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Headaches? How Do The Physio Group Clinic’s Treat Headaches

chronic headaches, sports injury, physiotherapy


At The Physio Group Clinic we are seeing an increased number of clients suffering from chronic headaches.

There are many different types of headache such as : tension, migraine, cluster, vascular and hormone induced; these will be managed from a medical perspective.

Within our scope of practice it is the CERVICOGENIC headache that we can assess and treat effectively.

A cervicogenic headache is one that starts in the neck and refers up to the head. The upper neck contains joints, muscles, ligaments and nerves which if irritated can cause the headache.

The cause varies from poor posture to repetitive activities such as lifting and carrying. Significant use of phones, laptops and computers in poor positions also increases the load on your upper neck. Whiplash injuries are also common aggravating factors.

A true cervicogenic headache will always originate from the neck either during or after an activity And presents as a dull ache which spreads up the back of the head towards the temple, usually affecting one side rather than both.

headachesOn our physical examination we expect to find:

– reduction of normal cervical movement

– tenderness and or headache referral on pressing the upper neck joints

– muscular trigger points around the upper neck which refer to the head

– poor posture often with a rounded back and a poking chin.


Once  we at The Physio Group Clinic feel the headache is of cervical origin our treatment consists of:

-soft tissue massage to release the muscles

-joint mobilisation or manipulation to improve joint mobility

-postural and mobility exercises

-advice on computer set up etc


-postural taping if needed


A course of treatment yields high success rates for the true CERVICOGENIC headache so feel free to enquire whether Physiotherapy at The Physio Group Clinic can help you!!



sports injury, physiotherapy

Welsh rugby captain Sam Warburton faces a race against time to recover from injury to face Ireland in the Six Nations on Saturday.

In a bid to speed up the healing process he has been on an intensive ice machine to get rid of inflammation. This new High Tech bit of kit ” The Game Ready”  has also been endorsed by Rory McIlroy.


But what is the difference  between this and a bag of frozen peas from your freezer?

And what ultimately are we trying to achieve?


What these athletes are following is the PRICE regime for an acute injury:

Protection – Aim to prevent further injury e.g. using crutches

Rest – Allow healing by preventing further aggravating activities

Ice – Reduces pain, swelling and inflammation

Compression – A pressure strap such as tubi-grip to limit the swelling

Elevation – By raising the injured area above the level of the heart excessive swelling can allow swelling to drain away.


When we look at the outcome of an injury  we need inflammation to occur to facilitate the body healing itself, it is the excessive inflammation which as therapists we aim to minimise as this ultimately slows the recovery process.

This has led to an extensive array of treatment options using ice/cryo therapy all claiming to speed up the reduction of swelling and ultimately the recovery of injury.

So what are the options available????

Hyperbarbic Gaseous Cryotherapy

This technique consists in applying for a short time on the skin up to the painful area, carbon dioxide at −78 °C with a pressure of 50 bars and a frequency of 400 Hz. Sessions can be repeated at will. Unlike ice packs, the usage of carbon dioxide does not produce pain. Even if not as dangerous as liquid nitrogen used in cryosurgery, the low temperature could cause burns.

The Ice Bath

The theory behind ice baths is related the fact that intense exercise actually causes microtrauma, or tiny tears in muscle fibers. This muscle damage not only stimulates muscle cell activity and helps repair the damage and strengthen the muscles ( muscle hypertrophy ), but it is also linked with delayed onset muscle pain and soreness (DOMS) , which occurs between 24 and 72 hours after exercise.

The ice bath is thought to:

  • Constrict blood vessels and flush waste products, like lactic acid, out of the affected tissues
  • Decrease metabolic activity and slow down physiological processes
  • Reduce swelling and tissue breakdown

Then, with rewarming, the increased blood flow speeds circulation, and in turn, improves the healing process. Although there is no current protocol regarding the ideal time and temperature for cold immersion routines, most athletes or trainers who use them recommend a water temperature between 12 to 15 degrees Celsius and immersion times of 5 to 10 and sometimes up to 20 minutes.

The Game Ready

As modelled by Rory McIlroy below the Game Ready System continuously circulates cold water from the control unit’s ice reservoir, via a connector hose, through an inner chamber of the anatomical wrap  (this chamber is located closest to the body) before returning to the ice reservoir.

As a complete loop, the cold water is refreshed through the ice before returning through the anatomical wrap, thus delivering continuous cold therapy to the body part, allowing heat to be removed from the treatment site.

Simultaneously, the control unit pumps air into the separate, outer chamber of the anatomical wrap, intermittently inflating and deflating according to the pressure setting that is selected.

The compression not only assists in preventing/ limiting swelling, but also conforms the Anatomical Wrap to the contours of the body.  This increases the surface contact and aids the delivery of the circumferential cold therapy.

rory game ready

The Ice Pack 

Ice packs can be made from ice cubes in a plastic bag or wet tea towel. A packet of frozen peas may also be used as they mould nicely and can go in and out of the freezer. Purpose-made cold packs can also be bought which are reusable.  They can be applied for 15-20minutes and repeated every 2 hours. However care should be taken to protect the skin to prevent an ice burn.


Within our clinic we see trends towards a new type of ice therapy on a regular basis, with half a football team heading to cold baths in County Meath, or to an ice chamber in Portadown. Ultimately if the time spent travelling to these places was spent focusing on the PRICE regime with rest and ice packing maintained religiously, the same outcome would be achieved almost all of the time. So hold onto those peas for a little longer !!




Pilates is an exercise based therapy which is designed to strengthen, elongate and restore the body’s muscular Skelton system into balance.

The origins of pilates stem from early part of 1900 from its inventor ‘Joseph Pilates’ who as a child had been very frail but developed a technique of physical fitness using experiences from classical Roman to body building to martial arts.

He developed his own approach to exercise and body conditioning which gained popularity as athletes found it the best way to recover from injuries and prevent recurrence.

Over the years it has been developed and from the 1970’s on has become increasingly popular with the public.


It is a gentle, non-aerobic exercise method designed to strengthen weak muscles, lengthen tight muscles and improve general posture. The aim is for a properly balanced body which results in improved joint mobility, firm musculature and a good natural posture. It is a very specific form of exercise which is safe and controlled as well as low impact and works on the principle of ‘gain with no pain’.


Anyone can benefit from Pilates as it is a very gentle form of exercise. Traditionally the classes tend to be female dominated and there is still a tendency for Pilates to be avoided by men, however top premiership footballer Steven Gerrard is joining the growing list of sportsmen who are extending their career through incorporating it into their regime  so we encourage everyone to the class.


Although if attending for a specific ailment or injury it is best to inform the teacher prior to starting the class to ensure they can tailor certain exercises to specific needs.


Pilates is a complete exercise method developed by its founder Joseph Pilates over the course of a lifetime dedicated to improving physical and mental health. Pilates focuses on building your body’s core strength and improving your posture through a series of low repetition low impact stretching and conditioning exercises.

By core strength, we are talking about your back, abdominal and pelvic muscles. Through pilates, you will be able to develop these muscles without adding bulk, increasing your flexibility and agility and at the same time toning your stomach and thigh muscles.

Pilates goes far beyond your core muscles however and not only provides a complete body workout (you will be working muscles you didn’t even know you had!), but also helps you develop an awareness of how your body works, helping your mind and body to work in harmony.


Pilates is based on eight principles:

  1. Relaxation
  2. Alignment
  3. Control
  4. Precision
  5. Routine
  6. Breathing
  7. Centring
  8. Flowing movement

Should you wish to find out anymore about the benefits of pilates do not hesitate to contact our main office on 02830269733

Getting off Crutches after Surgery or Injury

When should you get off your crutches after surgery or serious lower limb injury?

Over the years clients have had different reasons for “getting rid” of their crutches. These include ” I thought I didn’t need them, my surgeon told me to cast them aside, their slowing me down and sure I’m back driving again”.

There is only ONE right answer! And that is when you can walk with a NORMAL gait. This is NOT debatable or negotiable as long as you had a normal gait prior to the surgery or injury.

In order to speed up healing and recovery, normal movement is essential. If you are limping in any form this is detrimental and you run the risk of overloading the injured area and increasing the inflammatory response instead of decreasing it, as well as possibly causing injury or dysfunction in other parts of the body due to compensation occurring.

This is especially important after surgery of Hip, Knee or Ankle due to the trauma of the actual surgery.

Progressive loading of the limb is essential so there is a smooth transition from Partial weight bearing to Full weight bearing with no change in gait whether it takes 2 days, 2 weeks or 2 months, regardless what the books, Internet, physio or surgeon tells you.

No two injuries are the same and everyone heals at different speeds and therefore the right time to “get rid” off your crutches depends on your ability to walk with a NORMAL GAIT.

Obviously this client should only be walking with two crutches as his gait seriously deteriorates as he attempts to walk with one crutch and even worse with no crutches.