Welcome

Physical Medicine doctors are trained to pinpoint and treat the underlying causes of musculoskeletal pain, chronic stiffness, whiplash, movement impairment and many other related ailments.


Physical Medicine doctors assess and treat non-surgical musculoskeletal pain and dysfunction, in all regions of the body. Their examination, localising a particular complaint to a specific region or a specific anatomical structure, and defining its relationship to movement and pain. The result?


Physical Medicine doctors formulate a very specific diagnosis, thereby delivering very specific treatments with very high success rates.


Treatment may vary from standard stretching, mobilisation and manipulative techniques, to advanced treatment formats designed by Physical Medicine specialists worldwide. Importantly, follow-up exercises help maintain improvement and prevent recurrence. Specific exercise prescription for the affected area is therefore an integral part of physical medicine treatments.


Doctors trained in Physical Medicine are qualified Medical Practitioners that have undergone extensive postgraduate training followed by Fellowship certification with the Australian College of Physical Medicine.

About Us

Physical medicine is defined as the management by medical practitioners of acute or chronic musculoskeletal injury, disease or dysfunction. Its aim is to address somatic dysfunction -- impaired or altered function of related components of the somatic (body framework) system. This involves skeletal, arthrodial and myofascial structures with related vascular, lymphatic and neural elements. (Hospital Adaptation of International Classification of Diseases, 2nd Edition, 1973). Treatment includes the application of physical modalities including manual therapy. Other therapies, such as pharmaceuticals or injection techniques, are also used to restore normal function. The "Blomberg" technique, prolotherapy & platelet rich plasma are examples of the injection techniques utilised.


Physical Medicine relies upon a very detailed physical examination. The object of the physical examination is to localise a complaint to a specific region and, if possible, a specific anatomical structure, and to define its relationship to movement and function. The physician then makes a logical analysis and application of the information obtained from the patients history and physical examination. There is a growing evidence base for musculoskeletal medicine and this is an important part of our training.


Fellows apply a biopsychosocial assessment, particularly with an emphasis on avoiding the development of chronic pain syndromes by appropriate early intervention. There is a greater emphasis on the "bio" in biopsychosocial. Highly skilled manual examination and postural examination skills are used as part of an integrated management. Fellows instruct the patient in self management of their condition using very specific exercises to mobilise and release shortened musculature, and to strengthen weakened musculature. The prescription of medication plays a reduced role as gentle manual therapy, injection of normal saline or lignocaine to muscle tender points and specific exercise prescriptions are the mainstay of most treatments. Rarely would they need to refer to a psychiatrist, pain clinic, rheumatologist or other practitioner or therapist. However Physical Medicine Physicians are well qualified to recognise that small minority who require referral. At times advanced imaging is required to exclude serious disease. Accurate diagnosis by clinical examination including palpation (scientifically supported eg palpation to find a symptomatic facet joint) does not require diagnosis by exclusion using multiple often expensive investigations (also scientifically supported).

About Our College

Physical Medicine in Australia was formally established as the Australian College of Physical Medicine in 1989 as a "not for profit" postgraduate medical education organisation. It developed in response to a need recognised by a group of experienced general practitioners. These doctors found that there was a large proportion of primary care patients suffering from soft tissue musculoskeletal dysfunction and associated pain. They found that general practice lacked the expertise to assess and treat these diverse conditions. They found that soft tissue musculoskeletal dysfunction was only a very small part of the area of knowledge covered by orthopaedic surgical colleagues and rheumatologists, the latter dealing mainly with connective tissue disease of an autoimmune type. Rehabilitation Physicians, although in the past were involved in Physical Medicine, had narrowed their field of expertise and in recognition no longer included the term Physical Medicine in the description of their faculty.


General practitioners seeking assessment and treatment skills attended the RACGP Introductory Course in 1985 under Professor John Murtagh of Monash University and Dr Clive Kenna of Monash Medical Centre. This course was available for GPs of at least three years post hospital experience. Because of the interest shown by 2000 GPs who attended the course, a longer course with written and clinical examinations was later held at Monash Medical Centre, and a certificate awarded. After 1989, the certificate course became a conjoint course of the RACGP and ACPM. A formal programme of further training and examination was developed. After two further years of study and attending specific courses, admission to Fellowship via a written examination and clinical viva was approved.


The previous training programme consisted of a Postgraduate Diploma in Physical Medicine or a Master of Medicine Degree in Physical Medicine from the University of Sydney in the Faculty of Medicine. These courses were taught in the Department of Anatomy and Histology as well as the Department of Pain Management and Anaesthesia Royal North Shore Hospital and the Department of Aged Care and Rehabilitation at Royal North Shore Hospital at The Northern Clinical School of the University of Sydney. The Physical Medicine component on management of postural abnormalities in the final year was taught by Fellows of the Australian College of Physical Medicine.


Because of their broad clinical training and experience in general practice, a number of the doctors who completed the Certificate Course realised the breadth and depth of specialised knowledge and skills required for the assessment of and treatment of acute and chronic musculoskeletal dysfunction and associated pain. We founded our small College to further educate ourselves and to continue the training of General Practitioners in such a relevant primary care area.


At the time of its inception, to be a Fellow of the College of Physical Medicine, doctors needed to hold the Advanced Certificate in Manual Medicine of the RACGP, to have studied at the University of Paris at the Department of Physical Medicine, attended an intensive two week course involving lectures, tutorials and outpatient clinics at Hotel Dieu, have attended a number of courses in soft tissue musculoskeletal pain and dysfunction in the fields of bio mechanics, myofascial pain syndrome, and an intense course including rheumatology, spinal neurosurgery topics and musculoskeletal radiology. These were mainly taught by visiting lecturers from medical schools in Europe and the USA.


Two years after completing the Diploma or Master of Medicine Degree, and attending ACPM teaching sessions the trainees were eligible to sit for the ACPM Fellowship. This involved a formal examination and viva.


The Diploma and Masters course offered by Sydney University is no longer available owing to university funding issues. Our new training programme follows similar lines and is now available at Maquarie University starting in 2010.


Enquiries can be made at www.medicine.mq.edu.au.

Conditions We Treat

The aim of our Physical Medicine clinic is to correctly diagnose somatic (bodily) dysfunctions, including restricted joint motion, muscles which are in spasm or which are hypotonic, altered muscle firing patterns and tight connective tissues such as ligaments or fascia. Such dysfunctions typically cause joint restrictions, pain, and nerve or vascular entrapment.


Diagnosis depends on taking a thorough history, noting the severity and location of the symptoms. Examination takes into account posture, gait and muscle behaviour patterns. The aim is then to reproduce the symptoms by palpation and joint motion testing. Care is taken to exclude possible underlying disease.


Some of the problems that we may be able to assist you in the management of are:

  • migraine-like headaches, cervicogenic headaches
  • neck stiffness or pain, acute and chronic whiplash
  • shoulder stiffness or pain, shoulder dysfunction
  • musculoskeletal chest pain, mid-scapular pain
  • acute and chronic lower back pain
  • musculoskeletal pelvic pain and dysfunction
  • peripheral limb pain or paraesthesiae
  • peripheral joint dysfunction
  • elbow tendonitis
  • foot pain, heel pain, ankle dysfunction
  • disturbance of gait or posture
  • TMJ dysfunction

Treatment will depend on examination findings, their severity and whether they are acute or chronic. The college members use a broad variety of manual (hands on) treatment modalities, as listed below:


Mobilisation employs rhythmical oscillations of a joint to encourage freer motion.


Manipulation involves applying a short thrust to a restricted joint to remove a dysfunction.


Muscle energy technique can be used to find and treat the causes of all types of pain. It relies on the concept that joints are held out of place by muscles which have too much tone. The technique uses a series of gentle muscle contractions, coordinated with breathing, to recalibrate the precise muscle spindles which cause the muscles to hold the bones in less than optimal position.


Counterstrain is a subtle indirect technique which involves placing the tight muscle or joint in a position of maximum comfort, holding this position till the tissues soften and then slowly returning the body to a neutral position.


Facilitated positional release is another indirect technique which involves positional placement towards a direction of freedom and away from restriction barriers. Positional placement involves a balance in flexion, extension and side-bending and then applying either compression or torsion which then induces release of tight or restricted tissue.


Ligamentous release works on the ligaments or connective tissue sheets (fascia) that surround a tight joint. It aims to rebalance tight or loose ligaments to return a joint to its normal physiological position. It involves compressing or decompressing tight tissues until a balance is found allowing a release into normal functional position.


Myofascial spray and release technique involves using a vapo-coolant spray (ethyl chloride) being applied to tight or painful muscles before using muscle energy technique to release them. This is useful for acute or chronic conditions and is especially valuable where a body region has become too sensitive.


Other modalities may involve the injection of a short acting local anaesthetic (1% xylocaine) into chronic painful muscle tender points before applying some of the above techniques.


Likewise low-level infrared laser (830 nm Ga-Al-As) or ultra-sound may be used to augment the therapy.


Exercise prescription is one of the most essential principles of our treatment regime. Once your key problems are identified, specific exercises can be taught to help alleviate your problems. Photocopied sheets of these exercises will be provided and you will be encouraged to undertake an appropriate exercise or stretch program. For chronic or recurrent problems, treatment by experienced practitioners is not enough to keep pain at bay. A daily release program is required for this; for example, home exercises augmented by weekly yoga, Pilates or Tai chi classes. Regular swimming, walking or gym classes may be prescribed.


REALTIME ULTRA SOUND OF CORE - Realtime ultrasound assisted core muscle re-training:


Lack of abdominal corset stabiliser activity has long been recognised in association with back dysfunction. The recent availability of RealTime ultrasound based assessment and retraining techniques represents, in the hands of a skilled operator, a great step forward in treating this problem. RealTime ultrasound biofeedback techniques utilising a monitor attached to the machine allow certainty in targeting the correct core muscle groups, and also in developing an appropriate individualised home exercise program.


Member Listing

Location Guide: Please note that all members are listed in alphabetical order according to State and numerical order according to postcode.


NEW SOUTH WALES


Dr Michael Oei
Level 3 Specialist Centre
Darlinghurst Medical Centre
213 Darlinghurst Rd, Darlinghurst 2010
Ph: 8302 1180
Musculoskeletal & Golf Injury Clinic
37A Wolseley Rd, Mosman 2088
ph: 02 9969 2198
www.musculoskeletalgolfinjury.com.au


Dr Shane Moloney
15/3 Meagher Ave
Maroubra NSW 2035
t: 02 9311 3633
f: 02 9311 3733


Dr Kevin Portley
56 Darling St
Balmain NSW 2041
t: 02 9555 6969
f: 02 9555 8114

Dr Graeme Romans
9 Johnston St
East Balmain NSW 2041
t: 02 9818 1370
f; 02 9810 5196


Dr Philip Lim
Northside Physical Medicine
Linea Suite 105
2 Atchison St
St Leonards NSW 2065
t: 02 9438 5088
f: 02 9438 5755
www.northsidephysicalmedicine.com.au


Dr Rod Ayscough
Sydney Spinal Associates
26 Stanhope Rd
Killara NSW 2071
t: 02 9498 1044
f: 02 94981411


Dr Michael Creswick
Suite 8 /1A Wongala Crescent
Beecroft NSW 2119
t: 02 9481 9585
f: 02 9484 0955
www.physicalmedicinesydney.com.au


Dr Valentine Kirychenko
PO Box 354
Balgowlah NSW 2093
t: 0403044808
f: 02 9968 4549


Dr Andrew Hung
269-271 Old Northern Rd
Castle Hill NSW 2154
t: 02 9634 5000
f: 02 9680 8052


Dr Michael Mock
Shop 6 Wetherill Park Shopping Centre
1024 The Horsley Drive
Wetherill Park NSW 2164
t: 02 9604 3900
f: 02 9609 6707

Northside Physical Medicine
Linea Suite 105
2 Atchison St.,
St Leonards NSW 2065
t: 02 9438 5088
f: 02 9438 5755
www.northsidephysicalmedicine.com.au


Dr Peter Cooke
Suite 2/20 Smith St.,
Health Square
Charlestown 2290
t: 02 4922 6400
f: 02 4920 9073


Dr Charles Hew
Goonellabah Medical Centre
616 Ballina Rd
Goonellabah
t: 02 6625 0000
f: 02 6624 4406


QUEENSLAND

Dr Peter Jackson
Brisbane Musculoskeletal Clinic
Centenary Aquatic Centre
3/400 Gregory Terrace, Spring Hill
Brisbane Qld 4000
t: 07 3236 5866
f: 07 3236 5228


Dr Geoff Harding
1st Floor 67 Brighton St
Sandgate Qld 4017
t: 07 3269 5522
f: 07 3269 6407

Dr Manus Maher
Zillmere Family Practice
55 Handford Rd
Zillmere Qld 4034
t: 07 3865 3832
f: 07 3865 4625


Dr Neil Hearnden
K Mart Plaza
3 Patricks Rd
Arana Hills Qld 4054
t: 07 3351 6444
f: 07 3351 6246


Dr Robert Liong
Greenslopes Spinal Medicine Clinic
757 Logan Road
Greenslopes Qld 4120
t: 07 3847 3300
f: 07 3847 4727


Dr Craig Glasby
Shalier Park Medical Centre
70 Bryants Rd
Shailier Park Qld 4129
t: 07 3209 6699
f: 07 3209 6892

Dr Yogesh Ravji
189 Old Cleveland Rd
Capalaba Qld 4157
t: 07 3245 9600
f: 07 3245 1908


Dr Ken Steffensen
Suites 2 & 3 Cleveland House
Cleveland Qld 4163
t: 07 3286 6899
f: 07 3286 3951


Dr Robert Gower
222 Charters Towers Rd
Hermit Park Qld 4812
t: 07 4725 5355


Dr David Jaa-Kwee
Suite 6/140 Robina Town Centre Drive
Robina Qld 2446
t: 07 5562 2088
f: 07 5562 2085
VICTORIA


Dr Clive Kenna
BMA House
Suite 1002


135 Macquarie St
Sydney NSW 2000
t: 02 9630 4772
f: 02 9233 5402


Dr Robert Brzozek
Kardinia Health
2-18 Colac Rd.,
Belmont 3216
t: 03 5202 9333
f: 03 5202 9399
www.brightonspinal.com.au


Dr Murray Grave
4 Princess Street
Warrnambool Vic 3280
t: 03 5561 0700
f: 03 5562 6416


WESTERN AUSTRALIA


Dr Keat Wong
233 Scarborough Beach Rd
Mt Hawthorn Perth 6016
t: 08 9443 2822
f: 08 9443 2874


Dr Sam Messina
3 Westbury Cr
Bicton WA 6157
t: 08 9339 1400
f: 08 9339 5753


HONG KONG


Dr Keith Kwok Wai Chan
Room 1201
12/F City Landmark 1
68 Chung On St Tsuen Wan
HONG KONG
t: 852 2407 7238
f: 852 2395 0101
www.hkimm.hk


Let's Get in Touch

For medical practitioners interested in our training program please contact:-


Associate Professor Michael Creswick

The Australian School of Advanced Medicine

2 Technology Place

Macquarie University NSW 2019

Australia

t: +61 (0) 2 9481 9585

f: +61 (0) 2 9812 3886

Email: michael.creswick@mq.edu.au


AUSTRALIAN COLLEGE OF PHYSICAL MEDICINE

President

Associate Professor Rod Ayscough

Sydney Spinal Associates

26 Stanhope Rd

Killara NSW 2071

t; 02 9498 1044

f: 02 9498 1411


Director

Associate Professor Michael Creswick

Suite 8/ 1A Wongala Cres

Beecroft NSW 2119

t: 02 9481 9585

f: 02 9484 0955


Secretary

Dr Kevin Portley

56 Darling St

Balmain East NSW 2041

t: 02 9555 6969

f: 02 9555 8114

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