Are Your Headaches Coming From Your Neck?

Do you suffer from headaches?

Headaches can be a very painful and frustrating thing to live with. Whilst there are many different types of headaches which people may suffer from, 1 of the most common forms which we as physiotherapists treat here at Bodyfocus are.. Cervico-genic headaches or neck headaces

In essence…

Cervico-genic headaches originate from any joint, ligament, muscle or disc dysfunction within the neck (cervical spine), particularly in the upper section. 

A dysfunction in any of these areas can trigger pain signals that travel to your trigeminocervical nucleus (TCN) in your brainstem. This information is then transmitted into your brain and interpreted as a headache (Bogduk 2003). 

Research tells us that upto 22% of all headaches stem from the neck.

What are the 3 main causes of Cervico-genic headaches?

  1. Neck joints too stiff – not moving enough
  2. Neck joints too loose – too much movement
  3. Locked up joints or compressed due to poor posture

Your physiotherapist is an expert in the assessment and correction of neck joint dysfunctions that result in neck headache. Their professional diagnosis and treatment is essential for neck headache sufferers.

What are the Symptoms of Neck Headache?

Neck headaches are very often misdiagnosed or confused with other types of headache, including migraine, since the location of the pain is typically felt in the same area as a migraine. 

Only after careful consideration of all of the examination findings as well as the history obtained, can your physiotherapist confirm a neck headache diagnosis

Commonly, neck headache sufferers will usually notice:

  • Tenderness at the top of their neck and base of the skull. 
  • Neck stiffness or a mild loss of movement, although this is sometimes is only subtle and needs to be confirmed during your physiotherapist’s physical examination.

One of the main differences between neck headache and migraine is that physiotherapy treatment of your neck is able to alter or relieve your headache immediately.

Common Characteristics of a Neck Headache?

The following symptoms are characteristics of a neck headache. You may experience any one or several of these symptoms:

  • Your headache may seem to radiate from the back to the front of your head.
  • Your headache is provoked or eased by a neck movement, a sustained posture, stomach sleeping or with your head turned to one side.
  • Your headache normally appears to be worse on one side of your head. The side is normally constant and does not swap sides.
  • Your headache appears to temporarily ease up when you apply pressure or you massage your neck or the base of your skull.

If you experience any of the above symptoms, you are more likely than not to be suffering a neck headache. Please inform your physiotherapist and they will assist you.

What if Your Neck Isn’t Sore?

Even if your neck isn’t sore or painful, you can still experience neck headaches. It is important to remember that your neck joints may NOT be sore at REST, but they may be tender to touch or painful on movement. 

Neck joints that are sore at rest will normally be very tender to touch and painful at the extreme of movement. Obviously, this scenario is a more severe neck headache.

If your headache or a migraine has been present for years and your neck has not been examined, then a thorough neck examination is recommended and is appropriate to either confirm and treat your neck headache or exclude a neck disorder as the cause of your headache.

Some of the risk factors for developing neck related headaches are..

  • You work in an office in front of a computer for more than 5 hours per day
  • You have poor sitting posture
  • You don’t exercise
  • You are stressed
  • Your workstation is not ergonomically setup

So, if you suffer from headaches and have any one of these risk factors, then there is a good chance your headaches are stemming from your neck.

To find out if physiotherapy can help with your headaches, get in touch with us and let us know that you need help with your headache and one of our friendly staff will arrange a Free Headache Assessment for you.

Prevent Running Injuries – Tips From A Physio

Running is a great form of exercise, recreation, and sport participation for adults, adolescents, and children. Whether alone or in a team environment, running, when done properly, can enhance physical fitness, coordination, sense of accomplishment and physical and emotional development. However,
running under adverse conditions or with inadequate clothing and equipment can cause a variety of injuries and physical stress.


Runner Holding Knee

Signs that you may be injured or need to alter or stop your running include:
• Pain or discomfort while running
• Pain at rest
• Inability to sleep
• Limping
• Easily experiencing shortness of breath (exercise asthma)
• Stiffness
• Headaches during or after running
• Dizziness or lightheaded feeling any time

Running injuries in kids are relatively common and
may include:
• Knee injuries – kneecap pain, tendonitis
• Lower leg pain – shin splints, stress fractures, calf problems
• Foot and ankle injuries- ankle sprain, heel pain, plantar fasciitis (bottom of foot pain), toe injuries
• Pelvic and hip injuries- muscle pulls, growth plate stress injuries, tendonitis, groin pain, buttock pain
• Heat injuries – sunburn, dehydration, heat exhaustion, stroke
• Skin injuries – blisters or heat rash

Pushing through pain just makes the problem worse, which will keep you from running for a long time. Stopping when there is a problem and correcting it gets you back running again in the shortest, safest amount of time. Whenever there is a problem, contact your doctor immediately for proper diagnosis and treatment. Most of the time, problems are easily fixed if attended to quickly.


Young athletic Asian women stretching outdoors in a public park.

Planning Goals
• Talk about running with a coach, athletic trainer, knowledgeable adult runner, or running organization
• Children and parents should consistently discuss the goals of the running program
• Determine the reason (goal) you are running (e.g. fitness, recreation, training, competition)
• Develop a running plan and strategy that is compatible with your goal and your current level of fitness
• Set safe, achieveable goals and advance slowly and cautiously
Preparing to Run
• Hydrate (drink water) well in advance
• Stretch for five minutes before beginning
• Speed up slowly
Proper Running Attire
The local running store is a good place to start and ask
questions. It’s important to remember the following:
• Lightweight, breathable clothing prevents perspiration buildup and allows for better body heat regulation
• Running hats, head covers, and ear covers shield the sun but allow temperature regulation – they are also
excellent for cold weather to avoid frostbite
• Proper fitting and proper thickness of socks help avoid blisters and irritation
• Proper shoes with good support arches should fit well and be comfortable
• Inspect your shoes before running: if they have worn thin or are angled, purchase new shoes
• Orthotic shoe inserts (commercial off-the-shelf or
custom-made) are especially valuable for people with flat feet, high-arched feet, unstable ankles, or foot problems

Safe Locations and Times to Run
• Flat ground is more gentle on the body than hills
• Avoid steep hills
• All-purpose track surfaces (high school track) are ideal – especially for beginners
• Stay in well-lit areas (e.g., schools, public streets).
• Always run with a partner (preferably a teen or parent)
• A parent should always know:
– where you are running
– when you are running
– how far you are running
– with whom you are running
– when you expect to be back
– when you are finished
• Use a bag to carry a cell phone with you
• Avoid using headphones, especially if you are running on the street, so you can hear traffic and
warning sounds

Safe Weather Conditions
Children and adolescents cannot tolerate the weather extremes that adults can, making them more susceptible to heat and cold injuries. Prevent heat illnesses (e.g. sunburn, dehydration, exhaustion) or cold injuries (frostbite) by monitoring the weather conditions.
Avoid running if:
• Temperatures are over 32 degrees CELSIUS
• Humidity levels are high
• Temperatures are cold or freezing

Sports Tips provide general information only and are not a substitute for your own good judgement or consultation with a physiotherapist or doctor.

Shockwave Therapy Can Heal Your Stubborn Injury Fast

Shock Waves are movements of extremely high pressure caused by, for example, an explosion, an earthquake or a plane breaking the sound barrier.

Extracorporeal Shock Wave Therapy (ESWT) is the application of Shock Waves in medicine.Screen Shot 2017-01-17 at 10.51.59 pm

It is clinically proven that pressure waves, when applied to injured tissues, stimulate metabolic reactions:

  • Reduction of pain felt by nerve fibers
  • Increase of blood circulation in surrounding soft tissues
  • Beginning of healing process triggered by stem cells activation

How The Human Body Reacts To Shockwaves


Screen Shot 2017-01-17 at 10.53.58 pm

Red chili peppers contain capsaicin. At first this substance overwhelms the so-called C nerve fibers responsible for transmitting pain but then disables them for an extended period of time.
Everybody knows the feeling – first, the mouth is on fire, then it feels completely numb.

Research has indicated that shock wave therapy works the same way.1 When activated, the C nerve fibers release a specific substance (substance P) in the tissue as well as in the spinal cord. This substance is responsible for causing slight discomfort during and after shock wave treatment. However, with prolonged activation, C nerve fibers become incapable for some time of releasing substance P and causing pain2

Less substance P in the tissue leads to reduced pain, but there is more: less substance P also causes so-called neurogenic inflammation to decline3

A decline in neurogenic inflammation may in turn foster healing – together with the release of growth factors and the activation of stem cells in the treated tissue4

We are please to announce that we have just taken delivery of our own SWISS DOLORCLAST® 

Shockwave machine and now offer this state of the art treatment from our Rhodes clinic location.

We can now treat many stubborn injuries in as little as 3 sessions.

Call our clinic today on 8732 8888 or alternatively click Book Online to arrange your consult.



1 Maier et al., Clin Orthop Relat Res 2003; (406):237–245.

2 In addition, shock waves activate the so-called Aδ nerve fibers (sensory afferent nerve fibers from the periphery) via receptors in the tissue.
According to Melzack and Wall’s gate control theory (Science 1965; 150:971–979) these activated Aδ fibers then suppress the conduction of pain in the second-order neuron of the sensory pathway in the dorsal horn of the spinal cord.

3 The release of substance P, CGRP (calcitonin gene-related peptide) and other inflammation mediators from afferent nerve fibers is generally referred to as “neurogenic inflammation” (Richardson and Vasko, J Pharmacol Exp Ther 2002; 302:839–845). It is also linked to the pathogenesis of tendinopathies such as tennis elbow and plantar fasciitis (Roetert et al., Clin Sports Med 1995; 14:47–57; LeMelle et al., Clin Podiatr Med Surg 1990; 7:385–389).Shock wave treatment causes a drop in substance P and CGRP in the tissue (Maier et al., 2003; Takahashi et al., Auton Neurosci 2003; 107:81–84).

4 Shock waves in the treated tissue lead to a stronger expression of growth factors such as BMP (bone morphogenetic protein), eNOS (endothelial nitric oxide synthase), VEGF (vascular endothelial growth factor) and PCNA (proliferating cell nuclear antigen) as well as to an activation of stem cells
(Wang CJ, ISMST Newsletter 2006, Vol. 1, Issue 1; Hofmann et al., J Trauma 2008; 65:1402–1410).

What Is Scoliosis? How Does It Affect You? How Physio Can Help You.

Scoliosis is an abnormal curve of the spine towards the side of the body. The spine naturally has curves in the back and neck when viewed from the side, but with scoliosis, a curve in the spine will be seen if viewed from the front or back.

In general, the more severe the curve in the spine, the more likely it is to create symptoms. Double curves, or “S” curves, may worsen more than a single curve, or a “C” curve. The curve in the spine has less chance of worsening if the bones are mature, or have stopped growing. The cause of scoliosis is often unknown, but it affects girls more than boys. Sometimes scoliosis is present at birth, and it may develop from a nervous system issue such such cerebral palsy. The growth period during puberty (between age 9-15) is a common time when scoliosis can develop.


Common symptoms of scoliosis include back pain, muscle weakness in the spine, and uneven heights of the shoulders and pelvis. Other symptoms can include difficulty breathing and spine or nerve injury. The symptoms may limit activities, and often affect self-esteem. Surgery may be a part of your treatment plan if the spinal curve is severe.

Physiotherapy can help manage the symptoms, pain, and challenges such as difficulty breathing which occur from the changes in the rib cage position. Therapy can teach you stretches, strengthening, and use hands-on techniques to help loosen your tissues and strengthen the muscles of your spine.


Headaches are a very common complaint seen in our society. Unfortunately, not all headaches are alike. In fact, there are literally dozens of different types of headaches found in the available literature. One type of headache which physiotherapists commonly treat is the cervicogenic headache. A cervicogenic headache is a specific type of headache caused by a neck injury or disorder, such as whiplash, a concussion or simply poor posture.

There are 2 types of structures in the neck which can produce this headache.

1. Muscular Structures


Your head is connected to your neck and upper back by many muscles. Large muscles such as the splenius and the trapezius attach to the base of the skull. Beneath the splenius and trapezius are smaller muscles, called the rectus capitis posterior and scalenes that also help support and move the head. When the head is in a more forward position, it pulls on the muscles in the neck and creates unnatural tension. With a cervicogenic headache, pain is felt in the head from a source in the neck. Continuous tension in the neck muscles can lead to pain commonly associated with a cervicogenic headache.

2. Articular Structures


The cervical spine is made up of 7 vertebrae, stacked upon each other. C1-7. Each vertebrae articulate with each other via the facet joints in the rear and the intervertebral disc in the front. It is well documented that the upper 3 cervical vertebrae and with their associated facet joints can be the source of headache. It is thought that poor postures and trauma can produce irritation and stiffness in the facet joints, resulting in referred pain to various parts of the head. Cervicogenic headache is an example of referred pain, which is pain felt in a part of the body other than its true source. Cervicogenic headaches often occur on one side of the head, and typically cause pain around the eyes, the forehead, and the temples.


A physiotherapist can help ease headaches by alleviating any excessive muscle tension, educating you on healthy posture, advice on work modification, restoring mobility to stiff cervical facet joints, re-strengthening the supporting muscles of your neck and providing you with a tailored neck flexibility program of stretches. Some of the treatments may include massage, cervical joint mobilisation, dry needling, traction and exercise using biofeedback.

By Oscar Yildirim – Physiotherapist



Is My Body Healthy? Tips on Maintaining Good Health


Is your body healthy?

In this day and age, the way we perceive our own health is largely driven by our cultural influences. From fitness gurus and media to doctors, friends, family, and lastly google. We all have preconceptions about what it means to be fit and healthy. Most of the time, pain tends to be our marker for health and numbers for fitness. We’ve accepted any loss of flexibility, coordination or balance as simply age related changes after high school and as long as we’re doing our jobs without pain we assume we must be healthy. Read more

How To Avoid Painful Weekend Warrior Injuries




oscar updated pic

By Oscar Yildirim
Principal Physiotherapist at Bodyfocus Physiotherapy & Sports Injury Clinic

It’s important to be physically active, and avoid injuries at the same time. This is especially important for a ‘weekend warrior’. If you are sedentary, it’s extremely important to plan ahead in order to avoid exercise-related injuries. After all, the human body cannot go from ‘inactive’ mode to ‘weekend warrior’ mode in an instant.

Exercise intensity must be progressive; otherwise the risk for injury increases. After all, professional athletes prepare for months (sometimes years) to reach a certain level of physical performance. Athletes prepare their bodies for months during the off-season, as they prepare their body for an intense season. Weekend warriors tend to bypass ‘preparation’ and jump right into intense activity.

Common injuries include joint inflammation, muscle tears, and ligament sprains.  Most injuries can be treated with Physiotherapy after the acute symptoms have subsided. In severe cases, surgery might be needed. Read more







By Oscar Yildirim – Principal Physiotherapist at Bodyfocus Physiotherapy & Sports Injury Clinic

Pain in the front of the knee is a very common problem that physiotherapists frequently treat. The most common type of frontal knee pain is Patello-Femoral Pain Syndrome (PFPS). Patients will describe an ache around the knee cap (patella) region which is commonly brought on by running, squatting and stair climbing. The actual area of  pain may vary amongst patients, with some describing their pain on the inside (medially) and some describing their pain on the outside (laterally). Read more

Surprising Truths About Degenerative Disc Disease

Degenerative disc disease, despite the name, is not a disease but a deterioration of the discs of the spine. It occurs over a period of time, resulting in neck or back pain and other musculoskeletal and neurological symptoms. It is common in adults in their thirties.


Types of degenerative disc disease

  1. Cervical: affects the neck and is referred to as cervical degenerative disc disease
  2. Lumbar: affects the lower back and is called lumbar degenerative disc disease

The cervical and lumbar regions of the spine are susceptible to damage due to increased movement capabilities. Constant motion over time results in the wear and tear of the discs.

Signs and Symptoms of DDD

Most patients report one or more of the following symptoms.

  • Pain is triggered by an activity
  • Pain flares up periodically and then settles to a low-grade pain/discomfort
  • Sitting or standing for long periods of time worsen the pain
  • Activities such as walking may alleviate the pain
  • Relief upon changing body position
  • Muscle spasms
  • Tingling sensations in the extremities

Any activity that triggers pain in the neck or lower back should be ceased immediately. If there is no relief with rest, consult with a physical therapist. Early intervention could save you from further damage to the disc, muscles and ligaments.

Management of Degenerative Disc Disease

Physical therapies such as physiotherapy and chiropractichelps treat the underlying factors such as the instability of the intervertebral joints and the associated inflammation. Your physician may recommend prescription medication to provide relief. Once the pain is reduced, specific exercises and specialized therapeutic techniques are utilized to achieve lasting relief.

Treatment falls into one of the following three categories:


  • Pain control with acetaminophen, prescription medications, narcotics, etc.
  • Nonsteroidal anti-inflammatory medication (NSAID, steroid injection etc.)

Surgical (if required)

  • Fusion of the discs
  • Replacement of the damaged disc with an artificial disc

Conservative (Physiotherapy or Chiropractic)

  • Exercise: Progressive controlled exercises under supervision. These include stretching, strengthening and low-impact aerobics.
  • Lifestyle modification: Improved posture and movement patterns reduce stress on the spine. Ergonomically designed chairs can also relieve pressure on the spine.
  • Joint mobilization / manipulation
  • Self-care including weight management, treatment of depression, etc.

A Stronger Spine

Prevention Tips

Poor posture, especially in a sitting position, can cause bone and joint issues over time. If your job is sedentary it is important to:

  • Perform stretching exercises at regular intervals.
  • Invest in footwear to reduce stress on the lower back
  • Adjust the height of your desk chair and computer to minimize strain on your neck and lower back. (Come to our office for an evaluation and we will identify the most appropriate height for you).

Physiotherapy and Chiropractic interventions may include:

  • Strengthening
  • Postural retraining
  • Ergonomic intervention
  • Use of modalities including electrical stimulation for muscle reeducation will improve blood circulation to the affected region and reduce pain by facilitating the release of endorphin (pain relief chemicals naturally produced by the body). The long-term goal is to reestablish range of motion over time and assist in recovery.
  • Core re-strengthening exercises
  • Spinal joint mobilization / manipulation
  • Gym based exercise program

Call us today to learn more about what physical therapy can do for you.