposure.
Sunglasses block essential light frequencies that regulate circadian rhythms, potentially impacting sleep and hormonal balance.
Striking a balance between sun protection and exposure is crucial for optimizing vitamin D levels, sleep quality, and overall well-being.
By embracing the power of sunlight, you can unlock a vast array of health benefits and support your overall well-being. I’ve seen first hand, the profound impact this essential nutrient can have on all aspects of health. So, step outside, soak up some sun, and let your body reap the rewards of this natural, free source of energy and vitality. Your health will thank you.
References:
Dror, A. A., Morozov, N., Daoud, A., Namir, Y., Yakir, O., Shachar, Y., … & Sela, E. (2022). Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness. PLoS One, 17(2), e0263069.
Karlsson, M. K., Magnusson, H., von Schewelov, T. P., & Rosengren, B. E. (2013). Prevention of falls in the elderly—A review. Osteoporosis International, 24(3), 747–762. https://doi.org/10.1007/s00198-012-2256-7)
Images sourced from:
https://www.hukseflux.com/library/measuring-sunlight-what-instrument-to-use
https://astonrx.com/blogs/read/managing-your-circadian-rhythm

Ryan Davey
Podiatrist, Shepparton, GV Sportscare
We are excited to introduce the Acute Sports Injury Clinic, focusing on weekend ankle injuries in Shepparton.
As physiotherapists and podiatrists, we often see ankle injuries further down the line (instead of straight away!) which we know slows down your recovery and delays your return to sport. For example, you might be on crutches for too long or not started rehab soon enough.
The Acute Sports Injury Clinic will run on Mondays, designed to see you in the 1-2 days following your ankle injury. This means that you can get high quality and timely management of your ankle injury, including the correct scans and referrals as needed – keeping you out of the emergency department!
What we can do in the Acute Sports Injury Clinic:
For more information on how to book an appointment: click here!

Ankle sprains are one of the most common injuries to occur. Women are at greater risk, as are children and adolescents and those that play indoor or court sports such as basketball or netball. This probably comes as no surprise, what may surprise you is how the management of these injuries has progressed away from the old ‘ice and rest’. At GV Sportscare our Shepparton Podiatrist and Physiotherapists are experts in ankle sprains, having worked on football teams, netball teams and closely with foot and ankle surgeons. Read on to learn about some of the myths behind ankle sprains!
Most people are surprised to find that their physio or podiatrist is very keen to get them off crutches ASAP. In severe ankle sprains or suspected fractures, crutches are required, however in the mild to moderate ankle sprain crutches will actually slow down your recovery. Crutches reduce the weightbearing through the joint (which is a good thing if there is too much pain and damage). However in a mild to moderate injury it is unnecessary and will cause you to lose movement and strength, which you will need to work harder to regain as part of your rehab. Your Shepparton Physio or Podiatrist are able to assess your injury and guide you as to whether or not crutches are required and work with you to wean you off them!
Podiatrists and Physios are well trained in assessing and treating ankle sprains and can refer you for any relevant scans such as x-ray and MRI, if required. We have specialist tests we can perform and provide you with taping or ankle supports on the spot, should you need them. We can also begin your rehab process of exercises from your very first session. This is very important as early movement and strength work can fasten your recovery or return to sport. So in summary within one physio or podiatry session we can diagnose or send for scans, tape or fit a brace or crutches (if necessary) and start you on exercises, all with the goal of return to activity or sport ASAP!
X-ray is used to clear fractures. Some fractures are too small to be picked up on x-ray and require a CT or MRI. This can include what we call an OCD (osteochondral defect), where a small piece of bone/cartilage has chipped off and can be sitting somewhere it shouldn’t. These often need to be removed as they can push and wear away on the cartilage where they shouldn’t.
X-ray is always used when the person is unable to weightbear as a precaution to check for fracture (we are actually required to x-ray if you cannot weightbear). This is even more important in the child or adolescent as they are more likely to fracture. This is because in children the bones aren’t fully fused as in adult bones and therefore the bones are more susceptible to fracture.

X-ray also can’t tell you how severe your ligamentous injury is. Sometimes you can see a syndesmosis injury (when the tibia and fibula have separated due to damage to the ligaments between them) on x-ray. However ligamentous injuries can often take much longer to recover from and have long lasting effects on your ankle stability.
The sooner you can be seen by your Podiatrist or Physio the better. When we waste a few days with the wrong management you are slowing down your recovery. Most people think injuries are a time based recovery, ie I have sustained a grade one ankle sprain therefore I will be back to sport in 2 weeks. This is partly true, injuries require healing and that takes time. However from our point of view your return to sport or activity is mostly based on ticking off certain criteria. For example can you raise onto your toes, can you stand on one leg, can you hop, can you run, etc. If you can’t do these things it doesn’t matter if your two weeks has passed, you are still not ready to return to activity. We then base our rehab on what you can and can’t do and aim to progress you on as quickly as possible.
Icing is great to help numb the area and therefore relieve pain. However compression and elevation are far more important to help decrease your inflammation. Swelling in the ankle is particularly hard to get rid of due to gravity, as the fluid has no chance to escape the area. Compression helps to increase the pressure and essentially push the fluid out and elevation allows gravity to assist the swelling to move out of the area. There is actually very limited scientific research to prove that icing has much effect on swelling!

Swelling management: you can see the effects of a compression bandage and elevation on the swelling of this ankle.
In the first 48-72 hours of your injury it is recommended to avoid anti inflammatories such as ibuprofen (Nurofen) and Voltaren. This is because the inflammation that occurs is your body’s response to injury and it actually brings special healing cells to the area that are beneficial for your recovery. This includes cells that remove debris and other cells that repair tissue. Therefore this early inflammation is actually a GOOD thing and taking anti inflammatories will be detrimental to this process (FYI this is true of any injury, not just ankle sprains).
The issue is when inflammation persists and essentially the fluid takes up room within your ankle joints and this can cause pressure and therefore additional pain. This is where the above advice for compression and elevation is key and at some stage after the first few days you may need to begin anti inflammatories. This should always be guided by a health care professional as anti inflammatories can commonly cause stomach lining irritation, which is not something to ignore!
If you need help with pain relief it is recommended to speak with your pharmacist or local Shepparton GP, however most people tolerate paracetamol (Panadol) and this has no known negative effect on your healing.
You may have noticed that everyone bruises to a different degree. For example some people just have to scratch their leg firmly and will bruise while others need a decent hit to bruise. This is related to each person’s clotting and other genetic factors. It can also be related to certain medication for example blood thinners and anti inflammatories can increase the amount of bleeding around an area and therefore the amount fo bruising that comes out. Therefore the amount of bruising that is evident in some ankle sprains doesn’t necessarily mean it is more severe than other injuries where there is minimal bruising. We take into account many factors when diagnosing the severity of the injury, bruising is taken into consideration but there is no hard and fast rule here.

A severe ankle sprain: minimal dark bruising, mostly yellow.

Although when in pain this is what we feel like doing, there is good evidence that early movement will help you to return to normal quicker. When you have sustained a severe injury or you have a lot of swelling you will require periods where you need to elevate your ankle. However if you are able to walk and weightbear this will be helpful. This is where it is important to visit your local Shepparton podiatrist or physiotherapist so we can help you determine what level of rest is required!
One of the biggest risk factors for future ankle sprain is previous ankle sprain. While those with mild ankle sprains will likely manage to get back to sport, the issue we commonly see is that the injury has caused a loss of range of motion, strength, balance or coordination on that side. Therefore you can understand how even though you have returned to sport that these deficiencies can result in subsequent ankle sprains and more time away from the sport that you love! With simple assessment and exercises we can get you on track to work on these deficiencies and therefore reduce your risk of future ankle injury!
Both ankle bracing and taping are thought to be just as effective in preventing ankle sprains and are highly recommended for those who have had an ankle injury and are playing sports such as netball, football, basketball, soccer etc. While some are resistant to taping or bracing, when comparing this to lengthy periods out of action should another ankle sprain occur, we know what we would chose!
The advantages to ankle braces is that you aren’t reliant on the person taping your ankle to tape it correctly or risk of tape cuts or allergic responses to tape (which is more common than you think). If you are paying for your own tape, bracing is also a more economical option as once you have bought 4-5 rolls of tape you have paid for your ankle brace. However football and soccer boots are too narrow for ankle braces so taping is often the only option in these sports. If you wear ankle braces and you are buying new shoes we highly recommend taking your ankle braces with you as you often need 0.5-1 size larger to allow for the ankle brace. We would also advise checking with your Physio or Podiatrist before purchasing an ankle brace as many braces don’t have the metal ‘stays’ built in on the sides and this a crucial component of an ankle brace that will actually prevent injury.
As a netball or footballer you may be one of those people where ~2 sprains/season is a given and you are well versed in your management. We do recommend these are still assessed for a number of reasons:
-recurrent sprains can result in chronic ankle instability, at some stage ankle reconstruction may need to be considered so that you don’t cause irreversible cartilage damage which can lead to osteoarthritis in later life. As we have worked closely with foot and ankle orthopaedic surgeons we can help you decipher when it is time to consider a surgical opinion
-some ankle sprains can result in a ‘high ankle sprain’ which is an injury to the syndesmosis, the joint between to the tibia and fibula. This is a much more serious injury and requires a different management to the average ankle sprain. It can often require surgery to prevent serious ankle instability. Our Shepparton physio and podiatrist can easily screen for this injury with clinical tests
-refer to myth #8, we are experts in finding your deficiencies post injury and providing you with a rehab plan to address this to reduce your risk of re-injury.

Distal syndesmosis joint = location of high ankle sprain.
Sophie Woodhouse
Physiotherapist Shepparton, GV Sportscare
Tom Davey
Podiatrist Shepparton, GV Sportscare

Image references:
X-ray: https://www.imageinterpretation.co.uk/ankle.php
Calf raise: https://www.popsugar.com.au/fitness/Ankle-Exercises-Do-Avoid-Sprains-Injuries-31086537?utm_medium=redirect&utm_campaign=US:AU&utm_source=www.google.com
Syndesmosis: https://www.academyofclinicalmassage.com/syndesmosis-sprains/
Ankle brace: https://www.djoglobal.com/products/donjoy/donjoy-stabilizing-pro-ankle-brace
Ankle sprain prevention: https://www.facebook.com/watch/?v=948001962331923
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