Physiotherapy

Physiotherapy

Physiotherapists are ACC registered health care providers that have undergone four years of specialty training in their field.  They use proven techniques to help restore movement and function to anyone affected by an injury, disability or health conditions.

Our Bespoke Physiotherapists use their in-depth knowledge of how the body works, combined with hands-on clinical skills to thoroughly assess, accurately diagnose and effectively treat your symptoms. We pride ourselves in delivering the highest possible level of quality care and we work hard to ensure you are fully equipped with the right tools to independently manage your body in the future. Our priority is to get you back to living your best life!

Physiotherapy is beneficial to people of all ages and abilities. It is helpful during times of pain, injury and dysfunction however the service can also be well utilised in a prevention space to reduce the risk of injuries from arising in the first place. Our expert knowledge allows us to address a range of complex and chronic injuries effectively.

We stand by our exceptional physiotherapy service, and we also expect results. If things are not progressing as well or as quickly as we believe they should, we will refer our patients on to ensure they get the level of care they need. This process can include direct referral to radiology outfits for further imaging to confirm the injury diagnosis such as X-rays and Ultrasounds. We can also arrange for a referral to be sent one of the many talented general practitioners, sports specialists or orthopaedic surgeons for a second opinion.

Please check out the menu below for a more in-depth description of how our Bespoke Physiotherapists can get you back to doing the things you love.

At your initial physiotherapy appointment, our Bespoke Physiotherapists will listen to your story and find out how your injury is affecting you. We will ask in-depth questions about your past medical history, current health status, physical function and we will discuss your personal health goals. We do ask that you bring any medical correspondence you have with you to your initial appointment – including a list of your current medications and any reports/referrals you have from GPs or specialists.

Following on from our initial subjective assessment, we will commence a thorough physical examination using diagnostic tests and evidence-based measures to help us find the root cause of your problem. This will include a biomechanical assessment, strength testing, flexibility testing and functional movement screening. We do ask that you wear appropriate clothing that will make it easy for us to assess your injured area.

Once we have completed our assessment, we will use this information to diagnosis your injury. We will work with you to ensure you have a sound understanding of your diagnosis, what your expected recovery time frames are and what your health care plan will involve ensuring you achieve your goals and reach your full health potential.

From here we get stuck into your treatment and let the magic unfold!

The emphasis at your initial physiotherapy session is to collect all of the information required to make an accurate diagnosis of your problem. At the end of your initial assessment, there is usually a small block allocated towards your treatment. At your follow up appointments, due to the initial information already being collected, we will spend more time on your physiotherapy treatment and get you set up on your rehabilitation plan.

Our Bespoke Physiotherapists are extremely qualified and offer a wide range of treatment interventions specifically tailored to your unique health care needs.

Common treatment modalities we use at Bespoke Physiotherapy and Health include manual therapy (hands on treatment), joint mobilisation, joint manipulation, stretching, myofascial release, massage, dry needling, acupuncture, trigger point release, exercise therapy, cupping, strength training, proprioceptive retraining and neuromuscular training to name a few.

At Bespoke we are very passionate about arming you with the tools you need to effectively self-manage your body in the future which is why you will often go home with some homework in the form of a rehabilitation program. We want you to reach your full health potential, sustain long term outcomes and not be dependent on our therapists for a passive quick fix. As a patient, you are only with our Bespoke therapists for a small amount of time relative to the time you spend out of the clinic living your life. Therefore, it is fundamental to your optimal recovery that you are adherent to the customised program that your physiotherapist prescribes. This program will often include a range of stretches, proprioceptive and strengthening exercises. Your program will be progressed and modified over the course of treatment to ensure your improvements do not plateau.

We may also call on other members of our amazing Bespoke Tribe to work collaboratively with if we feel their skills and expertise can play a part in accelerating your recovery. This could include working in with our personal trainers, nutritionist and massage therapists or by attending our yoga or Pilates classes.

If you have any questions about the treatments we provide or would like any further information, please do not hesitate to drop us line.

At Bespoke we believe that good things take time which is why we encourage all of our initial appointments to be 45 minutes or longer. This enables us to spend the time with you to ensure we can gain a thorough understanding of your condition and how it affects you, confirm your diagnosis, educate you on your condition, complete a referral for further imaging if required and get you set up on your unique Bespoke Health Care Plan. For the more complex and chronic injuries, we do recommend a 60 minute initial assessment.

Our follow up appointments range from 30 minutes to 60 minutes and the length of these depends on the complexity of your injury and what is going to be covered on the session. Your Bespoke Physiotherapist will let you know what appointment time would best suit your needs.

Our experienced team of Bespoke Physiotherapists treat an array of acute and chronic conditions including those arising from the muscular system, nervous system, pain systems, skeletal system and ligamentous system. We also treat and manage workplace injuries and repetitive strain injuries along with providing pre and post-surgery care plans to ensure each and every patient reaches their full health potential.

Our physiotherapists are very passionate about workplace ergonomics and reducing work related injuries and they can provide you with the most current, evidence-based workplace set up guidelines. We can also organise off site workplace visits, where we can assess you operating in your workplace, implement changes to reduce your injury risk and provide your company with a full report on the modifications that we have made.

At Bespoke, we also treat people without any conditions! We do movement screening and biomechanical assessments to identify potential injury risk factors and specifically tailor health care plans aimed at minimising these risks and enhancing your functional performance.

All of our physiotherapists are highly trained in concussion management. We have received training in the SCAT concussion assessments and have the capacity to complete individual and team base lines assessments. We guide our concussion patients through a graduated program to get them back into the work force and back into their sport safely. We strongly recommend all of our athletes participating in contact sports to have an annual baseline concession test. Our Bespoke Tribe have a close working relationship with Sports Doctors, Specialists and Occupational Therapists in the Bay of Plenty area and can refer on for additional services and support as required.

If you would like further information on how Bespoke Physiotherapy can assist you on your health journey, please do not hesitate to give us a call.

Your physiotherapist will need to sight the injured area, so we ask that you please wear clothing that allows for this and is easy to manoeuvre. We do provide shorts, singlets and robes for your convenience. If you are uncomfortable with revealing your injured body part to the physiotherapist – please let them know.

Your physiotherapist may also ask to see your footwear or sporting equipment if they believe it could be related to your injury. Some of our physiotherapy sessions may also include a rehabilitation or strengthening block to be completed in our onsite, fully equipped gym. Your physiotherapist will give you the heads up if this is required and you will need to bring work out gear, a sweat towel and appropriate training shoes.

Many studies have shown superior post-operative outcomes when physiotherapy is included both before and after orthopedic surgery. By visiting one of our Bespoke Physiotherapists prior to your surgery, we will complete a thorough assessment of your function, pain, joint movement, muscle flexibility and muscle strength. We will then prescribe a tailored exercise programme and health care plan to ensure we get your body in its best possible condition leading into your surgery which favours more desirable post-surgery outcomes. Our Bespoke therapists will educate you about what happens during your surgery, what the expected outcomes are and what your recovery time frames look like.

Following your surgery, one of our talented Bespoke Physiotherapists will guide you through your full return to function plan which will be directed by your personal goals and desired outcomes. Along the way, we will liaise with your surgeon and/or specialist to ensure we have a good understanding of their post operative requirements and protocols.

Your post-operative rehab will move through different phases based on your function and time since the surgery.  Initially your care plan will consist of range of motion exercises and gentle stretches, followed by muscle activation and strengthening exercises and then your return to sport, running or specific work-related exercises. It is up to the physiotherapist to progress you through your rehab and also to make sure you are meeting the specific requirements that are set by your surgeon. If there are any complications that arise, we can liaise with your surgeon directly and arrange a follow up appointment for you.

N.B. Please remember to check with your insurance company or ACC before you start driving as you may not be insured if you have an accident.

At Bespoke Physiotherapy and Health, our physiotherapists have expertise working with children of all ages and abilities.

Skeletal growth in children occurs at a phenomenal rate from childhood into adolescence which often gives rise to children experiencing growth related pains and dysfunction. Some of these growth-related problems resolve spontaneously with time however a number of them require further support to ensure your child makes a complete return to play and sport.

Physiotherapy management in this age group often includes education around correct warm up and warm down procedures, self-management strategies, activity modification, load management, stretching and strengthening exercises.

We can lodge ACC claims directly from Bespoke Physiotherapy and Health therefore you no longer have to be referred to physiotherapy by your GP.

ACC will contribute towards the costs of your physiotherapy treatment if you have sustained an injury secondary to an accident as long as your claim is lodged within 12 months of the accident occurring. If your claim is lodged outside of the 12 months of your accident occurring, ACC may need to contact you to collect more information regarding your claim. The ACC no faults scheme provides cover to all people in New Zealand, including international visitors as long as they have sustained their injury since they arrived in New Zealand.

Your physiotherapist will be able to provide further clarity in regard to whether your injury is ACC related or not at your initial appointment.

ACC will not cover injuries related to gradual overuse or those related to the natural aging process (ie degenerative conditions such as osteoarthritis). For further detail on ACC’s No Faults Scheme, please refer to the ACC Website www.acc.co.nz

Massage Therapy

Massage Therapy

Busy lives, poor sitting postures, hectic work schedules, sports participation and significant life events can lead to annoying aches and pains, cause headaches and limit your productivity.

Our talented Bespoke massage therapists are dedicated to providing you with the right type of massage to suit your needs. Whether you’re looking to relieve stress, reduce muscle tightness, relieve discomfort, enhance performance, or just to relax, we have got you covered.

Our massage therapists have extensive experience and have completed a wide range of post graduate training so rest assured, you are in good hands. Throughout the duration of your massage, your therapists will use a variety of techniques best suited to your condition. These techniques may include deep tissue mobilisation, trigger point release, Swedish massage, myofascial release, relaxation, soft tissue mobilisation, lymphatic drainage and passive stretching.

Massage therapy has been proven to relax tight muscles, sooth aches and pains, increase blood flow and assist in restoring our bodies balance and efficiency.

If you are working with another member of our Bespoke Tribe, with your permission, they can liaise directly with our massage therapists to ensure you get the most out of each session.

If you are new to Bespoke Physiotherapy and Health, we request that you please arrive 5-10 minutes before your appointment time to complete a patient registration and consent form.

At the commencement of your appointment, you will be warmly greeted by our massage therapist at the reception and they will take you into the massage therapy room. They will ask you questions around your injury history as appropriate along with your expected outcomes from the appointment and may perform some movement tests. Based on this information, they will tailor the style of massage to suit your unique needs and you will be advised on your massage therapy treatment plan. Please feel free to discuss any concerns or raise any questions you may have.

The massage therapist will then leave the room whilst you get undressed to your underwear (pending on what part of your body you are having massaged) and position yourself on the massage table. The massage therapist will return to the room when you are ready and your massage will begin.

Massage is a very personal experience and we aim to make you as comfortable as possible throughout the duration of your appointment. During your massage you will be appropriately gowned with towels with the exception of the area that the massage therapist will be working on. There is also the option to remain fully clothed however the effectiveness of your massage therapy may be reduced. Throughout the appointment, your massage therapist will be asking for your feedback on the pressure they are providing – please be open and honest in regards to your pressure preference. Should you have any concerns with the gowning or dressing procedure – please let your massage therapist know prior to your treatment starting.

Our massage appointments range from 30-90 minutes. When you confirm your massage appointment, you will be asked to confirm the length of time you would like to be massaged for.

If further massages are required, your massage therapist will guide you through the recommended frequency and duration of any subsequent appointments.

No, unfortunately massage is not an accredited modality within ACCs framework so the full cost of the appointment will need to be meet by the patient.

Lymphatic Massage – also known as manual lymphatic drainage (MLD) – is a specialized and gentle massage technique used to increase lymph flow and encourage the natural drainage of the lymph from the body tissues. It is a very safe and effective technique that is useful for many conditions where lymph flow may be compromised, such as lymphedema, swollen limbs caused by a variety of different things, in diabetics, sports injuries, post surgical, etc. For example, many clients require lymphatic therapy or lymphatic massage to treat the increased swelling and lymph accumulation that occurs after a mastectomy, or other surgical procedures, especially those where lymph nodes may be removed or damaged.

The lymphatic system relies on intrinsic contractions of the cells that line the walls of the lymph vessels, as well as the contraction and movement of skeletal muscles, to propel lymph through the vessels and to the lymph nodes. From the these nodes the lymph travels to the lymph ducts, which return the lymph to the cardiovascular system. Manual lymph drainage uses a small amount of pressure (<9 oz per square inch) and rhythmic movements to stimulate lymph flow

Manual Lymph Drainage (MLD) is a safe, effective, yet gentle approach to cleansing the body’s tissues. MLD drains excess fluid from the tissues and also has a detoxifying effect. It is beneficial to healthy individuals, and can be used to effectively treat a variety of different conditions.

The benefits of lymphatic therapy are many:

  • removal of metabolic wastes, excess water, toxins, bacteria, large protein molecules and foreign substances from the tissues.
  • through its gentle rhythmical and precise hand movements, lymphatic therapy works to alleviate pain by greatly reducing then pain signals sent to the brain.
  • relaxation of the sympathetic nervous system, thus helping to relieve stress.
  • supports and enhances the immune system
  • promotes healing from injuries, surgical trauma, chronic conditions, and edema
  • minimizes scar formation.
Personal Training

Personal Training

At Bespoke Physiotherapy and Health, our personal trainers work closely with all other members of our Bespoke Tribe to ensure you achieve your goals and get back to living your best life.

Your personal trainer will complete a full body assessment and discuss your goals to ensure your program is specifically tailored to suit your unique needs. The personal training sessions take place in our onsite rehabilitation gym which features brand new cardio and strength training equipment along with tidy changing room facilities. Your personal trainer will work with you on a weekly or fortnightly frequency or as requested. We find that having a personal trainer is incredibly valuable as they are able to critique you exercise technique and progress your program as you go. Our Bespoke clients find that having someone check in with them really helps them with accountability and keeps them on track which is often a key driver for them achieving their goals.

Bespoke Physiotherapy and Health offers a range of different personal training options. These include one on one training, couples personal training sessions, small group sessions and corporate training sessions.

The cost for each of these very depending on the number of people and duration of each session. For a specific quote, please contact our reception team with your full details and we can put together a package that best suits your needs.

Yoga

Yoga

At our Bespoke Movement Studio, we offer vinyasa and slow flow yoga.

We cater to all levels and abilities. Our main goal is to create an empowered, healthy and mindful community or workplace.

In a Vinyasa class, you will move in a flowing sequence from one pose to another with your breath. There will be music played in the background helping you find your natural rhythm. This will include building heat, strength, balance and flexibility to ensure you walk away feeling present and refreshed. This is for all levels as a range of options will be given.

Our slow flow yoga classes are run as a restorative class with an emphasis on prolonged stretching, breathwork and slow flowing sequences.

 

All of our yoga classes have a limit of 12 clients per class in order to ensure we can deliver a quality service. Our smaller classes enable our instructors to navigate around everyone in the class to ensure adequate progressions are given and that your technique is flawless.

Mainly just yourself! We encourage wearing comfortable clothing to our yoga classes as you will be coached into a range of various poses and positions. All mats, yoga blocks and stretching belts will be provided at each class. You are more than welcome to bring your own yoga equipment if desired.

Due to all of our yoga and mat Pilates classes being limited to 12 clients – booking is a must to ensure you secure a spot. We do also ask that if you are unable to attend a class that you have booked that you let us know at your earliest convenience so that other clients can attend in your absence. We have a range of various booking options ranging from casual one off classes to concession cards.

All of the Bespoke Classes will start on the advertised start time. We recommend arriving to your class 5-10 minutes before the start time. This will allow you time to get changed at our onsite changing facilities and get yourself set up prior to the class starting. It will also allow you to have a quick chat to the yoga instructor if you have any ailments that may hinder you during the class. It is important to keep your instructor up to date so they can provide suitable regressions to particular poses and positions as required. If you are seeing one of our Bespoke therapists – with your permission, they will be able to advise the instructor on your behalf.

Yes private classes and corporate packages are available on request. These classes can be run both onsite at the Bespoke Head Quarters or off site as required. Please contact the Bespoke Admin team if you require any further information on our Bespoke private sessions.

Pilates

Pilates

The term Pilates refers to a series of dynamic exercises that were developed in the early 20th Century by Joseph Pilates. The practice involves the use of the whole body through a range of controlled movements targeted to improve posture, core stability, muscular strength, endurance, balance, flexibility and breathing as well as assisting in injury recovery and prevention.

Pilates is believed to have a positive effect on both the mind and body. The movements in Pilates focus on strengthening the deep stabilising muscles of the torso, hips and shoulder girdle, enabling flawless movement and excellent body awareness. Evidence supports the use of the Pilates method in both the prevention and rehabilitation of common musculoskeletal injuries.

Pilates is for anyone who wants to move with grace and confidence whilst improving their physical health and well-being. Each of our Pilates’s classes are highly supervised and tailored towards the unique health needs of the clients in each class. There is a range of progressions and regressions for each movement, enabling a range of ages, sizes and abilities to enjoy all of the benefits Pilates has to offer.

At Bespoke Physiotherapy & Health, we offer both Reformer Pilates and Mat Pilates classes.

“The Pilates Method of Body Conditioning is gaining the mastery of your mind over the complete control over your body”
– Joseph Pilates

Reformer Pilates

The reformer is the most popular Pilates apparatus designed by Joseph Pilates, and it makes a dramatic impression when you first see it, and an even more dramatic change in your body when you use it! The machine consists of a carriage that moves back and forth along tracks within a bed-like frame. The carriage is attached to one end of the reformer by a set of springs which provide a variety of difference resistance levels as the carriage is pushed or pulled along the frame. The reformer also features long straps with handles that are attached to the top end of the frame which can be pulled with the legs or arms to move the carriage, resulting in a functional full body work out which is sure to get your heart rate elevated. Reformer Pilates is one of the most effective ways to tone your entire body from the inside out. Our low-impact classes are perfect for any age, fitness level and body. Our effective, small group Reformer Pilates classes utilise the spring-controlled resistance on the machines along with your body weight to provide a more challenging strength and endurance workout.

Mat Pilates

Mat Pilates is an excellent starting point to improve movement efficiency and address any physical imbalances. It is also slightly lower in intensity relative to our Reformer Pilates classes. In our Mat Pilates classes, you will be taken through a series of different exercises which have been specifically designed to be performed on a mat. Our Mat Pilates classes can also involve the use of Pilates rings, resistance bands and balls. The exercises in our Mat Pilates class are performed in a slow, controlled and precise manner. The exercises are targeted to help strength the body’s core by developing both pelvic and scapular stability with abdominal control and focused breathing patterns. The main goals of our Mat Pilates program are to improve your flexibility, increase your muscle tone, enhance your balance and improve your mind-body awareness.

Our mat Pilates classes are limited to 10 clients per class to ensure we can deliver a high-quality class. Smaller numbers enable our instructors to circulate the class, provide feedback to clients and appropriately progress or regress exercises as appropriate.

Our reformer studio features seven reformers.

We encourage you to wear comfortable clothing as you will be getting into a wide array of poses and positions in your Pilates classes.

Socks are mandatory for all of our reformer Pilates classes. We have a wide range of men’s and women’s Move Active grip socks available for purchase for $21.50 a pair.

Bookings are essential for all of the Bespoke Classes. Our numbers in our classes are limited so booking ensures that you have a spot available. You can book classes on our online booking platform or alternatively you can email or call the clinic. Due to the high demand for our classes, we require a minimum cancellation notice of four hours prior to the class commencing.

If the class is full – we do have a waitlist option. Should someone in the class cancel, you will be alerted via email and our Gymmaster app if you have been bumped up into the class.

We strongly encourage all clients who are new to reformer classes to book in for a private 1 on 1 consultation prior to doing a class.

This 1 on 1 will cover the basic Pilates movements. Our instructors will refine your technique to ensure you are using the correct muscles and they will teach you how to adjust the reformer. To book your 1 on 1, please click here.

Following your private session – our Bespoke instructor will be able to let you know what classes would be most suitable for you.

All of our Bespoke classes run to time. We recommend arrive to your class 5-10 minutes prior to your class commencing. This will provide you with ample time to get changed at our onsite changing facilities and get yourself set up and ready for the class. Arriving early also gives you the opportunity to meet our instructors and discuss any ailments you have with them to ensure they provide adequate progressions and regressions based on your needs. If you are seeing one of our Bespoke Therapists, with your consent, they can also let the instructor know of any limitations you may have on your behalf.

Yes, private classes and corporate packages are available on request. These classes can be run both onsite at the Bespoke Clinic or off site as required. Please contact the Bespoke Admin team if you require any further information on our Bespoke private sessions.

Acupuncture and Dry Needling

Acupuncture and Dry Needling

Acupuncture is a needling technique that stems from Chinese Medicine and has been used all over the world for the last 2500 years. Historically acupuncture has been considered as a form of alternative medicine however over the last 10 years it has grown in popularity and acceptance within the Western Medicine Model. There is a growing body of literature that supports the effectiveness of acupuncture in common musculoskeletal injuries and pain pathologies. Acupuncture is the practice of inserting very fine, disposable needles into the body to elicit a physiological change. There are over 400 Acupuncture points in the body which lie on traditional meridian channels. Although we use the same Acupuncture points as traditional Chinese practitioners, our physiotherapists apply a different theory to its use. Traditional Chinese Practitioners select their acupuncture points based on energy “qi” imbalances within the body’s meridian channels. Our physiotherapists use Western acupuncture, where they apply their knowledge of anatomy and pathophysiology to select the appropriate points with the aim of reducing inflammation, promoting tissue healing, improving blood flow, modulating pain pathways, improving muscle flexibility and enhancing overall function.

Dry Needling

Dry needling is a Western Acupuncture technique that we utilise to release myofascial trigger points, commonly known as knots. A knot or trigger point is defined by a localised area of tenderness and small palpable nodules which presents within a taut band of muscle tissue. Trigger points can occur for a multitude such as stress, tissue damage, injury and muscle overload. The side effects of trigger points include muscle soreness, stiffness, pain and dysfunction.

Dry needling is a technique we use at Bespoke to reduce trigger points within tight muscle tissue with an aim of reducing pain and stiffness and enhancing muscle function. We use the same fine needles that are used during acupuncture treatment, however, the application is not the same. The key difference with dry needling is that the needle placement is determined by palpation of the muscle opposed to the pre-defined acupuncture points.

Your Bespoke physiotherapist will use their palpation skills along with your feedback to localise the myofascial trigger points. Once the knots have been localised a very fine needle is inserted directly into the trigger point and stimulated until a number of involuntary muscle twitches have occurred. The insertion of the needle into a trigger point stimulates a local twitch response, where there is a rapid contraction and relaxation within the taut band that is being needled. When this occurs, there is an increase in blood flow to the tight area, a reduction in pain sensitivity and an increase in muscle length. This phenomenon is often associated with discomfort, and it is normal to experience a residual ache in the muscles for a few hours following your dry needling session. Once the initial aching from the needling wears off, the muscle pain should be significantly lower, and your movement should be much freer.

Don’t hesitate to ask your therapist should you have any further questions or require more information around the dry needling technique.

Our physiotherapists will complete a thorough assessment and discuss with you whether acupuncture is going to be an effective intervention. Based on their assessment findings and your diagnosis, they will select the appropriate acupuncture points. The total number of needles used could range from 1 through to 20. If the acupuncture points are over the surface of a joint, an anti-bacterial solution will be applied in order to minimise infection risk in the joint. The very thin needles are then inserted into the body as various depths and are left in for up to 30 minutes. Within this time, the therapist may twist or flick the needle to increase the stimulation. The insertion of the acupuncture needle is usually fairly comfortable with most patients experiencing a small prick followed by a sense of heaviness or dullness during the session. Very rarely will acupuncture be completed as a standalone intervention. Our physiotherapists will often use acupuncture as an adjunct to their treatment, along with manual therapy and exercise prescription. All of the needles in our practice are clean, single use, disposable needles therefore any risk of infection is incredibly minimal.

Shockwave Therapy

Shockwave Therapy

Shockwave therapy has been utilised in Western Medicine since the 1980s where it was first introduced to treat kidney stones and other urological disorders. Over the last 20 years, the technology has improved dramatically. Shockwave therapy is now being used by physicians, orthopaedic surgeons and physiotherapists all around the world to treat musculoskeletal conditions.

Shockwave treatment is supported by clinical studies affirming its healing and reparative effects on the body, with over 80% of patients experiencing complete resolution of pain. Our Bespoke extracorporeal shockwave machine is the top of the range and has come from BTL in Europe, one of the worlds leading medical manufacturers.

How does it work

Shockwave is an acoustic wave which carries high energy to painful areas in musculoskeletal tissue. The energy values of shockwave are low enough to deliver gentle therapy, but high enough to promote physiological changes and trigger a healing response. The energy in the machine is created by transferring compressed air under large pressure into the applicator. The kinetic energy of the air is then pushed at high speed against the transmitter, generating high-energy-peak acoustic waves. Upon contact with the skin, these acoustic waves penetrate the tissue non-invasively and promote overall medical effects of accelerated tissue repair and cell growth, analgesia and mobility restoration.

What to expect

An initial assessment is essential. Your Bespoke therapist will conduct a thorough examination to ensure your diagnosis is appropriate for Shockwave Treatment. Your Bespoke Practitioner will then start your five-step treatment plan.

  1. LOCATION OF THE AREA TO BE TREATED
    The area to be treated is located using palpation in order to deliver the therapy precisely
  2. GEL APPLICATION
    Sufficient amount of gel is applied to the area located in step 1. Use of gel is necessary to transfer the acoustic waves efficiently and smoothly
  3. THERAPY INITIATION
    The Shockwave applicator is slightly pushed against the area to be treated and the start button is pressed
  4. APPLICATION
    The shockwave applicator is then moved continuously across the painful tissue with a painting or swivelling technique. This application typically takes about five minutes to deliver a single treatment. Most people describe the pressure sensation of the application as uncomfortable rather than painful and is well tolerated amongst most patients
  5. REPEAT TREATMENT
    This process is repeated between three and five times with three to seven days between each treatment. Some patients notice an immediate improvement in their pain; however, the best results occur 12 weeks after the initial treatment. It is recommended that patients do rest from physical activity that involves the treated area for 48 hours following each treatment.

Key effects of shockwave therapy

Reduce pain mediators
Substance P is a neurotransmitter that mediates pain information through C-fibres. This neuropeptide is associated with intense, persistent and chronic pain. Acoustic waves generated by Shockwave work to decrease Substance P, histamines and other nociceptive metabolites resulting in a reduction in pain and inflammatory oedema.

Enhance collagen production
The production of collagen is necessary for the repair of damaged tissue. Shockwave therapy stimulates the tissue at a cellular level to accelerate collagen synthesis, improve collagen alignment and reduce scar tissue.

New blood vessel formation
Nutrient blood flow is necessary to start and maintain the repair processes of damaged tissue. The application of acoustic waves creates capillary micro ruptures in tendon and bone tissue, resulting in the stimulation and remodelling of new blood vessels to support faster healing.

Reversal of chronic inflammation
Mast cells are one of the key components of the inflammatory process and their activity is increased by using acoustic waves. Mast cell activation is followed by the production of chemokines and cytokines. These pro-inflammatory compounds enhance the inflammatory process and help to restore normal healing and regenerative processes.

Reduce calcifications
Calcium build-up is most often a result of micro-tears to a tendon. Acoustic waves generated by the shockwave machine help to break up the existing calcifications. The granular particles of calcium are then removed by the lymphatic system and tendon health is restored.

Release of trigger points
Trigger points are the principal cause of muscle pain and tightness. They are the result of a metabolic crisis within the tissue and are associated with palpable nodules in taut bands of muscle fibres. The acoustic energy delivered by the shockwave machine unblocks the calcium pump, reverses the metabolic crisis and releases the trigger points resulting in a reduction in pain and increase in muscle length.

Most sub-acute – chronic conditions of the musculoskeletal tissue. Commonly treated conditions include:

  • Plantarfascitis
  • Achilles tendinopathy
  • Rotator cuff tendinopathy
  • Patella tendinopathy
  • Calcific tendonitis
  • Frozen shoulder
  • Bursitis
  • Gluteal tendinopathy
  • Scar tissue
  • Calcifications
  • Tennis & golfers elbow

And much more! Get in touch to find out what else shockwave can help with.

Most patients with chronic pain problems have been through various unsuccessful types of treatments. Up to 80% of the same patients worldwide report that Shockwave therapy has helped them eliminate their problem.

There may be a slight feeling of discomfort during the treatment, depending on the level of pain the patient is already experiencing in the area. However, since the treatment lasts only about five minutes, most patients are able to tolerate this discomfort. Additionally, the intensity of the treatment can be adjusted throughout the session.

The number of treatments varies depending on the indication and tissue response. The effect of the treatment is cumulative, so you will typically need between three to five treatments.

Most indications require 3 to 5 treatments which are done 3 to 7 days apart, depending on the patient’s tolerance and their tissue response.

Most patients will experience an immediate pain relief following the treatment. However, within 2 to 4 hours after the treatment, they may experience some soreness in the treated area. This soreness has been reported as tolerable and not limiting.

It is recommended that patients refrain from physical activity, especially one that would involve the treated region, for about 48 hours following each treatment session.

$260 for a three session bundle plus $85 per top up session.

BradCliff Breathing Method

BradCliff Breathing Method

Did you know that one in ten New Zealanders experience some form of breathing disorder or chronic over-breathing? These breathing disorders can produce a wide range of symptoms, having a direct impact on your physical and mental health. Disordered breathing occurs when upper chest breathing becomes the dominant breathing pattern, especially at rest. This apical breathing pattern often results in an increased respiration rate and reduced oxygen efficiency.

Symptoms of disordered breathing include:

  • frequent sighing and yawning
  • breathing discomfort*
  • disturbed sleep
  • erratic heart beats*
  • feeling anxious
  • pins and needles
  • upset gut/nausea/reflux
  • chest pains*
  • shattered confidence
  • tiredness and fatigue
  • achy muscles and joints
  • dizzy spells* or feeling “spaced out”
  • irritability or jumpiness
  • feelings of “air hunger”

*see your doctor if you experience these symptoms

There are many triggers to disordered breathing such as:

  • anemia
  • asthma or COPD
  • burn out
  • cough and colds/bronchitis
  • chronic pain – physical and emotional
  • frequent or stressful telephone calls
  • grief/anxiety
  • hormone imbalances – PMT or menopause
  • mouth breathing/nasal problems
  • poor posture/ergonomics
  • tight clothing
  • viral sickness

Our specialised physiotherapist Stephanie is trained in the well-researched, physiotherapy-based approach to breathing retraining called The BradCliff Method. The BradCliff breathing service is designed to break the cycle, restoring energy efficient breathing, improving energy levels and renewing self-confidence.

Your initial breathing appointment will involve an in-depth assessment including assessment of your medical history, possible causes and contributing factors to your breathing dysfunction, you will be asked to complete a brief questionnaire also. The physiotherapist will also assess your breathing pattern and look at factors that could be contributing to your symptoms. The initial appointment will also include educating you around your current pattern and how to restore energy-efficient breathing. Over the following sessions, we will aim to begin to change your unconscious breathing pattern, and you will be taught the skills to practice daily to help improve your breathing and recognise when you are returning to poor breathing patterns.

Initial breathing appointments are 1 hour in duration. This allows for an in-depth assessment of your medical history, assessment of your own breathing pattern and educating you around more optimal breathing patterns, you will be set up with a home program to continue with until your next follow up appointment. Follow up appointments are 30-45 minutes depending on your individual needs.

Most people feel better after the first appointment. Sometimes it takes two appointments to see some improvement. Remember, you need to put in the practice to get ongoing change and improvement. It also depends on how often events or circumstances are triggering poor breathing as to how quickly you can recover.

It can take up to 15,000 repetitions to change a habit. For breathing retraining, it usually takes three to six weeks to change the habit, and six months to firmly entrench the new habit.

$180 for the 60 minute initial consultation and follow ups range from $95-$130 depending on the length of the appointment.

Typically, between 2-6 appointments. The frequency of appointments is dictated by your response to the treatment, the level of complexity of your breathing disorder and your adherence to your breathing exercises.

Pelvic and Women’s Health

Pelvic and Women’s Health

Pelvic health physiotherapy is a specific type of physiotherapy for which our physiotherapists have completed additional post-graduate training in. Pelvic health physiotherapy is tailored to both men and women. Common pelvic conditions that can benefit from this specialised physiotherapy approach include include continence disorders, bowel issues, post-surgical management involving the abdomen, pelvis and bowel, pre and post-natal care, return to sport and exercise, uterine prolapse, prostate dysfunction, lower back pain and pelvic girdle pain.

Our Anna Ellingham has completed post-graduate courses in pelvic health physiotherapy and has all of your pelvic needs covered!

Did you know?

  • Incontinence is common and affects 1.1 million New Zealanders (20% of whom are men)
  • Over 80% of pregnant women will leak during their pregnancy and 33% of these will go on to leak after giving birth
  • Over 50% of women will develop a pelvic organ prolapse post menopause
  • At least 15% of women have pain during sex
  • Pelvic health physiotherapy can improve erectile dysfunction in 75% of males

Pregnant women or women trying to conceive:

  • Pelvic girdle and lower back pain
  • Pelvic floor and pregnancy exercise programmes
  • Pregnancy WOFs (recommended at around 20-weeks)

women (from 6-weeks postpartum, and anytime after):

  • Post-natal WOF – general check up and assessment of pelvic floor, abdominals, return to exercise advice and planning
  • Bladder issues and pelvic floor dysfunction
  • Screening for returning to exercise

Incontinence:

  • Leaking with sneezing/coughing/laughing/exercising
  • Leaking with sneezing/coughing/laughing/exercising
  • Increased urgency or leaking associated with urge.
  • Increased frequency, or overactive bladder

Bowel issues:

  • Constipation
  • Incontinence or difficulty controlling wind/faeces

Seeking help and taking action to regain control over this part of your body can take a lot of courage for some people, and it is normal to feel a bit anxious coming into your first appointment. Please remember our therapists are highly experienced, and we understand the emotional and social implications of these conditions. We are also very passionate about this area of physiotherapy and want to help you restore confidence in your body.

An initial appointment is typically 1-hour long and involves:

  1. A subjective assessment – a discussion about your history, current symptoms, and goals. This discussion will typically revolve around toileting habits, sexual function, menstrual cycles, pain and activity levels.
  2. A physical assessment – once we have gathered enough information and have a good understanding of your issues, we will typically assess breathing and abdominal patterns, general pelvic strength and spinal range of motion, and then move on to an internal assessment as needed, and with your consent. Not every one needs an internal (vaginal) examination, and there is no obligation to have one, but typically it gives us more information regarding pelvic floor strength/endurance/coordination, alongside the ability to assess for other issues such as pelvic organ prolapse and scar tissue.
  3. Treatment and education – once we have a clear picture from our assessment, we can prescribe a specific plan for you. This will often include an individualised exercise program, education, and recommendations around the use of any adjunctive treatment. If you need further medical advice, we would not hesitate to liaise with your GP to ensure appropriate intervention is obtained.