Tips for headache sufferers. Can my Physiotherapist help? Dave O'Brien

Nearly everyone will have a headache at some point in their lives.  For most people, this will be a temporary irritation, without a significant impact of daily life and enjoyment.  For some, however, facial and head pain can be a daily struggle and severely restrict quality of life.

The issue with recommending a one size fits all treatment is that everyone’s headache experience is very individual.   The International Headache Society has now classified more than 200 different headache types.  Approximately one in 9 Australians will suffer from migraine at some point in their lives, with women twice as likely to be affected.

Headaches are said to be either;

Primary -  (caused by sensitisation of structures within the brain and associated structures (migraine / cluster headache / tension type headache etc)


Headache symptoms occur as a result of another condition:

  • Alcohol induced headache

  • Brain bleed / clots or tumour

  • Infection

  • Concussion

  • Dehydration

  • Thyroid levels

  • Cancer

  • Medication interaction

  • Poisoning             and many others

Over the past 10 years I have developed a passion for managing headaches, dizziness, whiplash and jaw pain.  I have been fortunate enough to complete further training under international presenter Dr Dean Watson, Specialist Physiotherapists Trudy Rebbeck,  Michael Ryan and Guy Zito and attend the International whiplash conference earlier this year.     


Physiotherapists whom are trained to manage headaches work in close liaison with Doctors, Neurologists, dentists, psychologists, Ear Nose and Throat specialists, rheumatologists and endocrinologists.  

Due to the vast range of possible causes, the most important skills are in differential diagnosis (narrowing down the possible source of headache).    It is vital we can accurately identify which headaches will respond well to Physiotherapy or when it is necessary to refer you on further opinion or investigation.  

Which headaches can Physio help?

Dean Watson has work for years to refine an evidence based hands on approach to accurately determine how the neck can influence headache and migraine.   When stiff and sensitised, the top 3 joints in the neck can refer pain to the head.   

Often these are clues that your headache or migraine might be related to your neck:

  • If your headache is one sided, or shifts sides between episodes

  • If your headache is provoked by sustained neck postures (sitting or driving)

  • If you headache starts in your shoulder and progresses to your head.

Dean explains more here:

Management approaches

Once the area of the neck responsible for your headache is identified,  Physiotherapy can use gentle release techniques to desensitise and reduce the symptoms.  

Postural awareness, strengthening, fitness and education regarding self management options are all integral.

Please contact your Physiotherapist today for more information.  


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Ankle Sprains- Management to Prevent Chronicity

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Ankle sprains are among the most common sporting injuries. They are often seen as trivial injuries to many people, however up to 40% of ankle sprains can lead to chronic pain, instability and recurrent sprains. Effective early management and rehabilitation and a guided return to sport program are important in reducing the risk of chronic symptoms. For more information read the attached blog post.

Ankle Sprains- Management to Prevent Chronicity

Ankle sprains are among the most common sporting injuries. They most commonly occur with an inversion (rolling out) mechanism that causes stretching or tearing of the supportive ligaments of the outside of the ankle.

The lateral ankle consists of three ligaments the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL) and the posterior talofibular ligament (PTFL). The anterior talofibular ligament is the most commonly torn ligament in the body.

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Ankle sprains can vary greatly in severity from a minor “rolled ankle’ to a complete ligament rupture with or without a fracture, tendon or muscle injury. They are graded as 1, 2 or 3 depending on the severity.

Ankle sprains can be viewed as a trivial injury by many people, however up to 40% of ankle sprains can lead to chronic ankle instability, chronic pain and recurrent ankle sprains. Effective early management, rehabilitation and guided return to sport program is important in reducing chronic symptoms.

Early management:

Early management follows the RICE principle.

Rest- Relative rest is recommended, the amount of rest required with depend on the severity of the sprain. Complex sprains and sprains that are associated with a fracture may need to be immobilised in a camboot for up to 6 weeks, whereas low grade sprains are generally ok to walk on as tolerated.

Ice- Icing for 20 minutes on and 20 minutes off for the first 48 hours is necessary to reduce inflammation.

Compression- Compression using tubi-grip can help reduce swelling.

Elevation- To reduce swelling pooling in the foot and ankle, elevation is required throughout the day.

Early physiotherapy management will focus on reduction of pain and swelling and restoring normal joint range of movement. This is achieved by using techniques such as soft tissue massage and joint mobilisations.


Next, you will be given exercises to increase the strength, flexibility and proprioception of the muscles in the legs including around the ankle, knees and hips. Proprioception is the awareness of where your body is in space. Following an ankle sprain this can be impaired and increases the risk of further sprains and chronic instability.

Return to Sport:

Your physiotherapist will guide you through exercises targeted specifically towards your sporting requirements. Starting with straight line running, then adding in change of direction and more sports specific drills.

Taping and bracing is recommended in the early stages of return to sport to reduce to risk of reinjury.

If you have sprained your ankle or are experiencing ongoing pain, instability or recurrent ankle sprains your Physiotherapist will be able to thoroughly assess you and recommend suitable management.