By Auckland Physiotherapy | Posture, Mobility & Exercise Tips for Flights and Road Trips
The holiday season is finally here, and whether you're flying overseas to visit family, taking a road trip around New Zealand's stunning landscapes, or heading to the beach for a summer break, travel is often part of the festivities. However, long hours sitting in planes, cars, or buses can leave you arriving at your destination with a stiff back, tight hips, aching neck, or swollen legs—hardly the way you want to start your holiday.
At Auckland Physiotherapy, we see a surge in travel-related pain and discomfort during the holiday season. The good news is that with some simple strategies and awareness, you can arrive at your destination feeling comfortable and ready to enjoy your break. Here's your comprehensive guide to staying pain-free while travelling this summer.
Understanding why travel causes discomfort helps you prevent it. Whether you're flying long-haul from Auckland to Europe or driving from Auckland to the Coromandel, prolonged sitting creates several challenges for your body.
Prolonged Static Posture
Sitting in the same position for hours reduces blood circulation, causes muscle stiffness and fatigue, places sustained pressure on spinal discs, and restricts natural movement patterns your body craves. Your spine is designed for movement—when forced into static positions for extended periods, the supporting muscles tire and joints become compressed.
Limited Space and Poor Ergonomics
Airplane seats and car interiors are rarely designed with optimal posture in mind. Economy class seats often lack adequate lumbar support, have limited legroom that restricts position changes, force your body into awkward angles, and provide minimal space for stretching or movement. These factors combine to create the perfect conditions for pain and stiffness.
Reduced Movement and Circulation
When you're immobile for long periods, blood pools in your lower legs increasing swelling and DVT risk, lymphatic drainage slows causing fluid retention, muscles weaken from disuse, and joint mobility decreases. This is why you might feel stiff and swollen after a long flight or drive, even if you weren't in pain when you started.
Smart preparation before you leave Auckland can make a significant difference to your comfort during travel.
Strengthen and Mobilize Before You Go
In the weeks leading up to travel, focus on strengthening your core and postural muscles to better withstand prolonged sitting. Include exercises like planks, bridges, and rows in your routine. Work on hip and spine mobility through gentle stretching and movement. If you have existing pain or stiffness, address it with your physiotherapist before travelling rather than hoping it won't worsen on the journey.
Pack Smart for Comfort
Consider bringing a small lumbar support cushion or rolled towel, a neck pillow for flights (the U-shaped variety or a scarf that can be rolled), compression socks for long flights, comfortable, loose-fitting clothing, and a refillable water bottle. These simple items can dramatically improve your comfort during travel.
Plan Your Journey Strategically
When booking flights, consider aisle seats for easier movement, seats with extra legroom if possible, and breaking up very long journeys with stopovers. For road trips, plan regular stops every 90-120 minutes, identify rest areas or scenic spots where you can stretch, and share driving duties if possible to avoid prolonged static posture.
Long-haul flights from Auckland present particular challenges due to limited space and extended sitting time. Here's how to stay comfortable at 30,000 feet.
Every 30-60 Minutes: Seated Movements
You don't need to leave your seat to keep your body moving. Perform these exercises regularly throughout your flight:
Ankle circles and pumps help maintain lower leg circulation. Rotate your ankles in both directions 10 times each, then flex and point your feet 20 times. This simple movement activates your calf muscles, which act as a pump to return blood from your legs.
Seated spinal twists maintain spine mobility. Place your right hand on the outside of your left thigh, gently rotate your torso to the left, hold for 5-10 seconds, and repeat on the other side. This helps prevent the stiff, locked feeling that develops in your spine during long flights.
Shoulder rolls and neck stretches reduce upper body tension. Roll your shoulders backward 10 times, then forward 10 times. Gently tilt your head toward each shoulder, holding for 10-15 seconds. These movements counteract the forward head posture and rounded shoulders that develop during flights.
Seated marching engages your hip flexors and core. While seated, lift one knee slightly, hold briefly, then lower. Alternate legs for 20-30 repetitions. This maintains hip mobility and prevents the deep hip stiffness many people experience after flying.
Every 1-2 Hours: Walking and Standing
Whenever safe and permitted, get up and move around the cabin. Walk to the bathroom even if you don't need to use it, stand in the galley area and perform gentle stretches, walk up and down the aisle several times, and stand while doing some of the exercises listed above. Even five minutes of standing and walking makes a significant difference to your circulation and comfort.
Key Standing Stretches for Flights
When you're able to stand, maximize the benefit with these stretches:
Calf stretches are essential for circulation. Stand facing the wall or galley, place one foot behind the other, and lean forward gently, keeping your back heel down. Hold for 20-30 seconds each side. This stretch helps prevent calf tightness and reduces DVT risk.
Hip flexor stretches counter the shortened position of sitting. In a staggered stance, tuck your pelvis under slightly and lean your weight forward, feeling a stretch in the front of your back hip. Hold for 20-30 seconds each side.
Standing back extensions relieve spinal compression. Place your hands on your lower back and gently arch backward, holding for 10-15 seconds. This counteracts the forward-flexed position of sitting.
Optimal Sitting Posture During Flights
When seated, maintain the best posture possible given the constraints:
Use a small pillow or rolled sweater behind your lower back for lumbar support. Sit with your bottom all the way back in the seat rather than perching forward. Keep your feet flat on the floor or footrest, knees at roughly 90 degrees. Avoid crossing your legs for extended periods, which restricts circulation. Change your position frequently—even small shifts reduce sustained pressure on any one area.
Whether you're driving from Auckland to Rotorua, Wellington, or further afield, road trips present their own challenges and opportunities for staying pain-free.
Driving Posture Essentials
Proper setup of your driving position prevents much of the discomfort associated with long drives:
Adjust your seat so your knees are slightly bent when operating pedals, your back is supported by the seat back, and you can reach the steering wheel without leaning forward or hunching your shoulders. Position your mirrors correctly so you're not twisting or tilting your head repeatedly to check them. Use cruise control when safe to do so, allowing you to change your leg position occasionally.
The 90-Minute Rule
For road trips, plan to stop every 90-120 minutes regardless of whether you feel you need to. These breaks should include at least 5-10 minutes of walking and stretching. New Zealand has numerous scenic spots perfect for these stops—use them as opportunities to enjoy the scenery while caring for your body.
Roadside Stretches and Exercises
Make the most of your stops with these effective stretches:
Walking lunges wake up your hip flexors and glutes after sitting. Take 10-15 lunges on each leg in the car park or along a path. This dynamic movement reverses the shortened position of sitting.
Standing quad stretches address front thigh tightness. Hold onto your car for balance, bend one knee bringing your heel toward your bottom, and hold for 20-30 seconds each side.
Standing hamstring stretches relieve posterior chain tightness. Place one heel on your car's bumper or a low wall, keep your leg straight, and hinge forward at the hips until you feel a gentle stretch. Hold for 20-30 seconds each side.
Torso rotations mobilize your spine. Stand with feet hip-width apart, hands on hips, and rotate your upper body left and right 10-15 times. This addresses the rotational stiffness that develops from looking straight ahead for hours.
Arm circles and shoulder stretches release upper body tension. Perform large arm circles forward and backward 10 times each direction. Clasp your hands behind your back and gently lift to open your chest.
For Passengers: Taking Advantage of Your Position
If you're a passenger rather than driving, you have more flexibility for movement:
Perform all the seated exercises mentioned in the flight section. Remove your shoes (if appropriate) to allow greater ankle movement. Use rest stops to walk briskly for several minutes before stretching. Consider switching to the back seat periodically if it offers more room to change positions.
Lower Back Pain
Lower back pain is perhaps the most common travel-related complaint we see at Auckland Physiotherapy. To prevent and manage it:
Use lumbar support consistently—a proper lumbar cushion or even a rolled towel placed in the small of your back maintains your spine's natural curve. Avoid slumping, which places excessive pressure on spinal discs. Change position frequently, even if just shifting your weight from one side to the other. When standing during breaks, perform gentle back extensions and pelvic tilts. Apply heat if available—some people find heat patches helpful during travel.
Neck and Shoulder Tension
Long travel often leads to neck stiffness and shoulder pain from sustained head-forward posture:
Use a proper neck pillow that supports your head without pushing it too far forward. Avoid reading or looking at devices with your head bent down for extended periods—hold reading material at eye level. Perform regular neck stretches and shoulder rolls. When sleeping during travel, ensure your head isn't tilted at extreme angles. Apply gentle pressure to tight upper trapezius muscles or use a massage ball during breaks.
Hip and Knee Stiffness
Hips and knees suffer from the sustained flexed position of sitting:
Stand and walk as frequently as possible. Perform seated hip and knee movements regularly. During breaks, include lunges and squats to move these joints through their full range. If you have existing hip or knee problems, consider an aisle seat where you can extend your leg more easily. Use compression garments if recommended by your physiotherapist.
Swollen Feet and Ankles
Fluid retention in the lower legs is extremely common during travel:
Wear compression socks for flights over three hours—these significantly reduce swelling and improve circulation. Avoid crossing your legs, which restricts venous return. Perform ankle pumps and circles every 30 minutes. Elevate your feet when possible during breaks. Stay well hydrated, as dehydration actually worsens fluid retention. Reduce salt intake before and during travel. Walk immediately upon arriving at your destination rather than sitting down to rest.
What you eat and drink significantly affects how you feel during travel.
Hydration Strategies
Airplane cabins have extremely low humidity, leading to dehydration that contributes to fatigue, muscle stiffness, and headaches. Drink water regularly throughout your journey—aim for approximately 250ml every hour on flights. Limit alcohol and caffeine, which are diuretic and worsen dehydration. Bring an empty water bottle through security and fill it before boarding. For road trips, keep water readily accessible to encourage regular intake.
Smart Eating While Travelling
Heavy, salty meals worsen bloating and fluid retention. Choose lighter options like salads, lean proteins, and vegetables when possible. Avoid excessive salt, which promotes fluid retention and swelling. Eat smaller, more frequent meals rather than large ones that leave you feeling sluggish. Include foods rich in potassium (bananas, avocados) which help regulate fluid balance. Limit carbonated drinks that increase bloating and discomfort.
Making the Most of Sleep Opportunities
If you're able to sleep during travel, optimize your position:
Use a neck pillow that keeps your head in neutral alignment. Avoid having your head tilted far forward or to the side. If sleeping against a window, place a pillow or bundled clothing between your head and the window. Recline your seat if possible and appropriate (always check with passengers behind you on flights). Use an eye mask and earplugs to improve sleep quality.
Post-Arrival Recovery
When you arrive at your destination, resist the urge to immediately sit down and rest:
Take a 10-15 minute walk to maintain circulation and begin adapting to your new time zone. Perform a thorough stretching routine addressing all areas that feel stiff. Stay hydrated and eat a light, nutritious meal. If possible, engage in gentle activity rather than remaining sedentary. Consider a warm bath or shower to ease muscle tension. Get proper sleep in a supportive bed rather than napping in chairs.
Travelling with Existing Injuries or Chronic Pain
If you have ongoing pain or injuries, prepare more extensively:
Consult your Auckland physiotherapist before travel for specific advice tailored to your condition. Bring any supportive devices you use regularly (braces, cushions, etc.). Pack pain medication and ensure you have adequate supply. Plan more frequent breaks and movement sessions. Consider shorter travel days or overnight stops for very long journeys. Know your limits—sometimes choosing a more expensive direct flight is worth avoiding a long layover or connection.
Older Adults and Travellers with Reduced Mobility
For those with mobility challenges:
Request assistance at airports—there's no shame in using wheelchair services for long terminal walks. Choose accommodation close to your arrival point to minimize post-travel transit. Allow extra time for movement breaks. Focus on simple, gentle movements rather than ambitious stretching routines. Prioritize circulation through walking and ankle movements. Consider travel insurance that covers medical issues.
Pregnant Travellers
Pregnancy increases susceptibility to back pain, swelling, and blood clots during travel:
Consult your healthcare provider before long-distance travel. Wear compression stockings without fail. Move and walk even more frequently than general recommendations. Stay extremely well hydrated. Choose aisle seats for easy bathroom access and movement. Use extra lumbar support as your center of gravity shifts. Avoid travel during the final weeks of pregnancy unless medically approved.
Rather than trying to remember everything while travelling, create a simple plan before you leave:
For Flights:
For Road Trips:
Sometimes despite your best efforts, you arrive home with pain or discomfort. Seek professional assessment if:
At Auckland Physiotherapy, we're experienced in treating travel-related pain and can help you recover quickly so you can enjoy your holiday or get back to normal activities after returning home.
Travel doesn't have to mean arriving stiff, sore, and uncomfortable. With awareness, planning, and consistent implementation of these strategies, you can reach your destination feeling good and ready to enjoy your time away. The key is consistency—performing small movements frequently throughout your journey rather than trying to compensate with extensive stretching at the end.
Whether you're flying long-haul from Auckland, driving around New Zealand, or taking shorter trips, your body will thank you for the attention and care you give it during travel.
If you have concerns about travelling with existing pain, want a personalized travel wellness plan, or need treatment before or after your holiday, the team at Auckland Physiotherapy is here to help.
Contact Auckland Physiotherapy today:
Visit www.aucklandphysiotherapy.co.nz or call to book your appointment. We provide pre-travel assessments, personalized exercise and stretching programs, treatment for existing pain or injuries, and post-travel recovery support.
Have a wonderful, pain-free holiday season—you deserve to enjoy every moment of your well-earned break!
The information provided in this blog is for educational purposes and should not replace professional medical advice. If you experience severe pain, signs of DVT, or other concerning symptoms during or after travel, seek immediate medical attention.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
By Auckland Physiotherapy | Sports Injury Prevention and Performance
Whether you're pounding the pavements of Auckland's waterfront, tackling the trails of the Waitakere Ranges, or training for the Auckland Marathon, how you prepare your body before running can make the difference between a great run and an injury. Yet many runners either skip their warm-up entirely or rely on outdated stretching routines that may actually hinder performance and increase injury risk.
At Auckland Physiotherapy, we work with runners of all levels—from weekend joggers to elite athletes—and one of the most common areas where we see room for improvement is in pre-run preparation. Understanding what an effective running warm-up should include, and why each component matters, can help you run faster, feel better, and stay injury-free.
A proper warm-up isn't just something elite athletes do—it's a crucial practice for any runner who wants to perform well and avoid injury. When you start running without preparing your body, you're asking cold muscles, stiff joints, and an unprepared cardiovascular system to suddenly perform at high intensity. This creates a perfect storm for injury and poor performance.
Research consistently shows that proper warm-ups reduce injury risk in runners. Cold muscles are less elastic and more prone to strains and tears. Joints without adequate synovial fluid circulation are more susceptible to impact stress. Studies have found that runners who warm up properly experience significantly fewer running injuries, including muscle strains, tendon problems, and joint issues.
Improved Performance
Beyond injury prevention, warming up enhances your running performance. A good warm-up increases muscle temperature, which improves muscle contraction speed and force production. It enhances oxygen delivery to working muscles, improves nerve transmission speed for better coordination, increases range of motion in key joints, and prepares your cardiovascular system for exercise demands. Many runners find they can run faster and longer when properly warmed up compared to starting cold.
Mental Preparation
The warm-up also provides valuable mental preparation time. It allows you to transition from daily activities to focused running, assess how your body feels and adjust your workout accordingly, establish your breathing rhythm, and mentally prepare for the effort ahead. This psychological component is particularly important for race day or challenging training sessions.
The ideal warm-up duration varies based on several factors, including the intensity of your planned run, weather conditions, your age and fitness level, and whether you're racing or training. As a general guideline:
Remember that older runners and those with previous injuries often benefit from longer, more thorough warm-ups. At Auckland Physiotherapy, we can assess your individual needs and create a personalized warm-up routine that works for your body and running goals.
An effective warm-up isn't about checking boxes—it's about systematically preparing your body for the specific demands of running. Here's what your pre-run routine should include:
1. Light Aerobic Activity (5-10 minutes)
Start with easy movement to gradually increase your heart rate and body temperature. This could be a slow jog, brisk walking, or easy cycling. The goal is to increase blood flow to muscles without causing fatigue. You should be able to hold a conversation easily during this phase.
For those with knee pain or other concerns, starting with walking allows a gentler transition. Many Auckland runners find that beginning their warm-up with a walk from their front door, gradually transitioning to an easy jog, works perfectly.
2. Dynamic Stretching and Movement Preparation (5-10 minutes)
Unlike static stretching (holding stretches for extended periods), dynamic stretching involves controlled movements that take joints and muscles through their full range of motion. Research shows that dynamic stretching before running improves performance and reduces injury risk, while static stretching before exercise can actually decrease power output and running performance.
Effective dynamic stretches for runners include leg swings forward and back to prepare hip flexors and hamstrings, leg swings side to side for hip abductors and adductors, walking lunges to activate glutes and open hip flexors, high knees to engage hip flexors and improve running form, butt kicks to warm up hamstrings and quadriceps, and walking on toes and heels to prepare calves and ankles.
Perform each movement for 10-15 repetitions or 20-30 seconds, focusing on controlled movement rather than bouncing or forcing range of motion. The goal is to gradually increase movement amplitude as your body warms up.
3. Running-Specific Drills (3-5 minutes)
Running drills reinforce proper movement patterns and neuromuscular coordination while further warming up running-specific muscles. These drills prepare your nervous system for the coordinated movement patterns required for efficient running.
Key drills include A-skips to practice knee drive and foot strike, B-skips for hamstring engagement, high knees for hip flexor activation and cadence, butt kicks for hamstring flexibility and coordination, and bounding for power and running economy. Each drill should be performed for 20-30 meters or 15-20 seconds, with a walk or easy jog recovery between drills.
4. Gradual Pace Progression (2-5 minutes)
After your dynamic warm-up and drills, gradually build up to your planned running pace. If you're doing an easy run, this might mean starting at a slow jog and gradually reaching your comfortable pace. For interval training or racing, include several short accelerations (strides) building up to near race pace.
Strides are particularly valuable before faster running. These are smooth accelerations over 50-100 meters where you build from a jog to about 85-90% of maximum speed, then decelerate. Perform 4-6 strides with full recovery between each, focusing on relaxed, efficient running form rather than maximum effort.
Understanding what not to do is just as important as knowing the right approach. Here are mistakes we commonly see at Auckland Physiotherapy:
Static Stretching Before Running
Many runners still believe they should sit and hold stretches before running. Research has consistently shown that static stretching before exercise decreases power output, reduces running economy, and doesn't effectively prevent injury. Save static stretching for after your run when it can aid recovery and improve flexibility without compromising performance.
Warming Up Too Intensely
Some runners turn their warm-up into a workout, running too hard too soon. Your warm-up should prepare you for exercise, not fatigue you. If you're breathing hard or feeling tired from your warm-up, you've overdone it.
Skipping the Warm-Up Entirely
Perhaps the most common mistake is skipping the warm-up due to time constraints or perceived inconvenience. Even a brief 5-minute warm-up is better than nothing. If you're short on time, shorten your main run rather than eliminating the warm-up.
Not Adjusting for Conditions
Your warm-up needs change based on temperature, time of day, and your individual circumstances. Cold mornings require longer warm-ups than warm afternoons. After sitting at a desk all day, you need more movement preparation than if you've been active.
Ignoring Individual Needs
Every runner is different. Some people naturally warm up quickly, while others need more time. Previous injuries, age, and individual biomechanics all influence warm-up requirements. Pay attention to how your body responds and adjust accordingly.
Easy Run Warm-Up
For relaxed, conversational-pace runs, your warm-up can be relatively brief. Start with 5 minutes of walking or very slow jogging, followed by 3-5 minutes of basic dynamic stretches like leg swings and walking lunges. Then simply begin your run at an easy pace, allowing the first 5-10 minutes to serve as additional warm-up time.
Tempo Run or Threshold Training Warm-Up
These moderately hard efforts require thorough preparation. Begin with 10 minutes of easy jogging, then perform a full dynamic stretching routine for 5-7 minutes. Include running drills for 3-5 minutes, followed by 3-4 strides at progressively faster paces. This comprehensive approach ensures you're ready for sustained hard effort.
Interval Training or Speed Work Warm-Up
High-intensity training demands the most thorough warm-up. Start with 10-15 minutes of easy running, follow with 8-10 minutes of dynamic stretching and mobility work, include 5 minutes of running drills, and finish with 5-6 strides that progress to near-race pace. This extended warm-up prevents injury during explosive efforts and allows better performance during the workout.
Race Day Warm-Up
Racing requires feeling ready to run hard from the gun. Begin your warm-up 40-60 minutes before race start, allowing time for toilet stops and getting to the start line. Include 10-15 minutes of easy jogging, 5-7 minutes of dynamic stretching, 3-5 minutes of running drills, and 4-6 strides at race pace. Finish your warm-up 5-10 minutes before race start so you're ready but not cooling down.
At Auckland Physiotherapy, we often work with runners managing or recovering from injuries. Your warm-up can be adapted to protect vulnerable areas while still preparing you for running.
Achilles Tendinopathy
If you're dealing with Achilles issues, include extra calf preparation in your warm-up. Perform gentle calf raises and ankle circles, progress to walking on toes, and gradually introduce easy jogging. Avoid aggressive stretching of the Achilles, which can aggravate symptoms.
Plantar Fasciitis
For heel pain sufferers, start with gentle foot rolling on a tennis ball, perform toe curls and spreads, begin walking before transitioning to jogging, and ensure footwear provides adequate support. Never run through sharp pain—if your warm-up doesn't ease symptoms, it's not a good running day.
Runner's Knee (Patellofemoral Pain)
Knee pain often responds well to proper warm-up. Focus on hip activation exercises like clamshells and hip bridges, include lateral movements to activate hip stabilizers, and progress gradually from walking to jogging while monitoring symptoms. If pain persists or worsens, consult with a physiotherapist before continuing.
IT Band Syndrome
For lateral knee or hip pain, emphasize hip mobility work, include hip strengthening exercises, perform extra dynamic stretching for hip external rotators, and consider foam rolling the lateral thigh before running (though research on this is mixed). Consistent hip strengthening often provides more benefit than warm-up alone.
While general warm-up principles apply to most runners, individual assessment can identify specific areas that need extra attention. At Auckland Physiotherapy, we evaluate your running biomechanics, identify muscle weaknesses or imbalances, assess joint mobility and flexibility, review your injury history, and consider your training goals and running volume.
Based on this assessment, we create personalized warm-up routines that address your individual needs. This might include specific exercises for weak hip stabilizers, mobility work for restricted ankle dorsiflexion, activation drills for underactive glutes, or modified movements to protect recovering injuries.
We also teach you how to recognize when your warm-up is adequate—understanding the difference between muscles that need more preparation and pain that signals you shouldn't run. This body awareness is crucial for long-term injury prevention.
Many runners benefit from including targeted strength and activation exercises in their warm-up routine, particularly for commonly weak areas that contribute to running injuries.
Hip Activation Exercises
Strong, active hip muscles are crucial for running efficiency and injury prevention. Consider adding clamshells to activate hip external rotators, hip bridges for glute activation, single-leg deadlifts for balance and glute strength, and lateral band walks for hip abductor engagement. These exercises only take a few minutes but can significantly improve running mechanics.
Core Activation
A stable core supports efficient running form. Simple exercises like planks, bird dogs, and dead bugs can be performed before running to engage your core musculature. This preparation helps maintain good posture throughout your run, especially as fatigue sets in.
While most runners can implement an effective warm-up routine on their own, certain situations warrant professional guidance from a physiotherapist:
At Auckland Physiotherapy, we specialize in working with runners to optimize performance and prevent injuries. Our comprehensive assessments identify potential problems before they become serious, allowing you to continue doing what you love—running.
The best warm-up routine is one you'll actually do consistently. Here are strategies to make your warm-up sustainable:
Build it into your schedule by considering warm-up time when planning runs. If you have 30 minutes, plan for 10 minutes of warm-up and 20 minutes of running rather than skipping preparation to maximize running time.
Create habits by doing your warm-up in the same order each time. This routine becomes automatic, reducing the mental effort required.
Keep it simple—especially for easy runs. You don't need an elaborate routine for every run. Match warm-up intensity to workout intensity.
Listen to your body and adjust based on how you feel. Some days you'll need more warm-up time, other days less.
Proper warm-up before running isn't about adding inconvenient extra time to your workout—it's an investment in better performance, fewer injuries, and greater running longevity. The few extra minutes you spend preparing your body pay dividends in how you feel during and after your runs, and in your ability to keep running for years to come.
Whether you're running along Tamaki Drive, training for the Auckland Marathon, or just staying fit with regular jogs around your neighborhood, taking time to warm up properly is one of the smartest things you can do for your running.
If you want to optimize your running performance, prevent injuries, or address existing problems, the team at Auckland Physiotherapy is here to help. We provide comprehensive running assessments, biomechanical analysis, personalized warm-up routines, injury treatment and rehabilitation, and training advice for runners of all levels.
Contact Auckland Physiotherapy today:
Visit www.aucklandphysiotherapy.co.nz or call to book your running assessment. Let us help you develop the warm-up routine that will keep you running strong, feeling great, and achieving your goals.
Remember: Every run begins before you take your first step. Invest in proper warm-up, and your body will reward you with better runs and fewer injuries.
The information provided in this blog is for educational purposes and should not replace professional medical advice. If you're experiencing pain or have concerns about your running, consult with a qualified physiotherapist or healthcare provider.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
By Auckland Physiotherapy | Evidence-Based Arthritis Management
If you're living with arthritis, you've likely received conflicting advice over the years. Perhaps you've been told to rest your joints, avoid certain activities, or that there's little you can do except manage pain with medication. However, the latest research is challenging many long-held beliefs about arthritis management and revealing more effective approaches to maintaining joint health and reducing pain.
At Auckland Physiotherapy, we stay current with the latest arthritis research to provide our patients with evidence-based treatment strategies. The good news is that recent studies show you have far more control over your arthritis symptoms than previously thought. From exercise and strength training to supplements and lifestyle modifications, let's explore what the current evidence tells us about managing this common condition.
Arthritis isn't a single disease but rather a term encompassing over 100 different conditions affecting joints and surrounding tissues. The two most common types are osteoarthritis (OA), which involves the breakdown of joint cartilage and underlying bone, and rheumatoid arthritis (RA), an autoimmune condition causing joint inflammation. In New Zealand, arthritis affects approximately one in six people, making it one of the most prevalent chronic health conditions.
For decades, arthritis was viewed as a wear-and-tear condition—inevitable joint deterioration that worsens with age and use. However, modern research reveals a much more complex picture. We now understand that arthritis involves inflammation, changes in bone structure, alterations in surrounding muscles and tendons, and importantly, many modifiable factors that influence disease progression and symptoms.
Perhaps the most significant shift in arthritis management over the past decade is the overwhelming evidence supporting exercise as a primary treatment. This represents a complete reversal from older recommendations to rest arthritic joints.
What the Research Shows
Multiple high-quality studies and systematic reviews now demonstrate that exercise for people with arthritis reduces pain levels as effectively as pain medication, improves physical function and mobility, enhances quality of life, slows disease progression, and reduces the need for joint replacement surgery. A landmark 2020 study published in the British Journal of Sports Medicine found that exercise therapy was as effective as surgery for knee osteoarthritis, challenging the assumption that joint replacement is inevitable for many patients.
Importantly, research shows that appropriate exercise does not damage arthritic joints or accelerate cartilage loss. In fact, the opposite is true—controlled joint loading through exercise promotes cartilage health by improving nutrient delivery, stimulating beneficial cartilage cell activity, and strengthening supporting structures.
Types of Exercise That Help Arthritis
The evidence supports several exercise modalities for arthritis management:
Aerobic exercise such as walking, cycling, and swimming has been shown to reduce pain and improve cardiovascular health without stressing joints excessively. Studies indicate that even gentle walking for 30 minutes most days significantly improves arthritis symptoms and overall health. For Auckland residents, our numerous walking paths along the waterfront and through parks provide excellent low-impact exercise opportunities.
Strength training, which we'll discuss in detail shortly, has emerged as particularly beneficial for arthritis. Research consistently shows that strengthening muscles around affected joints reduces pain, improves function, and may slow disease progression.
Flexibility and range of motion exercises help maintain joint mobility and prevent stiffness. While once considered the primary exercise for arthritis, we now know these are important but shouldn't be the only form of exercise.
Balance and proprioception training reduces fall risk and improves joint stability, particularly important for those with lower limb arthritis. Tai chi has shown particular promise in research studies for improving balance and reducing arthritis pain.
One of the most exciting developments in arthritis research is the compelling evidence supporting strength training, even for people with moderate to severe arthritis.
Why Strength Training Works
When you have arthritis, the muscles around affected joints often become weak, either from disuse, pain avoidance, or the inflammatory process itself. This muscle weakness creates a vicious cycle where weak muscles provide less joint support, leading to increased pain, causing further reduction in activity, resulting in more muscle loss. Strength training breaks this cycle.
Research published in recent years demonstrates that strength training for people with arthritis reduces joint pain by 30-50%, improves physical function and daily activity performance, increases muscle mass and strength around affected joints, enhances joint stability and protection, and improves bone density, particularly important for those at osteoporosis risk.
Is Strength Training Safe for Arthritic Joints?
This is the question we hear most frequently at Auckland Physiotherapy, and the evidence provides a clear answer: yes, when done appropriately. Multiple studies have monitored people with arthritis performing strength training over months and years, finding no evidence of joint damage or accelerated cartilage loss. In fact, appropriate strength training appears to have protective effects on joints.
The key is "appropriate" strength training. This means starting with lighter weights and higher repetitions, progressing gradually based on individual response, using proper technique to distribute forces correctly, working within tolerable pain levels (mild discomfort during exercise is acceptable, but sharp pain is not), and ideally working with a physiotherapist initially to ensure correct form and progression.
What Type of Strength Training Is Best?
Research supports various approaches to strength training for arthritis:
Progressive resistance training, where you gradually increase weight or resistance over time, has the strongest evidence base. This can be performed with weights, resistance bands, or body weight. Studies show that training 2-3 times per week at moderate intensity (60-80% of maximum strength) provides optimal benefits.
Isometric exercises, where muscles contract without moving the joint, can be particularly useful during arthritis flares when movement is more painful. Research shows these still provide strength benefits while minimizing joint stress.
Functional strength training that mimics daily activities—such as sit-to-stand exercises, step-ups, and carrying tasks—helps translate strength gains into improved daily function.
Getting Started with Strength Training
If you're new to strength training with arthritis, the evidence suggests:
Start with bodyweight exercises or very light resistance. Focus on major muscle groups around affected joints—for knee arthritis, this means quadriceps, hamstrings, and hip muscles; for hip arthritis, focus on hip abductors, extensors, and core muscles. Begin with 1-2 sets of 10-15 repetitions, performed slowly with control. Progress gradually, increasing resistance only when exercises become comfortable. Allow at least one day of rest between strength training sessions for the same muscle groups.
At Auckland Physiotherapy, we design individualized strength training programs based on your specific arthritis presentation, fitness level, and goals. Professional guidance ensures you're exercising effectively while minimizing injury risk.
The supplement industry for arthritis is enormous, with countless products claiming to relieve pain, rebuild cartilage, or cure arthritis entirely. Let's examine what the evidence actually shows.
Glucosamine and Chondroitin
These supplements have been extensively studied, with mixed results. Recent meta-analyses and systematic reviews suggest that glucosamine sulfate may provide modest pain relief for some people with knee osteoarthritis, though effects are generally small. Chondroitin shows similar modest benefits in some studies. However, these supplements do not rebuild cartilage or reverse arthritis progression as once hoped.
The current evidence-based position is that glucosamine and chondroitin are safe and may be worth trying for 2-3 months to see if you notice benefits, but they're not miracle cures and work for only some people. If you notice no improvement after 2-3 months of consistent use, continuing is unlikely to help.
Omega-3 Fatty Acids (Fish Oil)
The evidence for omega-3 supplements in arthritis management is more promising, particularly for rheumatoid arthritis. Studies show that omega-3 fatty acids reduce inflammatory markers, may decrease pain and morning stiffness in RA, and might reduce the need for anti-inflammatory medications. For osteoarthritis, the evidence is less clear but suggests possible modest benefits.
Dosage matters—research typically uses 2-3 grams of EPA and DHA combined daily, which is higher than many standard fish oil supplements provide. Quality also matters, as some fish oil supplements contain less omega-3 than claimed on the label.
Vitamin D
Low vitamin D levels are common in people with arthritis, and research increasingly links vitamin D deficiency with increased arthritis pain and progression. Several studies suggest that correcting vitamin D deficiency reduces arthritis pain, though the evidence is still emerging.
Given that vitamin D deficiency is common in New Zealand, particularly during winter months, and that vitamin D is important for bone health, immune function, and muscle strength, testing your vitamin D levels and supplementing if deficient makes sense for most people with arthritis.
Turmeric and Curcumin
Turmeric has gained significant attention for arthritis management. Research shows that curcumin, the active compound in turmeric, has anti-inflammatory properties and several studies demonstrate modest pain reduction in knee osteoarthritis. However, curcumin is poorly absorbed, so supplements with enhanced bioavailability or added black pepper (piperine) are more effective than standard turmeric powder.
While evidence is promising, effects are generally modest and curcumin shouldn't replace proven treatments like exercise and weight management.
What About Collagen Supplements?
Collagen supplements have become extremely popular, with claims about rebuilding cartilage and reversing arthritis. The evidence, however, is limited and mixed. Some small studies suggest possible benefits for joint pain, but high-quality research is lacking. The body breaks down collagen supplements into amino acids during digestion, so the idea that consuming collagen directly rebuilds joint cartilage is oversimplified.
Supplements with Little Evidence
Many other supplements are marketed for arthritis with minimal scientific support, including MSM (methylsulfonylmethane), SAMe (S-adenosylmethionine), green-lipped mussel extract, and various herbal preparations. While some people report benefits, robust evidence is lacking.
The Bottom Line on Supplements
Supplements might provide modest symptom relief for some people but are not primary treatments for arthritis. Exercise, weight management, and physiotherapy have much stronger evidence and larger effect sizes than any supplement. If trying supplements, give them 2-3 months to assess effectiveness, choose reputable brands with third-party testing, and discuss with your healthcare provider to avoid interactions with medications.
For people with lower limb arthritis, weight management deserves special attention. Research consistently shows that excess body weight increases arthritis risk, accelerates disease progression, and worsens symptoms. Every kilogram of excess weight places approximately 3-4 kilograms of force on knee joints during walking.
However, the good news is equally compelling: studies demonstrate that even modest weight loss (5-10% of body weight) significantly reduces arthritis pain, improves physical function, and may slow disease progression. For someone weighing 90 kilograms, losing just 5-9 kilograms can substantially improve symptoms.
Weight loss is particularly effective when combined with exercise. Research shows that the combination of weight loss and strengthening exercises provides greater benefits than either intervention alone.
Older arthritis advice often emphasized avoiding activities that stress affected joints. Current evidence takes a more nuanced approach, recognizing that complete avoidance of activities you enjoy reduces quality of life and that appropriate activity modification allows continued participation.
What the Research Shows About Impact Activities
For years, people with arthritis were told to avoid running and other high-impact activities. However, recent research challenges this blanket advice. Studies show that recreational running doesn't increase arthritis risk in people with healthy joints and that runners have similar or lower rates of knee arthritis compared to non-runners.
For people who already have arthritis, the evidence is more complex. Running may be possible for some people with mild to moderate arthritis if they have good biomechanics, adequate strength and conditioning, appropriate footwear, and are willing to modify training based on symptoms. However, high-mileage running and competitive running do appear to increase stress on arthritic joints.
The key message is individualization—some people with arthritis can continue running with modifications, while others need to transition to lower-impact activities like cycling or swimming.
Sports Participation with Arthritis
Research increasingly supports the idea that staying active in sports you enjoy, with appropriate modifications, provides better outcomes than complete activity cessation. Benefits include maintained strength and fitness, better weight management, improved mood and quality of life, and continued social engagement.
The evidence supports working with physiotherapists to identify necessary modifications—such as reduced training volume, appropriate rest and recovery, strengthening supporting muscles, and using proper equipment and technique.
While medications have their place in arthritis management, research increasingly emphasizes multimodal approaches to pain control.
Exercise as Pain Management
We've already discussed exercise extensively, but it's worth emphasizing that exercise is one of the most effective pain management strategies for arthritis. Studies show that exercise reduces pain as effectively as many pain medications, with benefits lasting as long as exercise is continued.
Manual Therapy and Physiotherapy
Research supports hands-on physiotherapy techniques for arthritis pain management. Studies show that joint mobilization reduces pain and improves mobility, soft tissue massage decreases muscle tension around affected joints, and taping techniques can provide short-term pain relief. While these passive treatments are helpful, evidence indicates they work best when combined with active exercise programs.
Heat and Cold Therapy
Research supports both heat and cold applications for arthritis pain. Heat therapy before activity can reduce stiffness and improve flexibility, while cold therapy after activity can reduce inflammation and pain. Many people with arthritis find alternating heat and cold provides optimal relief.
Pain Neuroscience Education
Emerging research shows that understanding pain itself—how it's produced by the nervous system and doesn't always reflect tissue damage—can reduce arthritis pain and disability. This approach, called pain neuroscience education, helps people understand that some arthritis pain relates to sensitization of the nervous system rather than ongoing joint damage, movement and activity are safe even with some pain, and pacing strategies can help manage symptoms.
At Auckland Physiotherapy, we incorporate pain neuroscience education into arthritis management programs.
Research continues to explore new arthritis treatments:
Platelet-Rich Plasma (PRP) Injections
PRP involves injecting concentrated platelets from your own blood into affected joints. Research results are mixed—some studies show modest improvements in pain and function, while others show no benefit beyond placebo. Current evidence suggests PRP is not a cure for arthritis but might provide temporary symptom relief for some people.
Stem Cell Therapy
While promising in theory, current evidence for stem cell therapy in arthritis is limited and based mostly on low-quality studies. More rigorous research is needed before this can be recommended as a standard treatment.
Dietary Interventions
Research is exploring various dietary approaches for arthritis management. The Mediterranean diet shows promise for reducing inflammation, anti-inflammatory diets may help some people with RA, and eliminating specific trigger foods helps some individuals. However, no single diet cures arthritis, and dietary changes should complement rather than replace proven treatments.
Based on current research, an effective arthritis management plan should include:
Foundation: Exercise and Physical Activity
Weight Management (if relevant)
Professional Physiotherapy
Selective Supplement Use
Pain Management Strategies
Lifestyle Modifications
While exercise and conservative management work well for most people, some situations warrant consideration of injections or surgery:
However, research consistently shows that even candidates for surgery often benefit significantly from pre-surgical physiotherapy and exercise programs. Some people improve enough to delay or avoid surgery altogether.
If you're living with arthritis, the evidence is clear: you have more control over your symptoms and disease progression than you might think. Exercise, particularly strength training, represents one of the most powerful treatments available. Combined with appropriate weight management, targeted supplements if desired, and expert guidance from physiotherapists, most people can significantly improve their quality of life.
At Auckland Physiotherapy, we specialize in evidence-based arthritis management. We stay current with the latest research to provide you with treatments proven to work, not outdated advice or unproven gimmicks.
We provide:
Don't let arthritis limit your life. The latest evidence shows that with the right approach, you can reduce pain, improve function, and maintain an active lifestyle.
Contact Auckland Physiotherapy today:
Visit www.aucklandphysiotherapy.co.nz or call to book your comprehensive arthritis assessment. Let us help you develop an evidence-based management plan tailored to your specific needs and goals.
Remember: arthritis is not a condition you simply endure—it's a condition you can actively manage. The research shows that what you do matters enormously. Start taking control of your arthritis today.
The information provided in this blog is for educational purposes and should not replace professional medical advice. Always consult with your physiotherapist or healthcare provider regarding your specific arthritis management needs. If you experience sudden severe joint pain, significant swelling, or signs of infection, seek immediate medical attention.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
By Auckland Physiotherapy | Evidence-Based RA Management
Rheumatoid arthritis (RA) is more than just joint pain—it's a complex autoimmune condition that can significantly impact your quality of life, daily activities, and overall health. If you've recently been diagnosed with RA, or have been living with it for years, you're likely navigating a maze of treatment options, from medications and injections to physiotherapy and lifestyle changes.
At Auckland Physiotherapy, we work alongside rheumatologists and other healthcare providers to deliver comprehensive, evidence-based care for people with rheumatoid arthritis. While we can't cure RA, modern treatment approaches have transformed what's possible. Many people with RA now live active, fulfilling lives with well-controlled symptoms. Understanding your treatment options and how they work together is the first step toward optimal management.
Rheumatoid arthritis is an autoimmune condition where your immune system mistakenly attacks the lining of your joints (the synovium), causing inflammation, pain, and eventually joint damage if left untreated. Unlike osteoarthritis, which is primarily a wear-and-tear condition, RA is driven by immune system dysfunction.
RA typically affects joints symmetrically—meaning both hands, both knees, or both feet rather than just one side. Common affected joints include hands and wrists, feet and ankles, knees, shoulders, and elbows. However, RA is a systemic disease that can affect other body systems including the heart and blood vessels, lungs, eyes, and skin. This is why comprehensive treatment addressing the whole condition, not just joint symptoms, is essential.
Early Diagnosis and Treatment: Critical for Long-Term Outcomes
One of the most important advances in RA care is the recognition that early, aggressive treatment significantly improves long-term outcomes. Research consistently shows that starting disease-modifying treatment within the first few months of symptom onset prevents irreversible joint damage, reduces long-term disability, and improves quality of life. If you suspect you have RA but haven't been diagnosed, seeking prompt evaluation from a rheumatologist is crucial.
Modern RA treatment aims for several interconnected goals. The primary objective is achieving remission or low disease activity, meaning minimal or no symptoms and no active inflammation. Research shows this is achievable for many people with current treatments.
Additional goals include preventing joint damage and deformity, maintaining physical function and independence, managing pain and stiffness effectively, reducing systemic inflammation and associated health risks, and optimizing quality of life and participation in valued activities. Achieving these goals requires a multifaceted approach combining medications, physiotherapy, lifestyle modifications, and regular monitoring.
While physiotherapy and exercise are crucial components of RA management, medications form the foundation of disease control by targeting the underlying immune dysfunction.
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
DMARDs are the cornerstone of RA treatment. Unlike pain medications that only address symptoms, DMARDs actually slow or stop disease progression by modifying the immune response. The most commonly prescribed DMARD is methotrexate, which has decades of research supporting its effectiveness and safety when properly monitored.
Methotrexate works by suppressing the overactive immune response driving RA inflammation. Studies show it reduces joint pain and swelling, prevents joint damage when started early, and is generally well-tolerated with regular monitoring. Most people take methotrexate once weekly, along with folic acid supplementation to reduce side effects. Regular blood tests monitor for potential side effects on the liver and blood cells.
Other conventional DMARDs include hydroxychloroquine (Plaquenil), sulfasalazine, and leflunomide. Sometimes these are used in combination with methotrexate for better disease control.
Biologic DMARDs
Biologic medications represent a major advance in RA treatment. These are engineered proteins that target specific components of the immune system driving RA inflammation. Biologics are typically used when conventional DMARDs like methotrexate don't provide adequate disease control, or sometimes as first-line treatment in severe RA.
Common biologic classes include TNF inhibitors such as adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade), which block tumor necrosis factor, a key inflammatory protein. Other biologics target different immune pathways, including rituximab which depletes B cells, tocilizumab which blocks interleukin-6, and abatacept which modulates T cell activation.
Research shows biologics are highly effective, often achieving remission when conventional DMARDs haven't worked. They're generally well-tolerated, though they do increase infection risk by suppressing immune function. In New Zealand, access to biologic medications often requires meeting specific criteria and approval through Pharmac.
JAK Inhibitors
Janus kinase (JAK) inhibitors are a newer class of RA medications taken as pills rather than injections. They work by blocking enzymes involved in the inflammatory process. Examples include tofacitinib (Xeljanz), baricitinib (Olumiant), and upadacitinib (Rinvoq). Studies show JAK inhibitors are as effective as biologics for many people, with the advantage of oral administration rather than injections.
Corticosteroids
Steroids like prednisone rapidly reduce inflammation and can provide quick symptom relief. However, long-term steroid use carries significant risks including bone loss, weight gain, diabetes, and increased infection risk. Current RA treatment approaches use steroids as a "bridge" therapy—providing symptom control while waiting for DMARDs to take effect (which can take weeks or months), or during disease flares for short-term symptom management.
The goal is to use the lowest effective steroid dose for the shortest time possible, while DMARDs provide long-term disease control.
Pain and Anti-Inflammatory Medications
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or celecoxib help manage pain and reduce inflammation but don't modify disease progression. They're useful for symptom management alongside DMARDs. Paracetamol can help with pain relief though it doesn't address inflammation.
These medications treat symptoms but don't prevent joint damage, which is why DMARDs remain the treatment priority.
While medications control the underlying disease process, physiotherapy addresses the physical impacts of RA on joints, muscles, and functional abilities. Research consistently demonstrates that physiotherapy is an essential component of comprehensive RA care.
Exercise Therapy: Essential Despite Inflammation
One of the most important shifts in RA management is the recognition that exercise is beneficial, not harmful, even during active disease. For years, people with RA were told to rest their joints, but current evidence shows that appropriate exercise reduces pain and fatigue, improves joint function and range of motion, maintains and builds muscle strength, enhances cardiovascular health, and improves mood and quality of life.
Importantly, research shows that exercise does not increase disease activity or accelerate joint damage in RA. In fact, people with RA who exercise regularly often have better long-term outcomes than those who remain sedentary.
Types of Exercise for Rheumatoid Arthritis
Evidence supports several exercise modalities for RA:
Strengthening exercises are particularly important because RA causes muscle weakness around affected joints. Research shows that strength training performed 2-3 times weekly significantly improves muscle strength, reduces pain, and enhances physical function. At Auckland Physiotherapy, we design progressive strength programs that respect joint limitations while building supporting musculature.
Aerobic exercise such as walking, cycling, or swimming improves cardiovascular fitness, helps manage fatigue (a major RA symptom), supports weight management, and reduces cardiovascular disease risk (which is elevated in RA). Studies show that moderate-intensity aerobic exercise 3-5 times weekly is safe and beneficial for people with RA.
Flexibility and range of motion exercises help maintain joint mobility and prevent contractures (permanent joint tightening). These are particularly important for hands, wrists, and shoulders commonly affected by RA. Gentle stretching and range of motion work should be performed daily.
Balance and proprioception training reduces fall risk, which is important as RA affects foot and ankle joints that are crucial for balance. Exercises improving balance help maintain independence and reduce injury risk.
Exercising During Flares
During RA flares when joints are particularly inflamed and painful, exercise requires modification but shouldn't be abandoned entirely. Research suggests that during flares, reduce exercise intensity and duration, focus on gentle range of motion exercises to prevent stiffness, consider water-based exercise which reduces joint stress, and avoid high-impact activities. Once the flare subsides, gradually return to your regular exercise program.
Manual Therapy and Joint Protection
Physiotherapists provide hands-on treatment techniques that complement exercise. Research shows that joint mobilization can reduce pain and improve mobility in affected joints, soft tissue massage decreases muscle tension and improves circulation, and therapeutic taping provides temporary pain relief and joint support.
We also teach joint protection principles—techniques to reduce joint stress during daily activities. These include using larger, stronger joints for tasks when possible, avoiding positions that strain small finger joints, using assistive devices and adaptive equipment, and balancing activity with rest to prevent overuse.
Hand Therapy for RA
Hand and wrist involvement is extremely common in RA, often causing significant functional limitations. Specialized hand therapy includes exercises to maintain finger and wrist mobility and strength, splinting to support joints and prevent deformity, activity modification to protect hand joints, and recommendations for adaptive equipment that reduces hand strain.
Research shows that early hand therapy intervention can prevent or minimize hand deformities that were once considered inevitable in RA.
Fatigue is one of the most challenging and underappreciated symptoms of RA. Unlike normal tiredness, RA fatigue is overwhelming exhaustion that doesn't improve with rest. Studies show that up to 80% of people with RA experience significant fatigue that impacts daily activities.
Evidence-Based Fatigue Management Strategies
Research identifies several effective approaches to managing RA fatigue:
Regular exercise, paradoxically, is one of the most effective fatigue management strategies. Studies consistently show that people with RA who exercise regularly experience less fatigue than those who are sedentary. Start with gentle activities and gradually increase as tolerated.
Energy conservation and pacing involves balancing activity with rest, prioritizing important activities, breaking tasks into smaller segments, and planning rest periods before becoming exhausted. Occupational therapists and physiotherapists can teach specific energy conservation techniques.
Sleep optimization is crucial, as poor sleep worsens RA fatigue. This includes establishing regular sleep schedules, creating a comfortable sleep environment, managing pain that disrupts sleep, and addressing sleep disorders if present.
Addressing disease activity with appropriate medication management is fundamental, as uncontrolled inflammation is a major contributor to fatigue. Working with your rheumatologist to optimize disease control often significantly improves energy levels.
Managing stress and mental health is important because depression and anxiety, which are more common in people with RA, worsen fatigue. Psychological support, stress management techniques, and treatment for mood disorders when present all help reduce fatigue.
Beyond medical treatment and physiotherapy, several lifestyle factors significantly impact RA outcomes.
Diet and Nutrition
While no diet cures RA, research shows that nutrition influences inflammation and overall health. The Mediterranean diet, rich in fish, olive oil, fruits, vegetables, and whole grains, has the strongest evidence for reducing inflammation in RA. Studies show that following a Mediterranean-style diet may reduce disease activity and improve symptoms.
Omega-3 fatty acids from fish or supplements have anti-inflammatory properties and research shows they may reduce RA pain and morning stiffness. Maintaining a healthy weight is important, as excess weight increases stress on weight-bearing joints and obesity is associated with increased inflammation.
Some people with RA report that specific foods trigger symptoms, though this varies individually. Common reported triggers include processed foods, refined sugars, and nightshade vegetables (though scientific evidence for nightshades is limited). An elimination diet supervised by a dietitian can help identify personal triggers.
Smoking Cessation
If you smoke and have RA, quitting is one of the most important things you can do. Research shows that smoking worsens RA disease activity and severity, reduces the effectiveness of RA medications (particularly methotrexate), increases joint damage, and elevates the risk of RA-related complications. Studies demonstrate that people with RA who quit smoking experience improved disease control and better treatment responses.
Stress Management
Stress doesn't cause RA, but research shows it can trigger flares and worsen symptoms. The relationship is bidirectional—RA causes stress, and stress worsens RA. Effective stress management techniques supported by research include mindfulness meditation, which has been shown to reduce pain and improve quality of life in RA, gentle yoga incorporating breathing and relaxation, cognitive-behavioral therapy for managing chronic illness challenges, and regular physical activity, which reduces both stress and RA symptoms.
Sleep Quality
Poor sleep is common in RA due to pain, stiffness, and the inflammatory process itself. However, inadequate sleep worsens pain perception, increases fatigue, and may worsen inflammation. Improving sleep quality through good sleep hygiene, appropriate pain management at night, and treating sleep disorders when present is an important component of RA management.
RA treatment isn't a one-time prescription—it requires ongoing monitoring and adjustment. Modern RA care involves regular assessment of disease activity using validated measures, periodic blood tests monitoring inflammation markers and medication side effects, and imaging studies (X-rays, ultrasound, or MRI) to assess joint damage.
The treat-to-target approach, supported by strong research evidence, involves setting specific treatment goals (usually remission or low disease activity), regularly assessing whether goals are being met, and adjusting treatment if targets aren't achieved within 3-6 months. This proactive approach leads to better long-term outcomes than simply treating symptoms as they arise.
At Auckland Physiotherapy, we work collaboratively with your rheumatologist to monitor your physical function and adjust your exercise and physiotherapy program based on disease activity and treatment changes.
Pregnancy and Rheumatoid Arthritis
Many women with RA can have successful pregnancies, though planning is important. Some RA medications must be stopped before conception due to potential fetal harm (particularly methotrexate), while others are safe during pregnancy. Interestingly, many women experience reduced RA symptoms during pregnancy, though flares often occur after delivery.
If you have RA and are considering pregnancy, discuss this with your rheumatologist well in advance to optimize your treatment plan.
RA in Older Adults
Managing RA in older adults requires special considerations including increased risk of medication side effects, higher risk of infections with immunosuppressive medications, greater impact of RA on mobility and independence, and presence of other health conditions complicating treatment. However, research shows that older adults with RA benefit substantially from appropriate treatment, including exercise programs tailored to their abilities.
Work and Rheumatoid Arthritis
Many people with well-controlled RA continue working successfully. Strategies that help include open communication with employers about accommodation needs, workplace modifications such as ergonomic equipment, flexible scheduling to accommodate medical appointments and fatigue, and pacing strategies to balance work demands with energy levels. In New Zealand, employment protections exist for people with disabilities including RA. If work is becoming difficult, occupational therapy assessment can identify helpful modifications.
RA research continues to advance, with several promising areas:
Biosimilar Medications
Biosimilars are highly similar versions of existing biologic medications, typically available at lower cost. Research shows they're as effective and safe as original biologics, and increasing availability in New Zealand improves access to these important treatments.
Targeted Synthetic DMARDs
Newer medications that precisely target specific inflammatory pathways are being developed and tested. These may offer benefits similar to biologics with different administration routes or side effect profiles.
Personalized Medicine
Research is working toward predicting which patients will respond best to which medications, potentially avoiding the current trial-and-error approach to finding the right treatment. Genetic testing and biomarkers may eventually guide treatment selection.
Understanding Remission
Researchers are studying what happens during sustained remission to understand if some people might eventually discontinue medication. Current evidence suggests some patients in prolonged remission can reduce medication doses, but this requires careful monitoring and should only be done under rheumatologist supervision.
Living with a chronic condition like RA significantly impacts mental health. Research shows that people with RA have higher rates of depression and anxiety compared to the general population. This isn't surprising given the challenges of chronic pain, fatigue, functional limitations, medication side effects, and uncertainty about the future.
Importantly, mental health and RA symptoms influence each other—depression worsens pain perception and fatigue, while poorly controlled RA increases depression and anxiety risk. This is why addressing mental health is an essential component of comprehensive RA care.
Effective strategies include psychological therapy, particularly cognitive-behavioral therapy which helps develop coping skills, peer support through RA support groups where you can connect with others facing similar challenges, stress reduction techniques including mindfulness and relaxation practices, and appropriate treatment for depression or anxiety when present, which may include therapy, medication, or both.
At Auckland Physiotherapy, we recognize the emotional challenges of living with RA and can connect you with appropriate mental health resources when needed.
With modern medication management, many people with RA never require surgery. However, surgery may be considered when joint damage causes severe pain or functional limitation despite optimal medical treatment, joint instability creates safety concerns, or severe deformity significantly impacts quality of life.
Common surgical procedures for RA include joint replacement (hip, knee, shoulder), synovectomy (removing inflamed joint lining), tendon repair or reconstruction, and hand and wrist procedures to improve function.
Importantly, even when surgery is necessary, research shows that prehabilitation—physiotherapy and exercise before surgery—improves surgical outcomes. Postoperative physiotherapy is also crucial for optimal recovery and function.
Effective RA management requires coordination among multiple healthcare providers. Your team typically includes a rheumatologist managing medications and overall disease control, a physiotherapist addressing physical function and exercise, your general practitioner for overall health management, and potentially occupational therapists for workplace and daily activity adaptations, dietitians for nutritional guidance, and mental health professionals for psychological support.
At Auckland Physiotherapy, we function as part of your RA care team, communicating with your rheumatologist and other providers to ensure coordinated, comprehensive care.
Your RA management plan should include:
While receiving an RA diagnosis can be frightening, it's important to know that treatment has advanced dramatically in recent decades. With early, appropriate treatment, most people with RA can achieve good disease control, maintain physical function, continue working and enjoying activities, and live full, active lives.
The key is taking an active role in your care—adhering to medications, participating in physiotherapy and exercise, making lifestyle modifications, attending regular appointments, and communicating openly with your healthcare team about symptoms and concerns.
If you've been diagnosed with rheumatoid arthritis or are struggling to manage your symptoms, Auckland Physiotherapy can help. We specialize in evidence-based RA management, working alongside your rheumatologist to optimize your physical function and quality of life.
We provide:
Don't let rheumatoid arthritis limit your life. With the right treatment approach combining medication management, physiotherapy, and lifestyle modifications, you can achieve good disease control and maintain your quality of life.
Contact Auckland Physiotherapy today:
Visit www.aucklandphysiotherapy.co.nz or call to book your comprehensive rheumatoid arthritis assessment. Let us help you develop a personalized management plan that addresses your specific needs and goals.
Remember: rheumatoid arthritis is a manageable condition. With early diagnosis, appropriate treatment, and your active participation in care, you can live well with RA. Take the first step toward better management today.
The information provided in this blog is for educational purposes and should not replace professional medical advice. Rheumatoid arthritis requires medical management by a rheumatologist. Always consult with your healthcare providers regarding your specific treatment needs. If you experience severe joint swelling, fever, or signs of infection, seek immediate medical attention.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
Starting a new sport is exciting—whether you're taking up tennis to enjoy Auckland's outdoor courts, joining a local football club, trying CrossFit for the first time, or preparing for your first half-marathon. The anticipation of learning new skills, improving fitness, and connecting with like-minded people drives thousands of New Zealanders to begin new sporting activities each year. However, enthusiasm alone doesn't guarantee a successful, injury-free experience. At Auckland Physiotherapy, we frequently see individuals whose sporting journeys are cut short by preventable injuries that could have been identified and addressed through pre-participation physiotherapy screening.
The question "Should I see a physio before starting a new sport?" doesn't have a universal answer—it depends on various factors including your age, previous injury history, fitness level, and the demands of your chosen activity. This comprehensive guide explores the evidence behind pre-participation physiotherapy assessments, identifies who benefits most, explains what to expect during a sports screening, and provides practical advice for starting your new sporting endeavour safely and successfully.
Research consistently demonstrates that structured pre-participation assessments identify risk factors for sports injuries, and when combined with targeted interventions, significantly reduce injury rates.
A landmark systematic review published in the British Journal of Sports Medicine analysed multiple studies examining injury prevention programs. The research found that neuromuscular training programs based on screening assessments reduced overall injury risk by approximately 35%, with lower limb injuries showing even greater reductions of up to 50%.
Additional research in The American Journal of Sports Medicine demonstrated that athletes who underwent pre-season screening and received corrective exercises for identified deficits experienced 52% fewer injuries compared to control groups who didn't receive interventions.
The Scandinavian Journal of Medicine & Science in Sports published findings showing that functional movement screening followed by targeted exercise programs reduced injury rates in recreational athletes by 46% over a competitive season.
Pre-participation physiotherapy assessments identify:
Biomechanical Risk Factors:
Physical Deficits:
Previous Injury Sequelae:
Individual Risk Factors:
Once identified, these factors can be addressed proactively through targeted exercise programs, manual therapy, education, and graduated training protocols—preventing injuries before they occur rather than treating them after the fact.
While pre-participation screening benefits everyone, certain groups gain particularly significant advantages and should prioritize physiotherapy assessment.
If you've experienced sports injuries, accidents, or chronic pain conditions, physiotherapy screening is essential before beginning new activities.
Why this matters: Previous injuries often leave residual deficits even after pain resolves. Research shows that individuals with previous ankle sprains, for example, have a 70% increased risk of re-injury without proper rehabilitation and screening. ACL reconstruction patients who return to sport without addressing strength and movement deficits face re-injury rates of 20-30%.
What we assess:
Common injuries requiring pre-sport screening:
At Auckland Physiotherapy, we frequently identify persistent deficits in patients who believe they've fully recovered. A runner who sprained their ankle six months ago might still have 20% strength deficit in their calf muscles and proprioceptive deficits—setting them up for re-injury without proper rehabilitation.
Age-related physiological changes affect injury risk and require thoughtful preparation when beginning new sports.
Physiological changes with aging:
Why screening helps: Physiotherapy assessment identifies age-related limitations and creates appropriate training progressions that challenge you safely while allowing adequate adaptation time. We help distinguish between normal age-related changes and problematic dysfunctions requiring intervention.
Evidence: Research in the Journal of Science and Medicine in Sport found that adults over 40 who received pre-participation screening and graded exercise programs had significantly fewer injuries and better long-term adherence to new sports compared to those who started without professional guidance.
Sports requiring particular attention for older beginners:
Moving from swimming, cycling, or yoga to running, basketball, or CrossFit represents a significant change in musculoskeletal demands.
The challenge: While you may have excellent cardiovascular fitness from cycling or great flexibility from yoga, these qualities don't automatically transfer to handling impact forces or explosive movements. Your bones, tendons, and joints need gradual exposure to new loading patterns.
What happens without proper progression: Enthusiastic beginners often do "too much, too soon," overwhelming tissues' adaptive capacity. This leads to common overuse injuries including:
How physiotherapy helps: We assess your readiness for increased loading, identify any deficits that might increase injury risk, and create progressive training plans that safely bridge the gap between your current activities and your new sport's demands.
Example scenario: A 35-year-old woman who's been cycling for years wants to start running. While her cardiovascular fitness is excellent, physiotherapy screening reveals weak hip abductors and limited ankle dorsiflexion—both risk factors for running injuries. Addressing these through targeted exercises before beginning a run-walk program significantly reduces her injury risk.
Certain medical conditions require professional guidance to ensure safe sports participation.
Conditions benefiting from pre-sport physiotherapy:
The physiotherapy role: We work collaboratively with your GP or specialist, understanding medical considerations while assessing physical readiness. We help you choose appropriate sports, modify activities when necessary, and create safe progression plans respecting your health conditions.
Important note: Always consult your GP before starting new vigorous exercise if you have chronic health conditions. Physiotherapy assessment complements but doesn't replace medical clearance.
If you've been sedentary or minimally active, professional guidance prevents common beginner mistakes and builds a foundation for long-term success.
Why beginners benefit:
Common beginner issues we address:
Research support: Studies show that sedentary individuals beginning exercise programs with professional guidance have significantly better adherence rates and fewer injuries compared to those attempting self-directed programs.
Changing sports or moving from multi-sport participation to sport-specific training creates new physical demands requiring assessment.
Why this matters: Different sports load the body differently. A swimmer transitioning to volleyball needs to develop landing mechanics and explosive power. A runner taking up tennis requires lateral movement capabilities and upper body strength. Previous sport experience doesn't automatically transfer to new demands.
Youth athletes specializing: Increasingly, young athletes specialize early in single sports. While developing sport-specific skills, they may develop imbalances from repetitive, one-sided loading patterns. Physiotherapy screening identifies these imbalances and implements corrective strategies alongside sport training.
Research concern: Early sport specialization without adequate screening increases injury risk. The British Journal of Sports Medicine reports that specialized youth athletes have higher injury rates than multi-sport athletes, particularly overuse injuries from repetitive loading patterns.
Understanding what to expect helps you prepare and maximizes the value of your assessment.
Your physiotherapist begins by understanding your complete health and activity history:
Questions we ask:
This information contextualizes your assessment and helps us understand your specific situation and needs.
We observe how you move through various functional tasks, identifying movement quality, compensations, and risk factors.
Common screening components:
Squat Assessment:
Single-Leg Balance and Stability:
Lunge Patterns:
Upper Body Movements:
Sport-Specific Movements:
Research-validated screening tools: Auckland Physiotherapy utilizes evidence-based assessment frameworks including the Functional Movement Screen (FMS), Y-Balance Test, and sport-specific functional assessments proven to identify injury risk factors.
Objective measurements quantify your physical capabilities and identify specific deficits.
Strength assessment:
Flexibility evaluation:
Bilateral comparison: We always compare left and right sides. Research shows that strength differences greater than 10-15% between limbs significantly increase injury risk, particularly for knee and ankle injuries.
Passive and active range of motion testing identifies restrictions that might limit performance or increase injury risk.
Key areas assessed:
Joint quality: We assess not just range of motion but also joint quality—whether movement is smooth, controlled, and pain-free, or whether restrictions, clicking, or discomfort suggests underlying issues.
Static and dynamic posture assessment reveals patterns affecting movement efficiency and injury risk.
What we evaluate:
Why posture matters for sport: Poor postural habits from desk work or daily life don't disappear during sport—they influence movement patterns, create compensations, and increase injury risk. Addressing postural dysfunction improves both daily comfort and sporting performance.
For sports with significant cardiovascular demands, we may assess your current fitness level to inform training recommendations.
Assessment methods:
Important: Physiotherapy cardiovascular screening identifies functional capacity for training planning. It doesn't replace medical cardiac screening required for some individuals (discussed with your GP).
The assessment concludes with comprehensive discussion of findings and collaborative planning.
What we cover:
Individualized exercise program: You'll receive a personalized program targeting your specific needs. This might include:
Written summary: We provide written documentation of findings and recommendations you can reference as you begin your new sport.
Financial considerations influence healthcare decisions. Let's examine the economics of pre-participation physiotherapy.
A comprehensive pre-sport physiotherapy assessment at Auckland Physiotherapy typically costs $80-150 depending on assessment complexity and duration. Follow-up treatment sessions, if needed, range from $70-100 per session.
Average scenario:
Consider the potential costs of sports injuries that could have been prevented:
Direct medical costs:
Indirect costs:
Average cost of common sports injuries:
If pre-sport physiotherapy reduces your injury risk by even 30-50% (consistent with research findings), the expected value calculation strongly favors the initial investment. Preventing even one moderate injury more than pays for comprehensive pre-participation screening and preparation.
The value extends beyond pure economics:
Many New Zealand health insurance policies cover physiotherapy consultations with some providers offering full or partial coverage. Check your policy details and consider that preventive consultations may qualify differently than injury treatment. ACC covers injury-related physiotherapy but typically not pre-participation screening (as it's preventive rather than treating an existing injury).
While professional assessment is ideal, practical or financial constraints might delay physiotherapy consultation. If you're starting your sport without formal screening, follow these evidence-based guidelines to minimize injury risk.
The most common mistake causing beginner injuries is excessive early enthusiasm—doing too much, too soon.
The 10% rule: Increase weekly training volume by no more than 10%. If you run 10 kilometers this week, run no more than 11 next week. This guideline, while somewhat conservative, allows tissues time to adapt.
Progressive overload principles:
Poor movement patterns performed repeatedly create injury risk. Master proper technique before increasing training loads.
How to learn proper technique:
Even without formal screening, general strength and flexibility training reduces injury risk across almost all sports.
Universal beneficial exercises:
Lower Body Strength:
Core Stability:
Upper Body (If Relevant):
Mobility and Flexibility:
Frequency: Perform 2-3 strength sessions and daily mobility work alongside your sport-specific training.
Appropriate equipment significantly influences injury risk.
Footwear considerations:
Sport-specific equipment:
Adequate preparation and recovery reduce injury risk.
Effective warm-up (10-15 minutes):
Cool-down protocol (10 minutes):
Learn to distinguish normal training soreness from potential injury.
Normal: Mild muscle soreness 24-48 hours after exercise, symmetric between sides, doesn't affect movement quality, improves with warm-up
Concerning: Sharp or severe pain, pain localized to specific points, pain that worsens during activity, swelling or bruising, pain limiting normal movement, asymmetric pain
Action: If you experience concerning symptoms, reduce activity and consult a physiotherapist before continuing. Early intervention prevents minor issues from becoming major problems.
If you've already started your sport without initial screening, it's never too late to seek physiotherapy assessment. In fact, assessment after 4-6 weeks of training can identify issues emerging from your specific training patterns, allowing targeted intervention before injuries develop.
Different sports create unique demands and injury patterns. Here's guidance for popular Auckland sports:
Common injuries: Plantar fasciitis, shin splints, Achilles tendinopathy, patellofemoral pain, IT band syndrome, stress fractures
Key screening focuses:
Critical preparation: Build running volume gradually over 8-12 weeks before attempting longer distances or speed work.
Common injuries: Tennis elbow, rotator cuff problems, ankle sprains, lower back pain, knee injuries
Key screening focuses:
Critical preparation: Develop rotational power and lateral movement capabilities before competitive play.
Common injuries: Lower back injuries, shoulder problems, knee pain, wrist injuries, muscle strains
Key screening focuses:
Critical preparation: Master fundamental movement patterns with light loads before progressing to higher intensities or complex movements.
Common injuries: Ankle sprains, ACL tears, hamstring strains, shoulder dislocations, concussions
Key screening focuses:
Critical preparation: Develop neuromuscular control for jumping, landing, and direction changes before full-intensity participation.
Common injuries: Swimmer's shoulder, neck pain, lower back pain, knee problems (breaststroke)
Key screening focuses:
Critical preparation: Build training volume gradually (similar to running) and ensure proper stroke technique.
Common injuries: Knee pain, lower back pain, neck pain, nerve compression issues, saddle-related problems
Key screening focuses:
Critical preparation: Professional bike fitting prevents most cycling-related overuse injuries.
Pre-participation physiotherapy isn't just about preventing immediate injuries—it's about establishing foundations for lifelong physical activity and health.
Early professional guidance helps you develop movement awareness and body literacy that benefits all future activities. Learning to move well, recognize your body's signals, and understand proper progression principles creates habits supporting decades of active living.
Minor injuries inadequately addressed often lead to compensatory patterns causing secondary injuries. The runner who doesn't fully rehabilitate an ankle sprain develops knee pain from altered gait mechanics. The tennis player working through shoulder discomfort develops neck problems. Early intervention prevents these cascading issues.
Addressing limitations early accelerates skill development. The golfer who improves thoracic rotation learns proper swing mechanics faster. The runner who strengthens hip stabilizers develops more efficient stride patterns sooner. Better movement foundations enable faster skill acquisition.
Starting a new sport with professional support builds confidence. Understanding your body's capabilities, knowing you've addressed risk factors, and having a clear progression plan reduces anxiety and increases enjoyment—the key factor determining long-term participation.
The assessment process teaches self-awareness and proactive health management. You learn to recognize warning signs, understand the importance of maintenance exercises, and develop habits of addressing small issues before they become major problems—skills valuable far beyond your new sport.
Should you see a physio before starting a new sport? For many people—particularly those with previous injuries, over 40, transitioning between activity types, managing health conditions, or moving from sedentary lifestyles—the answer is a clear yes. The evidence strongly supports pre-participation screening as an effective injury prevention strategy that provides excellent value relative to the costs of treating preventable injuries.
Even for individuals without obvious risk factors, professional assessment offers significant benefits: identifying hidden limitations, optimizing movement patterns, creating tailored preparation programs, and building confidence for your new sporting journey.
At Auckland Physiotherapy, we're passionate about helping people start new sports safely and successfully. We've seen too many enthusiastic beginners sidelined by preventable injuries, and we know the frustration of being unable to participate in activities you're excited about. Our comprehensive pre-sport assessments provide the foundation for safe, enjoyable, long-term participation in the sports and activities that enrich your life.
Whether you're a 25-year-old beginning CrossFit, a 45-year-old returning to netball, a 60-year-old taking up lawn bowls, or anywhere in between, professional guidance optimizes your experience. The relatively modest investment in pre-participation screening pays dividends in reduced injury risk, faster skill development, greater confidence, and more enjoyment.
Your body is the vehicle through which you experience sport and physical activity. Investing in its preparation, understanding its capabilities and limitations, and addressing issues proactively creates the optimal conditions for a successful sporting journey. Don't let preventable injuries steal your enthusiasm and sideline your goals—start your new sport with the professional guidance that sets you up for success.
Ready to start your new sport safely and confidently? Visit www.aucklandphysiotherapy.co.nz to book your pre-sport physiotherapy assessment with Auckland's experienced team. We'll identify your strengths, address any risk factors, and create a personalized plan preparing you for success in your chosen activity. Don't wait for injury to happen—invest in prevention and start your sporting journey the right way.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
For runners and active individuals in Auckland, your feet are your foundation. They absorb impact forces up to three times your body weight with every running stride and provide the base for all weight-bearing activities. Despite their crucial role, feet often receive inadequate attention until pain or injury forces the issue. At Auckland Physiotherapy, we understand that proper foot care is essential for maintaining an active lifestyle and preventing common running injuries.
The human foot contains 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments working in coordination. During running, your feet undergo a complex sequence of movements: heel strike, pronation, midstance, supination, and toe-off. This intricate biomechanical process occurs thousands of times during a typical run, making foot health paramount for injury prevention.
Research published in the British Journal of Sports Medicine indicates that approximately 50% of runners experience foot and ankle injuries annually. Many of these injuries are preventable through proper foot care, appropriate footwear, and addressing biomechanical issues early.
Proper footwear is your first line of defence against foot injuries and discomfort.
Key considerations:
Evidence: A study in the Scandinavian Journal of Medicine & Science in Sports found that runners who changed shoes regularly experienced fewer injuries than those who continued using worn footwear beyond recommended mileage.
Toenail problems are surprisingly common among runners and can sideline training if neglected.
Best practices:
Common issues: Black toenails (subungual haematoma) occur when repetitive trauma causes bleeding under the nail. While often painless, they can indicate shoes that are too small or lacing that's too tight.
Modern footwear often leads to weak intrinsic foot muscles. Strengthening exercises improve foot function, stability, and injury resistance.
Effective exercises:
Toe Spreading:
Towel Scrunches:
Single-Leg Balance:
Arch Doming (Short Foot Exercise):
Research insight: A 2020 study in the Journal of Orthopaedic & Sports Physical Therapy demonstrated that runners who performed foot-strengthening exercises experienced significant improvements in arch height and reduced injury rates.
Adequate foot and ankle mobility enables proper movement mechanics and reduces compensatory strain on other structures.
Key stretches:
Plantar Fascia Stretch:
Calf Stretches (Gastrocnemius and Soleus):
Ankle Circles:
Toe Flexor Stretch:
Friction, moisture, and heat create the perfect environment for blisters and fungal infections.
Prevention strategies:
Auckland climate consideration: Auckland's humid subtropical climate increases moisture-related foot problems. Extra vigilance during summer months prevents fungal infections and maceration.
Sudden increases in training volume or intensity overwhelm your feet's adaptive capacity, leading to stress injuries.
Safe progression principles:
Evidence: Research in the American Journal of Sports Medicine found that runners who increased weekly mileage by more than 30% had significantly higher injury rates, with foot and ankle injuries being most common.
Early intervention prevents acute problems from becoming chronic conditions.
Common running foot injuries:
Plantar Fasciitis:
Metatarsalgia:
Morton's Neuroma:
Stress Fractures:
Achilles Tendinopathy:
While not necessary for everyone, custom orthotics can address specific biomechanical issues contributing to foot pain and injury.
When orthotics may help:
Important note: At Auckland Physiotherapy, we thoroughly assess whether orthotics are necessary or if strengthening, mobility work, and appropriate footwear can address your issues. Over-reliance on orthotics without addressing underlying weakness can sometimes perpetuate problems.
Proper preparation and recovery protocols reduce injury risk and enhance performance.
Effective warm-up:
Cool-down protocol:
Tissue adaptation and strengthening occur during recovery, not during exercise.
Recovery strategies:
Massage and Self-Myofascial Release:
Ice After Hard Efforts:
Elevation:
Adequate Sleep:
Nutrition and Hydration:
While these self-care strategies form the foundation of foot health, professional physiotherapy assessment offers significant advantages for runners and active individuals.
Auckland Physiotherapy services include:
Comprehensive Biomechanical Assessment:
Individualised Treatment Plans:
Education and Prevention:
Advanced Interventions When Necessary:
Consult a physiotherapist at Auckland Physiotherapy if you experience:
Auckland's unique environment presents specific considerations for foot care:
Varied Terrain:
Climate Factors:
Urban Running:
Integrate these practices into a comprehensive routine:
Daily:
After Each Run:
Weekly:
Monthly:
Your feet carry you through thousands of kilometres of running and countless hours of activity. Investing time in proper foot care prevents injuries, enhances performance, and ensures long-term participation in the activities you love. These evidence-based strategies provide a foundation for maintaining healthy, resilient feet throughout your running journey.
Remember that foot care is not just reactive—addressing problems after they arise—but proactive, implementing preventive strategies before injuries develop. By combining appropriate footwear, progressive training, strengthening exercises, and professional guidance when needed, you create the optimal environment for foot health and athletic success.
For personalised assessment, treatment, or advice on maintaining optimal foot health for your active lifestyle, the experienced team at Auckland Physiotherapy is here to help. We provide evidence-based care tailored to your individual needs, goals, and activities.
Keep your feet healthy and your running strong. Visit www.aucklandphysiotherapy.co.nz to book your foot assessment with Auckland's trusted physiotherapy experts today.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
As summer approaches in New Zealand, many Aucklanders are eager to return to their favourite outdoor sports and activities. Whether you're preparing for beach volleyball, cricket, tennis, or touch rugby, optimal mobility and joint health are essential for peak performance and injury prevention. At Auckland Physiotherapy, we understand that proper preparation can make the difference between an enjoyable summer season and time spent on the sidelines.
Mobility refers to your joints' ability to move freely through their full range of motion. Good mobility enables efficient movement patterns, reduces injury risk, and enhances athletic performance. During the cooler winter months, many people experience decreased activity levels, leading to joint stiffness and reduced flexibility. This makes pre-summer conditioning crucial for safe sports participation.
Research consistently demonstrates that structured exercise programs improve joint health, reduce injury rates, and enhance sports performance. A systematic review published in the British Journal of Sports Medicine found that neuromuscular training programs reduced sports injuries by approximately 35% across various athletic populations.
This fundamental yoga-based movement enhances spinal flexibility and engages core stabilisers.
How to perform:
Benefits: Improves thoracic and lumbar spine mobility, essential for rotational sports like cricket, golf, and tennis.
Hip mobility is crucial for running, jumping, and change-of-direction movements common in summer sports.
How to perform:
Benefits: Addresses hip internal and external rotation, reducing strain on knees and lower back during sports activities.
Ankle mobility is often overlooked but critical for balance, agility, and injury prevention.
How to perform:
Benefits: Reduces risk of ankle sprains and improves performance in sports requiring quick direction changes like netball and touch rugby.
Thoracic mobility is essential for overhead activities and rotational movements.
How to perform:
Benefits: Improves shoulder function and reduces neck and lower back compensation during throwing and overhead sports.
Strong, functional glutes are fundamental for lower body power and joint protection.
How to perform:
Benefits: Strengthens the posterior chain, reducing knee and lower back injury risk while improving running and jumping performance.
Balance training enhances joint stability and neuromuscular control.
How to perform:
Benefits: Improves ankle, knee, and hip stability, reducing injury risk in sports requiring balance and agility.
Shoulder health is paramount for swimming, tennis, cricket, and any overhead activities.
How to perform:
Benefits: Enhances shoulder blade movement and stability, preventing rotator cuff injuries and improving overhead performance.
Lateral movements challenge mobility and strength in often-neglected movement planes.
How to perform:
Benefits: Develops lateral stability and hip mobility crucial for sports involving side-to-side movement like tennis and squash.
This dynamic movement addresses multiple joints simultaneously.
How to perform:
Benefits: Combines hip flexor stretching, thoracic rotation, and ankle mobility in one efficient movement.
Core stability protects your spine and enhances force transfer during athletic movements.
How to perform:
Benefits: Develops anti-rotational core strength essential for all sports, particularly those involving throwing, hitting, or kicking.
The optimal approach combines these exercises into a structured routine performed 3-4 times weekly for 4-6 weeks before intensive sports participation. Research suggests that injury prevention programs are most effective when implemented consistently over this timeframe.
Sample Weekly Schedule:
At Auckland Physiotherapy, our experienced physiotherapists provide individualised assessments to identify mobility restrictions, strength imbalances, and injury risk factors specific to your chosen sport and body. Professional physiotherapy guidance offers several advantages:
Movement Screening: Identifies specific limitations requiring targeted intervention.
Personalised Programming: Tailors exercises to your individual needs and sport requirements.
Technique Coaching: Ensures proper exercise execution for maximum benefit and safety.
Progression Planning: Systematically advances your program as your capacity improves.
Injury Management: Addresses existing niggles before they become season-ending problems.
Avoid the "weekend warrior" syndrome by gradually increasing training volume and intensity. The 10% rule—increasing weekly activity by no more than 10%—provides a safe guideline for progression.
Mobility and joint health require adequate recovery between sessions. Incorporate rest days, proper sleep (7-9 hours), and nutrition to support tissue adaptation.
While these exercises provide an excellent foundation, sport-specific training should complement general mobility work. A physiotherapist can help design sport-specific drills that transfer directly to performance.
Joint health depends on proper hydration. Cartilage contains approximately 80% water, and dehydration can impair joint lubrication and increase injury risk. Aim for adequate fluid intake, especially during Auckland's warmer summer months.
Consult a physiotherapist at Auckland Physiotherapy if you experience:
Preparing your body for summer sports through targeted mobility and joint health exercises significantly reduces injury risk while enhancing performance. These ten evidence-based exercises provide a comprehensive foundation for safe and successful sports participation throughout the Auckland summer season.
Remember that consistency matters more than intensity when building mobility and joint health. Start your preparation now, and you'll be ready to enjoy your favourite summer sports with confidence and reduced injury risk.
For personalised assessment and treatment plans tailored to your specific needs and sports goals, contact Auckland Physiotherapy. Our team of qualified physiotherapists serves the Auckland community with evidence-based care designed to keep you active, healthy, and performing at your best.
Ready to prepare for summer sports? Visit www.aucklandphysiotherapy.co.nz to book your pre-season physiotherapy assessment today.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
Gift-giving occasions throughout the year—birthdays, Christmas, Mother's Day, Father's Day, anniversaries, or simply showing appreciation—often leave us searching for meaningful presents that go beyond material possessions. In an era where health and wellbeing have become paramount, wellness gifts offer lasting value that extends far beyond the unwrapping experience. At Auckland Physiotherapy, we believe the most meaningful gifts invest in someone's long-term health, mobility, and quality of life.
Unlike traditional gifts that may end up forgotten or unused, health-focused presents provide tangible benefits supported by scientific evidence. Whether you're shopping for an active athlete, someone recovering from injury, a stressed professional, or an elderly parent, evidence-backed wellness gifts demonstrate thoughtful care while contributing to genuine improvements in physical and mental health.
Research consistently demonstrates that experiences and health investments provide greater long-term satisfaction than material possessions. A landmark study published in the Journal of Positive Psychology found that experiential gifts create more lasting happiness and strengthen relationships between givers and recipients compared to material items.
Health-focused gifts offer multiple benefits:
Long-lasting Impact: Unlike physical items that depreciate or become outdated, wellness gifts contribute to ongoing health improvements.
Personalised Care: Shows you understand and care about the recipient's specific health needs or goals.
Preventive Investment: Addresses health proactively rather than reactively, potentially preventing future problems.
Stress Reduction: Many wellness gifts provide relaxation and stress management benefits backed by research.
Encouragement: Motivates recipients to prioritise self-care and wellbeing.
Gift vouchers for physiotherapy treatments at Auckland Physiotherapy provide professional care tailored to individual needs.
Why physiotherapy makes an excellent gift:
Physiotherapy addresses a wide range of conditions through evidence-based treatment approaches. Recipients might use vouchers for:
Scientific support: Systematic reviews in the Cochrane Database demonstrate physiotherapy's effectiveness for numerous musculoskeletal conditions, with manual therapy and exercise therapy showing significant benefits for pain reduction and functional improvement.
Perfect for:
Auckland Physiotherapy advantage: Our experienced physiotherapists provide comprehensive assessments, hands-on treatment, personalised exercise programs, and ongoing support tailored to each individual's goals.
Clinical Pilates combines traditional Pilates principles with physiotherapy expertise, offering low-impact exercise focused on core strength, flexibility, and body awareness.
Evidence-based benefits:
Research published in the Journal of Orthopaedic & Sports Physical Therapy demonstrates that Pilates significantly reduces chronic low back pain and improves functional disability. Additional studies show benefits including:
What makes Clinical Pilates different:
Unlike general Pilates classes, Clinical Pilates is:
Ideal recipients:
Gift options: Consider class packages (5, 10, or 20 sessions) allowing recipients to develop consistent practice and experience progressive benefits.
Professional therapeutic massage offers both immediate relaxation and cumulative health benefits when received regularly.
Evidence-based therapeutic effects:
Research in the International Journal of Neuroscience and other peer-reviewed journals demonstrates that massage therapy:
Types of therapeutic massage:
Remedial Massage:
Sports Massage:
Relaxation Massage:
Best suited for:
Consideration: Pair massage vouchers with a note encouraging regular sessions for maximum benefit, as research shows cumulative effects with consistent treatment.
A professional movement assessment identifies biomechanical inefficiencies, strength imbalances, and injury risk factors before problems develop.
What's included:
At Auckland Physiotherapy, comprehensive assessments evaluate:
Why this matters:
Many people develop compensatory movement patterns from previous injuries, lifestyle factors, or muscular imbalances. These inefficiencies often go unnoticed until pain or injury occurs. Early identification enables corrective intervention, preventing problems before they impact quality of life.
Research support: Studies in the British Journal of Sports Medicine demonstrate that movement screening combined with targeted intervention significantly reduces injury rates in athletic populations.
Ideal for:
Added value: Recipients receive detailed findings, personalised exercise programs addressing identified issues, and ongoing support implementing recommendations.
Dry needling, when performed by qualified physiotherapists, effectively treats muscular trigger points and myofascial pain.
Evidence-based mechanism:
Research demonstrates dry needling:
A systematic review in the Journal of Orthopaedic & Sports Physical Therapy found significant short-term pain reduction from dry needling for various musculoskeletal conditions.
Common applications:
Perfect for:
Important note: Dry needling should always be performed by qualified healthcare professionals as part of comprehensive treatment plans, not as standalone therapy.
Modern lifestyles, particularly desk-based work and device usage, contribute to postural dysfunction affecting millions of New Zealanders.
The problem:
Extended sitting, forward head posture, and rounded shoulders create muscular imbalances leading to:
The solution:
Structured posture correction programs at Auckland Physiotherapy include:
Evidence base: Research in the Journal of Physical Therapy Science demonstrates that multimodal posture correction programs significantly improve forward head posture and reduce associated pain.
Ideal recipients:
Supervised strength training provides fundamental health benefits supported by extensive research.
Why strength training matters:
Evidence demonstrates that regular resistance training:
Research in the American Journal of Preventive Medicine found that strength training 2-3 times weekly reduced all-cause mortality risk by 23%.
Professional programming advantages:
Programs designed by physiotherapy-trained professionals ensure:
Ideal for:
Gift idea: Package sessions with an introductory assessment, personalised program design, and initial supervised sessions teaching proper technique.
Falls represent a significant health concern, particularly for older adults, with one in three New Zealanders over 65 experiencing falls annually.
Evidence for prevention:
Cochrane systematic reviews demonstrate that structured exercise programs, particularly those including balance training, reduce fall rates by approximately 24% in older adults.
Program components:
Effective fall prevention programs include:
Beyond elderly populations:
Balance training benefits everyone:
Thoughtful gift for:
Modern wearables provide data-driven insights encouraging healthy behaviors.
Evidence-based benefits:
Research in JAMA found that wearable activity trackers increased physical activity by approximately 1,800 steps daily.
Sleep quality profoundly impacts health, with research linking poor sleep to numerous chronic conditions.
Evidence-backed sleep gifts:
Studies demonstrate that sleep hygiene improvements significantly enhance sleep quality and daytime functioning.
Digital mindfulness resources provide accessible mental health support.
Research findings:
Gift subscriptions to evidence-based apps like Headspace, Calm, or Insight Timer provide year-round mental health support.
Nutrition fundamentally impacts health outcomes across all body systems.
Why this matters:
Gift options:
Equipment enabling outdoor exercise provides both physical and mental health benefits.
Research-backed benefits of outdoor activity:
Ideas for Auckland's environment:
Consider these factors when selecting health-focused presents:
Recipient's Current Health Status:
Personal Interests and Preferences:
Time Availability:
Physical Capabilities:
Budget Considerations:
Wellness gifts suit all budgets:
Encourage recipients to fully utilize their gifts:
Initial Consultation:
Consistent Commitment:
Open Communication:
Integration:
When gifting services from Auckland Physiotherapy, recipients receive:
Qualified Professionals:
Comprehensive Care:
Convenient Access:
Evidence-Based Approach:
In an era where material possessions often provide fleeting satisfaction, wellness gifts offer lasting value by investing in someone's most important asset—their health. Whether you choose physiotherapy treatments, Clinical Pilates classes, therapeutic massage, or comprehensive wellness packages, these evidence-backed services demonstrate genuine care while providing tangible benefits extending far beyond the gift-giving occasion.
The beauty of health-focused gifts lies in their ripple effects: improved mobility enhances daily activities, reduced pain increases life enjoyment, better stress management improves relationships, and increased strength supports independence throughout aging. By gifting wellness services, you're not just providing a single experience but potentially catalyzing long-term positive health changes.
This holiday season, or for any gift-giving occasion, consider moving beyond traditional material presents toward meaningful investments in the health and wellbeing of those you care about. The recipients of wellness gifts may not immediately realise the profound impact of your thoughtful selection, but as they experience improvements in pain, mobility, stress, or overall function, they'll appreciate the lasting value of your genuine care.
Give the gift of health and wellbeing. Visit www.aucklandphysiotherapy.co.nz to purchase gift vouchers for physiotherapy, Clinical Pilates, massage, and comprehensive wellness packages. Contact our team to discuss customized gift options tailored to your recipient's specific needs and goals.
Housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera
Excessive Yawning: Your Body is Trying to Tell You Something
We all yawn—but when yawning becomes constant, it might be more than just tiredness. Your body has clever ways of telling you something isn’t quite right, and excessive yawning is one of them.
The Science Behind the Yawn:
Yawning is often linked to nervous system regulation. It can help:
But yawning isn’t always just about needing a nap! It can also signal breathing pattern dysfunction. If your breathing is too fast, shallow, or irregular, your body might be trying to correct your oxygen and carbon dioxide balance—hence the yawns.
When It’s Just Your Nervous System:
Sometimes, yawning is a simple way your nervous system regulates itself. Stress, tension, or changes in alertness can trigger it.
When It’s a Breathing Signal:
Excessive yawning can indicate:
In these cases, yawning is your body’s subtle alarm bell, nudging you to check in with your breathing habits.
What You Can Do:
Closing:
Yawning isn’t just a cute quirk—it’s your body speaking. Listen, understand, and respond. Your breath is more powerful than you think!
For more information check out our breathing disorder page or book a complimentary call with our Breathing Physio Niamh.
Auckland Physiotherapy is housed in the beautiful Foundation Precinct, sandwiched in-between Newmarket, Parnell & Remuera.
