So what is Telehealth? Physiotherapy Online available now in Port Macquarie

What is Telehealth and why do I need to know?

Telehealth is the delivery and facilitation of health care services by digital means, such as phone calls, sending documents and videoconferencing through your computer or mobile phone. It was used previously for remote communities, but now it is available to anyone who has a computer or mobile phone to do the consultations.

I started using Telehealth last year for some patients that I had seen at my practice, but no longer resided in Port Macquarie. It’s more important than ever with treatment of patients severely restricted by COVID19 protocols. Our government is now implementing Telehealth with full force, recognising the vital role that continued access to health care services such as Physiotherapy play for our communities.

Physiotherapy is an essential service for many important reasons:

  1. To reduce the need for people to visit a hospital.
  2. Help manage pain and provide effective self management tools.
  3. Provide ongoing education and advice to assist people to make the most out of life.

If you have a chronic illness that is managed by your GP, ask them about your access to physiotherapy through Telehealth. From April 14th 2020, private health funds will be providing rebates to those who use their physiotherapy cover in this way. Workcover and the NDIS clients are also able to access Physiotherapy Services through Telehealth.

Physiotherapy can also be accessed privately by booking an appointment through email: or phoning/texting me on 0437 373 100





Where are we headed? Covid-19 and Telehealth

Physiotherapy is a service to help you stay healthy, improve your function and reduce pain. Due to the Covid-19 Virus many people may be unsure whether seeing your physiotherapist is safe? Where are we going with this new way of life?

The infection control procedures are something that physiotherapists take seriously, even more so now. The risk is that through close contact, i.e. not socially distancing by the nature of our work, we may be putting our clients at risk of being exposed to Covid-19.  Of course we will not take any risks and not see clients if we are unwell, but there is another option, if you still have concerns… Telehealth!


As a Physiotherapist with lots of training and 21 years of experience, I am well placed to provide this service now privately. I use a secure program which connects with an App you download. You will have an individualised program and be able to send messages directly through this to provide information and assist in your injury management. I have already helped clients who live in remote areas through this service. Please contact me via email or phone if you have any questions, or are keen to get your injury assessed and managed.  I am looking forward to this opportunity to help people. Education and advice, along with exercise is MEDICINE!



Shoulder Savvy

Have you ever done lots with your shoulder in one day like hedge cutting or overhead painting, only to find you have developed a very painful shoulder? Hopefully not!

If you do get a sore shoulder from time to time it’s good to know why this can happen. You may have heard of the rotator cuff, a group of four muscles that control your humerus in it’s small socket. In fact it’s not really a socket, it’s more like a shallow disc- a tee, relative to a golf ball. Well, the tendons of the rotator cuff muscles have to run through some small spaces (called the coracoacromial arch) to then attach to the bone of the humerus. There are many factors that contribute to how large this space is. For example the position and way your shoulder blade sits at and move, as well as your own bony morphology (a cool way of saying how your bones are constructed through genetics and use in life). If the space is not big enough to allow the tendons to go through then we can develop symptoms.

In a recent research study by McCreesh, Purtill, Donnelly, et al (2017) in BMJ Open Sport & Exercise Medicine, it was found that at 1 hour and 6 hours after exercise the tendons actually swell, and this can be part of the pain you feel later in the day after pruning in the garden, or admiring your ceiling! The space is the same, but the tendon is bigger. This research also gives us good information of how to manage a painful shoulder. We know that exercise works, but if we know the tendon swells in response to it, we should do our rehab exercises once a day, or maybe even every second day to allow the tendon to calm down and not get compressed in the small space it has to go through.

If you live in Port Macquarie and need assistance to overcome a painful shoulder please contact me for an appointment.

If you live elsewhere, find a local Titled APA Sports Physiotherapist. Titled therapists have a Masters Degree (Sports Physiotherapy) and spend time at the Australian Institute of Sport, and must be approved by the Australian Physiotherapy Association to be called a ‘Sports Physiotherapist’.


Happy Hips

Do you stand like this occasionally?

Habits of hanging on one hip can start early and be exacerbated by carrying around your child on one side

How do I compress my gluteal tendons?

Sitting on low chairs with hips lower than the knees

Crossing your legs for long periods of time

Sitting with your knees together and feet apart, and moving from sitting to standing in this alignment

Sleeping on your side with the top leg flexed at the knee and hip

Sleeping on a hard mattress will compress the sore side

Standing with weight on one side- hip-hitching

Training errors with running, such as a camber at the beach or poor foot placement

Why does this happen to women more than men?

Women have wider hips and affects the alignment angles of the muscles, tendons and fascia

In post-menopausal women it is very common, as hormonal factors influence tendons

What can I do to make my hips happy?

Do exercises to keep your back, pelvis and hip muscles strong with hips and knees in good alignment

Use a pillow between your knees at night

If you have pain you can use an egg-shell pillowtop on your mattress

Avoid postures that compress your tendons

If you do have pain – see a physiotherapist for education and corrective low compression exercises to keep your hips happy!


Mel Turner is a Titled Sports Physiotherapist in Lighthouse Beach, Port Macquarie NSW

Growing Pains- Does my child need to see the Physio?

As a Sports Physiotherapist in an active town like Port Macquarie, it seems to be at certain times of the year kids complain about their joints. As we change over from summer to winter sport, some children will get sore legs, knees or ankles. As children go through growth spurts, cells under their skins are going through some mind- blowing changes.

Often growing pains such as aching legs can be eased with massaging the calves and thighs and using a hot water bottle or having a warm shower. These sorts of pains should resolve in a few days.

If your child plays sports, and they are particularly good athletes they will often get picked for representative teams. This means their ‘load’ on their muscles and joints is greater, as they have more training and games. Maybe they love what they do and play these sports in the playground too. Our bodies love movement, but our bodies also need rest. If kids end up doing too much their tissues can get ‘overloaded’.

There are also a few critical times in their growth. For girls aged 10-12 years, and boys aged 12-14 years, not only does puberty hit their emotions it also causes changes especially where tendons insert into the bone. The structure of their tissues undergo rapid change. For example where the Achilles’ tendon inserts into the heel bone, and where the patella tendon inserts onto the top of the shin are common sites of pain in children when they undergo these changes. These two conditions are called Severs Disease and Osgood-Schlatters, respectively. The cells in the tendon that were elastic and stretchy become more fibrocartilangenous, i.e. they get stiffer and stronger at their attachment to the bone. These microscopic level changes produce substances locally, and the mechanical loads will send signals to the brain which are then interpreted as pain.

It is worthwhile having your child assessed by a registered health professional who is able to diagnose their condition and has experience in this area. A specific stretching program will generally improve their symptoms, and massage to targeted areas can also have a significant effect to reduce pain, and help them get through the growth phases associated with adolescence. It is also another area in life where kids can learn to take responsibility for their health and well-being with support from their family.


Osteoarthritis Explained

IMG_1772Osteoarthritis is a form of joint disease that affects synovial joints of the body. People know that it is a disease that causes joints to degenerate, but how does actually happen?

There are two types of classification:
Primary osteoarthritis – has no clear initiating courses.
Secondary osteoarthritis – can be directly related to an initial cause and are classified as traumatic, anatomic, metabolic, and inflammatory.

In articular cartilage there are inter-fibre cross links which stabilise the collagen tissue in the extra-cellular matrix. Enzymes that originate in cartilage cells (chondrocytes) can cause cleavage of these collagen cross-links. For a great diagram of the extracellular matrix check out

Also inside a joint there are proteoglycans (which are proteins with chains) that make up the extra cellular matrix of the articular cartilage. One of the the main types of proteoglycan is aggrecan. This molecule gives cartilage the ability to resist compressive loads by osmosis. Breaks in collagen cross-links cause aggrecan molecules to expand by binding with more water.

Changes in hydration are sensed by the cartilage cells and this alters the metabolism of the cells. There is a reduced rate of synthesis of aggrecan, and an increase the breakdown of aggrecan, causing a net loss (of aggrecan) from the extra cellular matrix. This changes the biomechanical properties of the extracelluar matrix and the tissue can no longer with stand compressive loads. For more detail refer to

This inability to not take the load can lead to pain and swelling. Pain and swelling causes altered signalling to the brain, and the muscles around joints can actually stop working correctly due to to altered signals coming back down, to the joint from the brain. Fear of movement and altered movement can occur without conscious realisation.

Be guided by an experienced physiotherapist who can see what is happening to your movement and can develop strategies to improve pain and give appropriate exercises depending on the stage of your osteoarthritis.

Mel Turner
Titled APA Sports Physiotherapist in Port Macquarie, NSW


4 Physio Tips for the 2016 Season

  1. Are you consistent with training in the off-season? Lots of injuries occur due to unaccustomed use, such as muscle strains. Understanding what mechanical loads you place on your tissues can help you work out your training plan. Cells in muscle, tendon and bone adapt to mechanical stimulus, also known as…EXERCISE! If you wait until the first game to test your tissues, you might get issues!
  2. Previous injury is one of the biggest risk factors for another injury. Spend 15 minutes twice a week doing some pre-hab! E.g. Perform strength work on a muscle that your tore last season (e.g. calf raises for a calf tear, single leg bridges for your hamstring) or for a previous ankle sprain do some challenging balance exercises, such as the one in the photo.


3. Do a good warm up! A great resource for warming -up and injury prevention are the FIFA 11+exercises for soccer. These can give you an idea of good prevention exercises.

4. If you live in beautiful Port Macquarie and do get injured on the field, at home, school or work then get in touch sooner rather than later! I am available to give you a diagnosis, specific exercises and help you enjoy the 2016 Season.



Young Cricketers on the Mid-North Coast!

Research suggests that the total number of deliveries bowled in a week is closely linked to the potential for injury. In First Class Cricketers of average age 27, it has been shown that total workloads of more than 170 balls per week, results in a 1.45 times increase in the risk of injury (
The loads undertaken by adolescents need to be considered as they are in phases of growth and particular stages of motor development.

With regards to bowling it is recommended that the following guidelines be adopted for junior cricketers’ training schedules.

U-10/ 1 session per week, 24 balls

U-11/ 1 session per week, 24 balls

U-12/ 2 sessions per week, 24 balls

IMG_1514U-13/ 2 sessions per week, 30 balls

U-14/ 2 sessions per week, 30 balls

U-15/ 2 sessions per week, 30 balls

U-16/ 2 sessions per week, 36 balls

U-17/ 3 sessions per week, 36 balls

U -18/ 3 sessions per week, 42 balls

U-19/ 3 sessions per week, 48 balls

*substitute at least one practice session for each additional match played in the week


For more info contact Mel Turner – Sports Physiotherapist Port Macquarie


Are you close to 40? Watch out for the calf tear!


My 5 Top Tips for Muscle Injuries

  1. Use compression immediately whether it be a crepe bandage or tubigrip. It’s really important to minimise the bleeding and swelling. Keep it on for 48 hours.
  2. Use ice over the compression for 15 mins at a time, every 2 hours ideally. Rest and elevate the injured area. e.g. with a calf strain elevate it up on pillows, above your heart. Avoid alcohol, as it causes vasodilation and this causes swelling which is what to are trying to reduce.
  3. Get it diagnosed properly in consultation with your Sports Physiotherapist. This can be done by a clinical examination…a process of working out how much the muscle has been torn. You need to determine how much load the muscle can take. If it can’t take any it may be completely torn.
  4. Don’t do lots of stretching at the start. When a muscle isn’t right the natural instinct is to stretch it and see how sore it is, but stretching it too much just pulls the muscle fibres apart.
  5. Start a loading exercise program. By giving the muscle a good amount of stimulus it encourages repair at the cellular level.  Strengthening correctly is the key. This needs to be increased progressively. Muscle tissue generally heals well due to it’s abundant blood supply.

There are some muscle tears you can have that are easily managed and putting a bit of effort into your rehab exercises can leave you with very good healing result. There are also some muscle tears you really need to be diagnosed correctly as they may require surgery.

Look after yourself well, and I’ll see you out running in Port Macquarie!