Rotator Cuff Related Shoulder Pain

Are you tired of that shoulder pain that won’t let you sleep through the night? Did you do some spring cleaning on the weekend and now have an irritating ache in your shoulder?  Or perhaps you’ve had a little niggle that just won’t go away. You might have Rotator Cuff Related Shoulder Pain (RCRSP).

Chronic Exertional Compartment Syndrome

Shin Pain

Do you experience shin pain during running or exercise? Have you been told ‘its just shin splints’ and you will be alright? Shin pain during exercise can be a frustrating and painful condition for anybody from recreational runners to professional athletes. Most people have experienced themselves, or know somebody who has experienced shin pain but are unaware that there can be multiple causes that need to be treated differently.

Medial tibial stress syndrome, otherwise known as ‘shin splints’ is generally the most common cause of shin pain during running with 13.6-20% of runners experiencing some form in their lifetime. If left unmanaged, this condition can impede greatly on your sports performance, health and fitness so it is important these are managed correctly to get you back to doing what you love without pain. However, these symptoms can present similar to multiple other conditions including stress fractures, muscles strains, nerve/artery entrapments and more. One of the most common causes in which most people are unaware of is chronic exertional compartment syndrome (CECS).


What Is CECS?

CECS is pain caused by a build-up of pressure within your leg muscles whilst running. A normal muscle is supposed to expand during physical activity to allow adequate blow flow to supply the working muscles. In some cases, the muscle fascia is too thick and resilient which stops it from expanding during exercise. If your muscle does not expand correctly, then this causes a pressure build-up and results in pain and potential damage to the nerves and blood vessels in that compartment. This is why CECS must be firstly identified and secondly managed differently to other forms of running pains. Although it’s not well heard of, CECS is quite common with it being primary the cause of 14-27% of peoples lower leg pain.


Diagnosing CECS?

Chronic Exertional Compartment Syndrome will present similar to much other running pain or shin pain, however, there are a few key differences which your health professional will help you determine. The most common symptoms are:

  • No pain at rest
  • increasing pain in your leg during physical activity or running
  • usually occurs in both legs
  • Resolves within several minutes of rest after running
  • Occasionally pins and needles if pushing through pain


What should you do?

If you have any lower leg pain during physical activity you should seek assistance from a health professional such as a physiotherapist. They will assess your condition and if CECS is suspected, will initially manage your symptoms with multiple strategies including:

  • Running assessment and correction of biomechanics
  • Deep tissue therapy/needling
  • Progressive load management
  • Advise on appropriate footwear and running style

This is always the initial management strategy, however, it is important to note that in some individuals with more severe cases, conservative management may not fully relieve your pain or symptoms. In these cases, your physiotherapist (in conjunction with a Sports & Exercise Physician) will advise you on the possible options of surgical management which are shown to have an 80-90% success rate. Following this, they can assist you with your rehabilitation process and get you back to running and enjoying your sports without any pain.

Regardless of what specific condition you may have, if you are experiencing any shin pain it is beneficial to have it examined at by a health professional. Physiotherapists are highly skilled in differential diagnosis and will be able to confirm your diagnosis and assist you in getting back to doing what you love pain-free.



  1. Brukner, P. (2016). Brukner & Khan’s clinical sports medicine. North Ryde: McGraw-Hill.
  2. Lopes, A. D., Hespanhol, L. C., Yeung, S. S., & Costa, L. O. P. (2012). What are the main running-related musculoskeletal injuries?. Sports medicine42(10), 891-905.
  3. Schubert, A. G. (2011). Exertional compartment syndrome: review of the literature and proposed rehabilitation guidelines following surgical release. International journal of sports physical therapy6(2), 126
  4. West, R., Ferguson, J., & Butler, A. (2016). Chronic Exertional Compartment Syndrome. In Endurance Sports Medicine(pp. 113-125). Springer, Cham.


Medicare Funded Group Diabetes Education – Beating Diabetes Together


Understanding and Managing Diabetes through Good Nutrition

Knowing where to start with managing Type II diabetes can be overwhelming, especially when there is a lot of information (often contradictory) out there on what to eat and what not to eat. Perhaps you are left confused, wondering how the information you find on the internet compares with what people around you are saying.

Western Sydney Nutrition & Dietetics are able to help!

As Accredited Practising Dietitians, we are recognised professionals with the qualifications and skills to provide expert nutrition & dietary advice. Our goal is to provide excellent & quality services through nutritional counselling and dietary education, using evidence-based practice.

We are now pleased to announce that we are offering Medicare Funded (no out of pocket cost) Group Education Sessions on Nutrition and Healthy Living for those with Type II Diabetes.

At these group sessions, you can expect a supportive and friendly environment where we all work together to motivate and encourage each other to transform your health. Being run by an Accredited Practising Dietitian, we explain what diabetes is, equip you with various skills to manage your condition, address myths and misconceptions all while ensuring the promotion of good and adequate nutrition to maximise your health & wellbeing.


How does it work?

  • Patients who have Type II Diabetes, attend an initial consultation under an Enhanced Primary Care Plan (EPC) their GP has prepared. Please contact our clinic or your GP for further details.
  • Patients will then require a ‘Referral form for Group Allied Health Services under Medicare’ from their GP to attend Group Education Sessions
  • Patients will attend 4 – weekly education sessions run by a Dietitian, in a friendly and social group setting with other participants who are there for the same purpose.
  • Through education, participation in interactive activities, we aim to assist you in reducing your blood glucose levels, BMI and other metabolic factors to enable you to maximise your health and wellbeing.
  • All patients will receive written correspondence to your GP for a continuum of care.


Individual dietetic consultations are available for specific questions relating to T2DM and other health conditions. Medicare rebates are available for those with an EPC Plan (up to 5 per calendar year). Various level of Private Health Fund rebates are also available depending on your level of cover.


For more information about any of our services give us a call today on (02) 4721 5788.

3 Common Misunderstandings About Diabetes

National Diabetes Week 14-20th JULY 

Type 2 Diabetes Mellitus (T2DM) is one of the fastest-growing chronic conditions in Australia1. It is the most common form of diabetes making up 85-90% of all people diagnosed with the condition. 

In Type 2 Diabetes, the body is unable to convert the foods we eat into energy to keep us going. This is because the body can no longer produce sufficient insulin to convert the glucose in our blood into energy, or the action of insulin is no longer as effective. 

Knowing where to start with managing T2DM can be overwhelming, especially when there is so much information out there on how to best manage this condition.  

At Western Sydney Nutrition and Dietetics, our team of Accredited Practising Dietitian provide evidenced-based dietary advice and education. 

From listening to the many questions in our consultation rooms, here are the 5 most common misunderstandings of Type 2 Diabetes. 


1. Does eating too much sugar cause diabetes?  

Being mindful of what you eat is important in preventing the risk of T2DM and diabetes management. However, there are a combination of both genetic and lifestyle factors which influence the risk of developing T2DM. 

Non-modifiable risk factors include: having a family history of T2DM, Age, Ethnicity, Gestational Diabetes during pregnancy and Polycystic Ovarian Syndrome (PCOS). 

Eating too much sugar alone does not cause diabetes, but being at an unhealthy weight, a poor diet, insufficient physical activity and high blood pressure increases your risk of developing T2DM. 

The good news is that these lifestyle factors are modifiable, meaning that you can be proactive in making a change. 


2. I can’t have any bread, pasta, rice or sweet and sugary foods anymore. 

As a Dietitian, I hear this one a lot. Many times, people with T2DM tell me that they feel miserable and unwell from cutting out the bread, pasta, rice, sweet and or sugary foods from their day. 

This misunderstanding is very dangerous and could result in hypoglycaemia2. 

Hypoglycaemia occurs when a person’s blood sugar levels have dropped too low. It requires immediate treatment to prevent the person from becoming seriously unwell. Symptoms to watch out for include perspiration, shaking, dizziness, confusion and light-headedness. 

 What we all need to know is that carbohydrates are an important macronutrient. It the main source of energy for our bodies, especially our brain. 

Carbohydrates make up 45-65% of our total energy intake and are found across many food groups including: grains and cereals, vegetables, fruit, dairy and alternatives. Excluding foods from these groups prevents your body from getting the sufficient energy it needs to keep you going. 

It is important include carbohydrates in your diet by eating a nutritious and balanced diet. Choose whole foods and reduce your intake of processed and packaged foods, including those containing added sugars and fats.  


3. Will cutting out all sweet foods and carbohydrates cure my diabetes?

It is important to remember that T2DM is a condition where the function of insulin in the body is impaired. This means that it is vital for you to continue taking any diabetic medication or insulin injections your doctor has prescribed to manage your condition. 

With diabetes management, an appropriate reduction in carbohydrate foods including sweet and sugar foods can help with improving blood glucose levels. Excluding carbohydrates all together is not safe, as it could result in hypoglycaemia and does not cure diabetes. 

Some studies have shown that a combination of sustained lifestyle changes can result in long term improvements in blood glucose, improve insulin resistance and in some, reverse diabetes3,4. These changes include making appropriate dietary modifications, weight loss and sufficient physical activity.



Diabetes Take-aways

  • Carbohydrates alone are not responsible for causing Type 2 Diabetes
  • Making changes to your lifestyle changes can reduce your risk of T2DM, improve your insulin resistance and in some cases reverse T2DM. This includes eating a nutritious and balanced diet, maintaining a healthy weight and exercising regularly. 
  • Dietitians play an important role in the dietary management of Diabetes. This includes providing education, monitoring and equipping you with the skills to understand how carbohydrates work in your body. 

Dietitian services are available with our Accredited Practising Dietitians at our Penrith, Westmead and Norwest Rooms. We are also offering MEDICARE funded Group Education Session for those with Type 2 Diabetes. Give us a call today on (02) 4721 5788 to find out more today.



  1. Diabetes Australia; 2015; Diabetes globally (online). Available from; Last Accessed; 04/07/19
  2. Diabetes Australia; 2015; Hypoglycaemia (online). Available from: Last Accessed 04/07/19
  3. Hallberg, S. J., Gershuni, V. M., Hazbun, T. L., & Athinarayanan, S. J. (2019). Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients11(4), 766. doi:10.3390/nu11040766. Available from: Last Accessed 04/07/19
  4. Diabetes Co UK; 2019; Reversing Type 2 Diabetes (online). Available from Last Accessed 04/07/19