Searching for effective migraine treatment in Wellington? If you are reading this, chances are you already know the drill. The subtle warning signs. The creeping visual aura or nausea. The frantic search for your medication, followed by a hasty retreat into a dark, quiet room where you lose another day, or three, of your life waiting for the storm to pass.

If you suffer from chronic migraines, you do not need us to tell you how debilitating they are. You already know the toll they take on your career, your weekends, and your mental health.

But here is what you might not know. A significant portion of migraines are not just random neurological events or bad genetics. They are mechanically driven. And very often, the true culprit is sitting right at the top of your spine.

Let’s get one thing straight. If your current migraine management plan consists entirely of taking triptans, popping paracetamol, and waiting in the dark, you are treating the symptom and not the cause. At Severn Clinics, we look deeper. We look at the biomechanics of your upper neck, the tension in your fascia, and the state of your nervous system.

Here is why your neck might be the hidden trigger behind your migraines, and how specialised physiotherapy can actually help you break the cycle.

The Traditional Migraine Trap

The medical merry-go-round for migraines is well-worn and incredibly frustrating. You go to the GP. You are prescribed painkillers, anti-inflammatories, or perhaps beta-blockers or triptans. Sometimes, you might even be offered Botox injections into your scalp and neck muscles.

Do these things help? Sometimes, yes. They can act as a necessary fire extinguisher when a migraine is raging. But they are a chemical solution to what is very often a mechanical problem. Medication alters how your brain perceives pain or constricts blood vessels, but it does absolutely nothing to fix the stiff upper cervical joint, the compressed nerve, or the dysfunctional movement pattern that is setting off the alarm in the first place.

When the medication wears off, the mechanical trigger is still there, waiting to light the fuse all over again.

The Science: The Trigeminocervical Complex (TCC)

To understand how your neck causes a migraine, we have to look at a bit of neuroanatomy.

At the base of your skull and the very top of your neck lies an area called the Trigeminocervical Complex (TCC). Think of the TCC as a major electrical junction box where nerves from your upper neck (the C1, C2, and C3 spinal nerves) plug into the exact same switchboard as the Trigeminal nerve.

The Trigeminal nerve is the major sensory nerve for your head, face, eyes, and blood vessels in your brain.

Because these nerves share a physical pathway in the brainstem, your brain can easily get confused about where the pain signals are coming from. If the joints in your upper neck (C1-C3) are stiff, inflamed, or locked up, they fire constant distress signals into the TCC. Your brain receives these signals, misinterprets them, and projects the pain into your forehead, behind your eye, or across your scalp.

This mechanism is well-documented. Research published in The Lancet Neurology (Bogduk & Govind, 2009) highlights how dysfunction in the cervical spine directly refers to pain in the head, creating what is known as cervicogenic headaches. These headaches frequently masquerade as, or actively trigger, full-blown migraines.

In short, your neck is screaming, but your head is feeling the pain.

Central Sensitisation: When the Alarm Gets Stuck

When your upper neck constantly bombards the TCC with pain signals, something else happens. Your nervous system gets exhausted and overly sensitive. This is a clinical phenomenon known as Central Sensitisation.

As outlined in the journal Pain (Woolf, 2011), when the central nervous system is subjected to prolonged pain inputs, it physically changes. Its threshold for triggering pain drops significantly. It goes into a constant state of fight or flight.

Suddenly, things that should not cause a migraine, like a drop in barometric pressure over the Wellington harbour, a stressful day at the office, a glass of red wine, or bright fluorescent lights, become massive triggers. Your nervous system is so wound up by the constant mechanical stress from your neck that it only takes a tiny push to send you over the edge into a migraine.

To fix the migraines, we have to down-regulate that nervous system. And to do that, we have to remove the mechanical stress coming from the neck.

The Wellington Lifestyle Factor

We see this pattern constantly in our Wellington clinics. Our city is built on hills and driven by a massive population of public sector and corporate desk workers.

You sit at a computer for eight hours a day in the CBD. Your shoulders round forward. Your head drifts forward closer to the screen in a posture often called “tech neck“. For every inch your head moves forward, the load on your upper neck muscles doubles. The deep muscles at the base of your skull (the suboccipitals) clamp down to stop your head from falling off your shoulders.

Over months and years, this posture locks up the C1-C2 joints. It restricts blood flow. It compresses the nerves feeding into the TCC. Add in the stress of modern life, the financial pressures we are all facing, and perhaps a bit of jaw clenching (TMJ dysfunction), and you have built the perfect anatomical recipe for a migraine.

Signs Your Neck is Driving Your Migraines

How do you know if your migraines are mechanically driven by your neck? Look for these subtle clues:

• The Pre-Aura Stiff Neck: Do you notice your neck or shoulders feel incredibly tight, heavy, or locked a few hours or a day before the migraine hits?
• One-Sided Dominance: Does the migraine almost always start on the same side of the back of your head or neck before spreading behind your eye?
• Movement Triggers: Can you trigger a headache or alter the intensity of your migraine by pushing on the base of your skull or turning your head a certain way?
• The Jaw Overlap: Do you suffer from TMJ pain, clicking, or night-time teeth grinding alongside your migraines? The jaw and upper neck are intimately linked biomechanically.
• Posture Dependency: Do your migraines predictably strike on Thursday or Friday afternoons after a long week of desk work?

Why Standard Stretching Makes it Worse

Here is a controversial truth we regularly tell our patients. If your neck is triggering your migraines, standard neck stretching will often make you feel much worse.

When the joints in your upper cervical spine are locked up, the muscles around them spasm to protect the area. If you forcefully stretch a muscle that is trying to protect a vulnerable joint, your nervous system will panic and clamp the muscle down even harder. This is why aggressive neck cracking or generic chin-to-chest stretches often trigger a migraine instead of relieving one.

You cannot stretch your way out of a joint restriction or a hyper-sensitised nervous system. You need a targeted, clinical approach.

How Severn Clinics Treats Migraines

We do not do generic, cookie-cutter physio. We do not just rub your shoulders and give you a sheet of stretches. Our approach to migraine treatment is comprehensive, structural, and neurologically focused.

1. Upper Cervical Assessment and Mobilisation We gently assess the very specific, tiny movements of the C1, C2, and C3 vertebrae. We use targeted, low-force joint mobilisations (not aggressive cracking) to restore normal gliding motion to these joints, taking the immediate pressure off the Trigeminocervical Complex.
2. Dry Needling for Myofascial Release When the muscles at the base of your skull are in chronic spasm, they form tight bands called trigger points. These trigger points constantly leak inflammatory chemicals and refer pain directly into your head. We use precise dry needling to target these exact bands. The micro-lesion created by the fine needle forces the muscle to twitch and finally release, instantly resetting the neuromuscular junction and stopping the pain signal at its source.
3. High Power Laser (HPL) Therapy For joints and tissues that are too inflamed or hyper-sensitive for hands-on work, we utilise HPL therapy. This advanced clinical technology uses targeted light energy to penetrate deep into the cervical spine. It triggers a biological process called photobiomodulation, which drastically reduces local inflammation, increases blood flow (vasodilation), and accelerates cellular repair. It is a painless, highly effective way to calm down the nerves and speed up tissue healing.
4. Deep Neck Flexor Retraining Most migraine sufferers have severely weakened deep neck flexors (the core muscles of the neck) and overactive, exhausted upper traps and suboccipitals. We guide you through specific neuromuscular retraining to rebuild the strength in the front of your neck, allowing the back of your neck to finally let go.
5. Postural and Biomechanical Integration We look beyond the neck. We look at your thoracic spine (mid-back) mobility, your ribcage mechanics, and your jaw. If your mid-back is rigid from sitting at a desk all day, your upper neck has to hyper-extend to keep your eyes looking forward. We address the whole chain so the results actually last.

Do Not Accept Migraines as Your Normal

You are not destined to live your life navigating from one dark room to the next. You do not have to accept that losing two days a week to pain is just a normal part of life.

If you are exhausted by the medical merry-go-round and want to find out if your neck is the hidden driver behind your pain, it is time to look at the mechanics.

At Severn Clinics, we are committed to changing the standard of migraine and chronic pain care in Wellington. We deliver competent, root-cause physical therapy with outcomes that speak for themselves.

Ready to find the real trigger? Book a consultation at our Wellington clinic today, and let us start rebuilding your life, pain-free.

Physiotherapy for Scoliosis In Wellington: What to Expect from Experienced Practitioners

Let’s get one thing straight. If you or your child has been told you have scoliosis, it doesn’t mean you’re broken or destined for a life of pain. It means your spine curves sideways a bit more than it should, and depending on the type and severity, that might need some support. Not surgery. Just support. And that’s where physiotherapy comes in.

Understanding Scoliosis

Your spine naturally curves inward at the neck and lower back and outward around the upper back—like a suspension bridge. These curves help keep us upright, balanced, and shockproof. But scoliosis adds a new twist, a sideways bend, usually shaped like an “S” or “C.” Sometimes, it’s barely noticeable. Other times, it changes how you move, breathe, or even how your clothes fit.

Most people first notice scoliosis  in their teenage years, often during a routine checkup or after a parent spots uneven shoulders. It can also appear in adults from degenerative changes or uncorrected scoliosis earlier in life. In sporadic cases, it shows up in infants. Sometimes, it is accidentally picked up while investigating a completely unrelated issue.

Causes of Scoliosis

That’s the million-dollar question. Most cases are called “idiopathic,” which is medical-speak for “we don’t exactly know.” There’s likely a genetic component. Scoliosis can run in families, but it also shows up without warning. Other known causes include:

• Neuromuscular conditions like cerebral palsy or muscular dystrophy
• Congenital vertebral malformations (the spine develops abnormally before birth)
• Injuries or infections that affect the spine
• Conditions like Marfan syndrome or spina bifida

And yes, scoliosis can be mild, moderate or severe. But more importantly, it’s very manageable. The challenge is knowing what kind of scoliosis you’re dealing with and how quickly it’s likely to progress.

Recognising the Signs of Scoliosis

Some of the more subtle signs include:

• Uneven shoulders or waist
• One shoulder blade is more prominent than the other
• Ribs sticking out more on one side
• Head not centred over the pelvis
• Clothes that hang awkwardly

Sometimes, there’s back pain, fatigue or even changes in breathing, especially if the curve is severe. But here’s the thing: many people with scoliosis feel perfectly fine. That’s why assessment matters. A slight curve in the spine might not bother you much, but the effects can become more noticeable if it progresses over time.

How Scoliosis Is Diagnosed

Physios and doctors often start with a simple forward bend test, known as the Adam’s test. You’ll bend forward, arms dangling, and we’ll look for asymmetry in your rib cage or spine. If something looks off, we may recommend X-rays to measure what’s called the Cobb angle. This helps determine the curve’s size and whether it changes over time.

We also use scoliometers, postural assessments, and sometimes lung function testing if breathing is affected. The aim is to look at the whole picture—structure, movement, pain, and function. Just as importantly, we take the time to understand how it’s affecting your day-to-day life.

The Role of Physiotherapy in Scoliosis Management

Let me say plainly: a good physiotherapist won’t just throw generic stretches at you. They’ll assess your posture, muscle strength, joint mobility and functional patterns, then craft a plan that works with your body. Here’s what that often includes:

• Customised exercise programs like the Schroth Method or SEAS (Scientific Exercise Approach to Scoliosis)
• Breathing work to improve lung capacity and rib mobility
• Muscle re-education to strengthen weakened areas and lengthen tight ones
• Postural retraining using mirrors, verbal cues, and sometimes props
• Guidance on daily movement patterns (e.g., how you sit, carry a bag, sleep)
• Psychological support if scoliosis is affecting confidence or self-image

We also pay attention to the little things. Do you feel lopsided when you walk? Are you constantly leaning to one side when sitting on the couch? Does your backpack always slip off the same shoulder? These patterns give us clues and can become part of the solution.

Introduction to the Schroth Method

The Schroth Method is one of the most respected non-surgical treatments for scoliosis. It focuses on three-dimensional correction: sideways shift, rotation, and spinal elongation, all tailored to your curve type.

Exercises include:

• Breathing into the concave side of the trunk
• Holding corrected postures with active muscle work
• Repeating movements to embed new motor patterns

This isn’t passive rehab. It’s active, structured, and takes practice. But it works. Studies show Schroth can improve posture, reduce pain, slow curve progression, and even reduce the need for surgery in some cases.

Other Exercise-Based Interventions

While Schroth is the gold standard for structured correction, other movement approaches, such as Pilates, Klapp exercises, and core stabilisation work, can help, too. Especially when tailored by someone who knows scoliosis, just beware of generalised routines. Not all core work is helpful, and some can make things worse.

A trained physio will help you avoid the “just do crunches” trap and instead focus on meaningful strength, flexibility and breath control that supports your spine. And with consistent practice, most people find these exercises make a real difference—not just physically, but mentally too.

When Bracing or Surgery May Be Considered

Braces are usually recommended for adolescents with moderate curves (25 to 45 degrees) while their bones are still growing. The goal is to stop the curve from getting worse. They’re typically worn for 16 to 23 hours daily but can be removed for sport and showering.

Surgery is rare. It’s considered for severe curves (usually over 50 degrees) progressing or affecting lung function. Even then, it’s not the first option. A team approach, including your physio, GP, and spinal specialist, helps you decide what’s best for you.

Living with Scoliosis

Honestly? It depends. Some people barely think about it. Others find it frustrating or exhausting, especially if they’ve been told to “wait and see.” That’s why support matters—physically and emotionally. At Severn Clinics, we don’t just look at the curve on the X-ray for. We look at the person attached to it.

We work with children, teens, and adults to build strength, confidence, and body awareness. We talk about sleep, school bags, sports, and social situations. We help families understand what to expect. When needed, we refer to orthopaedic surgeons  or psychologists who specialise in this area.

Scoliosis can be challenging, particularly during rapid growth or significant life changes. That’s why consistency in care is so important. The reassurance that someone is watching your progress can make all the difference.

Importance of Early Intervention

The earlier you catch a curve, the more we can do. It’s not about “fixing” a spine, so it’s perfectly straight. It’s about creating balance, function, and strength so the body works well with the curve. And yes, even adults with long-standing scoliosis can benefit.

Physiotherapy won’t erase scoliosis, but it can:

• Reduce the progression of curves
• Improve spinal mobility
• Ease muscular pain
• Improve body image and confidence
• Minimise the need for surgery
• Help you stay active, mobile and strong

Conclusion

Scoliosis isn’t something to ignore, but it’s also not something to fear. With early detection, expert care, and the proper support, you or your child can live an active, confident life.

At Severn Clinics, we offer evidence-based scoliosis  management tailored to your needs. Whether you’re seeking a second opinion, starting early intervention, or exploring exercises after surgery, we’re here to help.

If you’re curious or concerned about scoliosis, come in for a chat. We’ll take the time to understand your spine and support your journey forward, one breath, one movement, one step at a time.

Wellington ACL Injury Rehab Specialists: Sports Physiotherapy That Gets Results

Hurting your ACL can turn life upside down. It’s not just the physical pain. It’s the frustration of lost momentum, missed games, and watching everyone else continue while you figure out what comes next. For many people in Wellington, this sports injury happens in the middle of the things they love most like rugby, netball, or trail running.

We see it all the time. And yes, it hits hard. But we also know that people do more than recover with the right rehab. They rebuild strength. At Severn Clinics, we work with you to regain strength, movement, and confidence so you’re not just okay. You come back even better.

What Happens When You Tear Your ACL?

The anterior cruciate ligament (ACL) is a tough band of connective tissue in the centre of your knee. Its job? Stabilise the joint and prevent too much forward movement or rotation of the shinbone. It also contains sensory nerve endings that help your brain sense what your knee is doing in space. That’s why it doesn’t just hurt when it tears, it makes your whole knee feel wonky and unreliable.

And here’s something people often don’t realise: an ACL isn’t just a torn ligament. It’s a disruption of how your brain and body communicate. That’s what makes proper rehabilitation non-negotiable.

Surgery or No Surgery: Do You Need to Go Under the Knife?

Some people need surgery, and others don’t. It depends on several factors, including your activity level, how unstable your knee feels, and your long-term goals. Some folks can return to walking, cycling, or even running with a solid rehab programme.

That said, if your knee is giving way or you’re keen to return to sports that involve pivoting or jumping, surgery might be your best shot. Either way, rehab is essential. The ligament doesn’t heal by itself, and your body needs help figuring out how to move correctly again.

So, What Should ACL Rehab Look Like?

Too often, people in New Zealand finish their surgery, get a couple of physio sessions, and are told they’re good to go. That’s not how recovery works. Research shows that many Kiwis receive far fewer sessions than international best practice recommends, sometimes just 12 sessions or less.

Real ACL rehab is a long game. We’re talking 9 to 12 months of structured, progressive training that evolves as you heal. We help you rebuild strength, restore joint movement, retrain your balance, and regain trust in your knee. It’s about more than just doing some squats and calling it a day.

At Severn Clinics, we break it down like this:

• Early phase: Reduce swelling, restore straightening and bending, and wake up those inhibited muscles (especially your quads).
• Middle phase: Start loading the knee gradually, rebuild movement, and improve symmetry between legs.
• Late phase: Develop power, control, and agility with exercises that simulate real-life and sporting movements.
• Return to sport: We test strength, hop distance, movement confidence and reaction speed because returning to the sport isn’t just about being pain-free.

Prehab: Why Starting Before Surgery Pays Off

One of the most significant predictors of good outcomes post-surgery is how strong and mobile you are. That’s why we offer prehab sessions, an early intervention physio designed to reduce inflammation, restore range of motion, and build foundational strength.

It sounds simple, but trust us: doing your prep pays off in faster recoveries and fewer complications. We’ve had patients who’ve put in the work beforehand and felt back to themselves months ahead of schedule.

Common Pitfalls (And How to Avoid Them)

Here’s where a lot of people slip up:

• Stopping too soon: You feel good for three months, so quit rehab. But your knee’s not game-ready yet.
• Focusing only on the injured leg: Rehab on both sides. Your uninjured leg has probably been compensating for months.
• Ignoring the mental side: Confidence matters. If you don’t trust your knee, you’ll move differently—and possibly reinjure it.
• Skipping return-to-play testing: If your physio isn’t measuring your hop performance, strength ratios, or symmetry, it’s hard to know if you’re ready.

Our job is to guide you through all of that. We track your progress closely, adapt exercises to suit your goals, and ensure you’re ready, not just cleared on paper.

The Numbers Tell the Story

Here’s something that might surprise you. A New Zealand study from 2019 found that more than 80 per cent of people who had ACL surgery didn’t even make it to 15 physio sessions through ACC. A few didn’t get any at all. That’s well short of what most rehab experts would call the minimum.

It’s not just how many sessions you get. It’s also about when they happen and how they’re structured. The research is clear; proper physio cuts your chance of reinjury, helps you build strength and control, and speeds up your return to work or sport. That’s the kind of rehab we deliver at Severn Clinics.

Our Philosophy at Severn Clinics 

We don’t rush. We don’t use cookie-cutter programmes. And we don’t stop once your swelling goes down. We build our rehab around your goals, returning to your job, weekend league, or just walking the dog without thinking about your knee.

We use a mix of hands-on treatment, guided exercise, movement retraining, and evidence-based return-to-sport testing. You’ll leave with a clear roadmap and constant support along the way.

Not Just for Athletes

Do you think ACL rehab is only for young athletes? Think again. We see everyone from teenagers to tradies to retirees. Some injured their knee playing sports, others on the farm or while out tramping. The need for rehab doesn’t change; your plan must be tailored.

We also offer group rehab sessions and ACC-covered services where applicable. We’ll help you determine what’s available so you’re not left in the dark.

Final Thoughts: The Right Physio Makes All the Difference

If you’ve injured your ACL—whether you’ve had surgery or not, your knee deserves more than a handful of rehab sessions and a prayer. A full recovery isn’t about luck. It’s about consistent work, guided support, and knowing what to expect.

At Severn Clinics, we’re committed to changing the standard of ACL rehab in Wellington. We believe in more competent care, longer-term thinking, and outcomes that speak for themselves.

Are you curious about your options? Want to know where you stand? Book a consultation. We’ll walk you through what rehab could look like and how to get started.

Understanding the Key Differences Between Physiotherapists and Osteopaths: An Evidence-Based Guide

When experiencing musculoskeletal pain or movement limitations, patients often wonder whether to consult a physiotherapist  or osteopath. While both professions share similarities in treating pain and improving function, their philosophical foundations, assessment methods, and treatment approaches  differ significantly. This comprehensive guide examines these differences to help you make an informed decision about your care.

Philosophical Foundations and Historical Context

The distinction between physiotherapy and osteopathy begins with their historical origins and underlying philosophies. Physiotherapy emerged from scientific medical traditions, with its modern foundations tracing back to the early 20th century. It developed alongside conventional medicine, incorporating evidence-based rehabilitation and pain management approaches. The profession maintains strong ties to medical science, continuously evolving its practices based on rigorous research.

Osteopathy, founded by Dr. Andrew Taylor Still in 1874, originated from a different perspective. Still proposed that many diseases stemmed from musculoskeletal problems that could be treated through manual manipulation. The traditional osteopathic philosophy emphasises the body’s inherent ability to heal itself and the importance of the musculoskeletal system in overall health. While modern osteopathy has incorporated more evidence-based approaches, this holistic foundation remains influential in practice.

Educational Pathways and Training Differences

The training pathways for physiotherapists and osteopaths education reveal important differences in their clinical preparation:

Physiotherapy education typically involves a three to four-year university degree (BSc or MSc) with substantial clinical placements across various healthcare settings. Students gain experience in:

• Hospital-based rehabilitation.
• Neurological conditions.
• Cardiopulmonary care .
• Musculoskeletal outpatient clinics.
• Sports medicine environments.

This broad exposure equips physiotherapists to manage diverse conditions using multiple treatment modalities. Their training emphasises evidence-based practice with strong foundations in anatomy, physiology, and biomechanics.

Osteopathic education generally requires four to five years of university study, focusing more on manual therapy  techniques from the outset. Clinical placements typically occur in osteopathic teaching clinics, where students primarily encounter musculoskeletal complaints. The curriculum includes:

• Extensive training in osteopathic manipulative techniques
• Detailed study of spinal mechanics
• Traditional osteopathic principles
• Some visceral manipulation approaches

Scope of Practice: What Each Profession Treats

While both professions treat musculoskeletal conditions, their typical caseloads differ:

Physiotherapists commonly manage:

• Sports injuries (ligament sprains, muscle strains)
• Post-surgical rehabilitation (joint replacements, ACL reconstructions)
• Chronic pain conditions (osteoarthritis, tendinopathies)
• Neurological rehabilitation (stroke recovery, Parkinson’s disease)
• Workplace and repetitive strain injuries
• Respiratory conditions (in some practice settings)

Osteopaths tend to focus more on:

• Acute and chronic spinal pain (particularly low back and neck pain)
• Joint restrictions and stiffness
• Postural-related discomfort
• Some headache and migraine cases
• Certain visceral complaints (when using osteopathic visceral techniques)

Assessment Approaches: Similarities and Differences

Both physiotherapists and osteopaths conduct detailed assessments that include reviewing medical history, performing physical exams, analysing movement patterns, and examining affected areas through touch. These initial evaluations help identify the root causes of pain or dysfunction.

However, their assessment methods differ in focus. Physiotherapists prioritise functional movements tied to a patient’s daily activities or recovery goals, often using measurable tests and imaging like ultrasound to pinpoint issues in specific muscles, tendons, or joints. Osteopaths, meanwhile, take a broader view, assessing how different body regions influence one another—sometimes including cranial rhythms, organ mobility, or spinal joint function—to understand imbalances affecting overall health.

This distinction reflects their treatment philosophies: physiotherapy targets localised dysfunction, while osteopathy seeks to restore whole-body harmony.

Treatment Modalities: Comparing Approaches

Physiotherapy treatments commonly include:

• Exercise therapy: Targeted strengthening, flexibility, and motor control exercises.
• Manual therapy: Joint mobilisations, soft tissue techniques, and manipulation.
• Modalities: Shockwave therapy (particularly effective for chronic tendinopathies), laser therapy.
• Education: Activity modification, ergonomic advice, pain science education.
• Functional retraining: Sport-specific or activity-specific rehabilitation.

Osteopathic treatments typically feature the following:

• Osteopathic manipulative treatment (OMT): Including high-velocity, low-amplitude adjustments.
• Soft tissue techniques: Myofascial release, muscle energy techniques.
• Cranial osteopathy: Gentle techniques focused on the skull and sacrum
• Visceral manipulation: For abdominal and pelvic complaints.
• Lifestyle and postural advice.

Evidence Base and Research Support

Contemporary research in pain science and exercise physiology supports physiotherapy, with strong evidence validating its core interventions. Key approaches backed by high-quality studies include exercise therapy  for chronic pain management, progressive loading protocols for tendon rehabilitation, motor control training to address spinal dysfunction, and graded exposure for overcoming movement-related fear.

Osteopathic research has expanded significantly in recent years, demonstrating effectiveness for specific applications. The evidence is particularly robust for spinal manipulation in treating acute low back pain and manual therapy approaches for neck pain and headaches. Some visceral techniques also show promise for functional digestive disorders. However, certain traditional osteopathic concepts, such as cranial rhythm assessment or Chapman’s reflexes, lack sufficient scientific validation.

This distinction highlights physiotherapy’s firmer grounding in evidence-based medicine while acknowledging osteopathy’s growing research base for its most commonly used techniques.

Integrated Care: When Both Approaches Help

Many patients benefit from combining osteopathic  and physiotherapy treatments for comprehensive care. Osteopaths restore joint mobility through manipulation, while physiotherapists provide exercises to maintain these gains. Manual therapy offers immediate pain relief, allowing patients to progress to active rehabilitation  for long-term recovery. 

This integrated approach, which addresses structural alignment and functional movement, often proves more effective than either treatment alone, particularly for chronic or complex conditions. Many clinics now offer coordinated care plans that strategically combine these complementary therapies.

Conclusion: Making an Informed Choice

Both physiotherapists and osteopaths offer valuable approaches to musculoskeletal care. Physiotherapy provides a more exercise-focused, evidence-based approach with a broader scope across medical conditions. Osteopathy offers specialised manual techniques with a whole-body perspective. Your choice should consider your condition, treatment preferences, and healthcare system requirements. Many patients find value in both approaches at different stages of their recovery journey.

Feeling dizzy can throw your whole day off. It’s more than just a strange sensation. For some, it’s a deep unease that hits without warning. In Wellington, we meet a lot of people who’ve had to put parts of their lives on pause because of it. Whether it’s struggling to stay upright in the shower or feeling the ground shift while walking to the dairy, dizziness changes things. The good news is, you don’t have to just live with it. Vestibular rehabilitation is a targeted physiotherapy approach that gets to the root of these issues and helps people feel steady, capable, and safe again.

What’s Causing the Room to Spin?

Before discussing solutions, let’s clarify a few things about balance and dizziness. Your ability to stay upright isn’t just about muscles or bones. It’s a complex team effort between your brain, inner ear, eyes, and joints. When something disrupts how these systems communicate, whether inflammation, injury, or age-related changes, you can feel off balance, lightheaded, or like you’re moving when you’re not.

Common causes include:

• Benign paroxysmal positional vertigo (BPPV)
• Vestibular neuritis or labyrinthitis
• Ménière’s disease
• Stroke or concussion
• Age-related decline  in balance reflexes
• Persistent postural-perceptual dizziness (PPPD)

And then there’s the ripple effect: fatigue, anxiety, nausea, and even fear of falling. No wonder many people start limiting activity, avoiding places they love, or withdrawing socially.

How Vestibular Rehabilitation Works

Vestibular rehabilitation is not a one-size-fits-all program. It’s a structured, physiotherapy-led approach that uses specific exercises to retrain your brain and body. The goal is to improve how your vestibular system processes motion, stabilises vision, and responds to balance challenges.

Your physiotherapist will assess your symptoms, eye movements, walking patterns, and postural control. Depending on what’s going on, your rehab might include:

• Gaze stabilisation exercises help your eyes stay fixed on a target while your head moves, which is key for reducing blurry vision and disorientation.
• Balance retraining: Tailored balance exercises may involve standing on different surfaces, closing your eyes, or moving your head while walking. It’s all about reprogramming your stability system.
• Habituation techniques: Repeated, controlled exposure to movements that usually trigger dizziness. The brain learns to desensitise and adapt.
• Positional manoeuvres: If you’ve got BPPV, your therapist might use the Epley or Semont manoeuvres to reposition crystals in your inner ear.
• Functional training : Working on real-life tasks like getting out of bed, bending to tie shoes, or walking through a crowded market without feeling overwhelmed.
• Education: Understanding what’s happening is half the battle. We explain the why behind the exercises, the expected progression and how to pace yourself safely.

When to See a Vestibular Physiotherapist

If you’ve been feeling dizzy or unsteady for more than a few days, it’s worth getting checked. Sudden or severe dizziness should continuously be assessed urgently by a doctor, especially if it’s accompanied by other symptoms like headache, slurred speech, or weakness.

But if you’ve had a diagnosis and the symptoms are lingering, or if you’ve had a few “close calls” with falls or are avoiding activity out of fear, that’s a good time to reach out to a vestibular physio.

It’s also worth noting that not all dizziness is inner-ear-related. Cardiovascular changes, medication side effects, neck stiffness, and anxiety can all play a role. A thorough assessment helps sort through those possibilities.

What to Expect From Your Sessions

Your first session will include a detailed interview, physical testing, and trial exercises to see how your body responds. Don’t be surprised if you feel a little dizzy during the session. That’s expected, and it’s how your brain learns to adapt.

You’ll get a tailored exercise plan to do at home. Most people come in weekly for a few sessions, but some might only need one or two visits, especially if they manage a straightforward BPPV episode. Others with more complex issues may require longer.

Progress is tracked weekly. We’re looking for improvements in confidence, steadier walking, reduced symptom frequency, and better eye-head coordination.

Getting Back to What You Love

One of the best parts of vestibular rehab is watching people return to the things they thought they’d lost. It might be as simple as going for a walk along the waterfront without needing to sit down or being able to ride the bus without nausea. Some clients go from months of avoiding social situations to rejoining community groups or travelling again.

We recently had a client who hadn’t driven in over a year due to dizziness. After eight sessions of tailored rehab and home exercises, she passed her driving re-assessment and was confidently back behind the wheel. For her, it wasn’t just about movement but about freedom.

Why Choose Severn Clinics?

At Severn Clinics, vestibular rehab is not an afterthought. It’s a core part of what we offer. Our clinicians have postgraduate training in vestibular disorders and bring years of hands-on experience treating dizziness in all its frustrating forms.

We collaborate with GPs, neurologists, ENT specialists, and audiologists across Wellington. So, if your case needs a second opinion or further testing, we know who to call and how to coordinate.

We also get that dizziness can be distressing. You’re not just coming in for a sore ankle; you’re dealing with something that affects your confidence, safety, and overall well-being. That’s why we take time to listen, explain, and support, not just instruct.

A Note on Safety

Vestibular rehab  is very safe, but it should always be guided by someone who knows what they’re doing. Self-prescribing exercises from the internet can backfire, especially if you’re doing the wrong manoeuvre for your type of vertigo. We assess thoroughly and proceed carefully. We also give you tools to track progress and know when to stop or scale back.

Some people feel worse before they feel better. That’s normal. Rehab works by stimulating your system and asking it to recalibrate. It’s like getting your sea legs back after a rocky ferry ride. The wobble doesn’t last forever.

Small Steps, Big Impact

The exercises may seem simple, such as turning your head while looking at a target or walking in a straight line with your eyes closed, but the effects can be huge. We’re training your brain to trust your body again. That’s not nothing.

Vestibular rehab doesn’t just help with symptoms. It helps people move through life without second-guessing every step. That’s real progress.

If you or someone you know has been struggling with unexplained dizziness or balance issues, we’d be happy to help. Book a consultation at Severn Clinics and take the first step toward steadier ground.

Want to feel more stable, in control, and confident on your feet? Get in touch. We’re ready when you are.

When Headaches Start in the Neck

If you’ve ever had a headache that creeps in from the base of your skull, chances are it wasn’t just a regular headache. Many people living with migraines also experience chronic neck pain, tension, or stiffness. And while it might seem like a coincidence, it often isn’t.

Neck pain and migraines are more closely connected than most people realise. In some cases, neck tension can trigger a migraine. In others, migraines worsen neck pain through a frustrating cycle of nerve sensitivity and protective muscle guarding. Whichever way it plays out, focusing on just one part of the problem often leads to short-lived relief and long-term annoyance.

That’s where physiotherapy can help. A good physio will look beyond the obvious symptoms and go straight to the source. More often than not, that means starting with the neck. The neck is not just a passive structure; it plays a key role in how our nervous system processes sensory input, stress, and posture.

Why Does Neck Pain Happen With Migraines?

Migraines are complicated. They’re not just about blood vessels or nerves or hormones. They involve the central nervous system, including the brain stem, spinal cord, and cervical spine. One of the major pathways involved in migraine pain passes right through the upper neck.

So if there’s any stiffness, inflammation, or dysfunction in that area, it can make the nervous system more sensitive and more likely to trigger a migraine. That’s also why many people notice tightness or stiffness in their necks before or during an attack.

It’s not just the deep structures that matter, either. Muscle tension closer to the surface, especially in the traps, suboccipital, and levator scapulae, can contribute to that heavy, foggy feeling that often comes with migraines. These muscles are often overworked by poor posture, stress, and even jaw clenching, which many people don’t realise they’re doing.

Not All Headaches Are Created Equal

Even if you’ve had a migraine diagnosis for years, it’s worth remembering that not all head pain is a migraine. Cervicogenic headaches, for example, originate in the neck but can feel very similar. These usually affect one side of the head, cause pain around the temple or behind the eye, and are made worse by specific neck movements or positions.

They can also show up with symptoms that look like migraine — things like light sensitivity, nausea, or visual disturbances. It’s easy to confuse the two, which is why having a physio assess both your neck and your history of headaches can be a game-changer.

How Can Physiotherapy Help?

Let’s be real. When your head is pounding, the idea of someone poking around your neck isn’t exactly appealing. But good physiotherapy doesn’t push your body harder. It works with your nervous system to help it settle down. It builds resilience and gives you the tools to feel more in control.

Here’s what treatment might include:

1. A Proper Assessment

Your physiotherapist will examine your neck, jaw, upper back, and even eye movement patterns. They’ll also ask about sleep, stress, symptoms, and any patterns you’ve noticed. The goal is to determine what’s triggering the cycle and keeping it going.

2. Hands-On Treatment

This might include gentle joint mobilisations, soft tissue release, or guided movement work. All of this is done with your comfort in mind and can help restore natural mobility through the neck and upper spine. Some physios may also use trigger point therapy if muscle knots are a key feature in your pain.

3. A Personalised Exercise Program

Once things settle down, you’ll likely be given a home program. This could include:

• Deep neck flexor activation
  
• Thoracic mobility work
• Postural control drills
• Jaw tension release (if TMJ issues are involved)

Everything is tailored to suit your body and your schedule. Even a few minutes a day of the proper movement can shift the dial.

4. Addressing the Nervous System

Physiotherapy can also include techniques like breathwork, sensory training, and mindfulness strategies to help calm an overactive nervous system. If you often feel like your body is always “on high alert,” this kind of work can be especially powerful. It’s not just about the neck, it’s about helping the whole system regulate more easily.

Adjunct Therapies: Do They Add Value?

For people with more persistent symptoms, physiotherapy can be paired with technologies like extracorporeal shockwave therapy or high-powered laser therapy. These options help reduce pain and support tissue healing by improving blood flow and calming inflammation.

They are not usually the first tools we reach for, but in cases involving chronic trigger points or deep myofascial involvement, they can make a noticeable difference. These treatments can help when other options have reached a plateau.

The Problem With Relying on Medication Alone

Painkillers can help you get through the day, and medications like triptans or anti-inflammatories often do a good job during an attack. But they don’t fix the underlying problem. If the mechanics and movement habits behind the pain don’t change, the headaches usually return.

Think of it like resetting a smoke alarm without putting out the fire. The noise might stop for a while, but the source of the problem is still smouldering. Physiotherapy helps you find and fix the fire.

When Should You See a Doctor?

Always be cautious with new or severe symptoms. If your headache comes on suddenly and feels explosive, or if you have slurred speech, dizziness, or changes to your vision, get medical attention immediately. These could be signs of something more serious.

For ongoing migraines that have already been checked by your doctor, especially when they come with neck pain or tension, physiotherapy is a safe next step. It works well with other treatments and does not interfere with medication.

Can Physio Actually Help?

In many cases, yes. Manual therapy, exercise, and relaxation strategies were all associated with good outcomes.But for most people, the biggest win isn’t just fewer headaches. It’s the feeling of being back in control. Knowing your triggers, what to do early, and how to move with more ease makes a real difference. That sense of confidence often leads to better long-term outcomes.

Final Thoughts from Severn Clinics

We treat neck pain and migraines every week, and we can tell you it’s never just about one stiff joint or one bad movement habit. Usually, it’s a mix of tension, posture, sensitivity, stress, and lifestyle factors that build up over time. Everybody has a story, and migraine is often just one chapter.

Our job is to help you unravel those layers. We listen, test, and create a plan that fits your life. Whether you’ve just started getting migraines or have been managing them for years, we’re here to help.

Let’s discuss whether your neck’s been bothering you or your migraines are becoming more frequent. Your body will thank you for it, and so might your sleep, workday, and overall peace of mind.

Wellington has a way of testing people. The wind alone feels like it deserves its own citizenship. Add to that the hills, the housing squeeze, and lately, the relentless rise in costs, and you’ve got a city that asks a lot of its residents. 

People love it here, our coffee culture, our compact city centre, our sense of creativity and community, but there’s no denying it’s become harder to live comfortably. Here’s the part that doesn’t get talked about enough: the cost of living doesn’t just affect wallets. It affects bodies. It affects health. And, quite often, it causes pain.

I’ve been a chiropractor in Wellington for over 20 years, and I’ve noticed a subtle trend. People aren’t just presenting with sore backs, stiff necks, or headaches; they’re carrying the weight of financial stress, which manifests in their muscles, joints, and even their movements.

So, let’s pull back the curtain on something many of us feel but don’t always link together: how money, stress and pain are far more connected than most people realise.

Stress is More Than “Just Stress”

We often talk about stress as if it’s some vague emotional fog. But stress has a body. It lives in your shoulders, in your gut, in your sleep cycle. When the rent jumps another $60 a week or the power bill spikes in winter, your nervous system doesn’t treat that as a theoretical concern; it responds.

And here’s the kicker: chronic stress makes existing pain worse and can even trigger new pain conditions. A stiff back that might have healed in a few weeks now lingers for months. A nagging shoulder issue becomes a constant hum in the background of daily life.

Cutting Corners on Health

Another hidden link between cost of living and pain is the simple fact that healthcare becomes optional when budgets are tight. People often delay check-ups, skip follow-up appointments, or fail to fill prescriptions.

I see it all the time. Someone tweaks their back at work, thinks it’ll settle down, and doesn’t want to “waste” money on a visit. Six months later, they’re sitting in my clinic with not only back pain but a whole cascade of compensations, tight hips, altered walking patterns, and even knee pain from the way they’ve been moving to avoid the original problem.

It’s a false economy. But it’s an entirely human one. When the choice is between physio and paying the power bill, most people will keep the heater running.

A 2019 National Health Interview Survey in the US found a strong association between financial stress and chronic pain. People worried about medical bills were much more likely to report ongoing pain. You don’t need a research paper to see it playing out in Wellington, although the data certainly backs up what’s happening on the ground.

Food, Exercise, and the Everyday Choices That Add Up

Let’s talk about food for a moment. Wellington’s supermarkets are expensive. Anyone who’s stared down the price of cheese or olive oil lately knows what I mean. Under financial pressure, people naturally turn to cheaper calories, such as processed foods, white bread, and instant noodles.

It fills the gap, but over time, diets lacking essential nutrients can contribute to inflammation, weight gain, and reduced energy levels, all of which can worsen or trigger pain.

Exercise is similar. Gyms are pricey, sports clubs have fees, and even running shoes are an investment. Sure, you can walk along Oriental Parade for free, but when you’re working two jobs, managing kids, and feeling wiped from financial stress, exercise becomes yet another thing that gets trimmed from the schedule.

It’s easy to dismiss these small choices as isolated. But stack them together—poor diet, lack of movement, less healthcare access, and you’ve got fertile ground for pain to flourish.

When Pain Hits Back at the Wallet

Now here’s the cruel irony: pain doesn’t just result from financial stress. It creates financial stress. Unsurprisingly, chronic pain is one of the primary reasons people experience reduced productivity, miss work, or reduce their work hours.

Think about someone with sciatica. They can’t sit comfortably, struggle to drive, and can’t stand for long without discomfort. Add in the cost of treatments, appointments, medications, and sometimes imaging and pain itself becomes a cost-of-living issue. The costs aren’t just money, either. They’re social, emotional, and personal. People give up hobbies, cancel plans, or slowly shrink their world to fit the shape of their pain.

The Vicious Cycle That Nobody Wants to Talk About

So here’s where it all loops back. Rising living costs make it more challenging to maintain your health. Chronic poor health makes it more difficult to earn or maintain an income. Less income makes the rising costs even more challenging to bear. It’s a cycle that spins tighter the longer it goes unchecked.

And yet, it’s invisible. Chronic pain doesn’t leave a cast or a scar. To an employer, a partner, or even a friend, it can look like nothing’s wrong. But inside, people are negotiating every step they take, every hour they sit, and every night they try to sleep.

It’s isolating. It’s frustrating. And too often, it’s brushed off as “just stress” or “part of getting older.”

A Tangent on Stigma (Because It Matters)

I want to pause here. Because beyond money and medicine, there’s stigma. Chronic pain is often misunderstood. People are told it’s “in their head.” They hear comments like “but you looked fine yesterday.”

This disbelief adds another layer of stress. Imagine struggling to pay rent, coping with constant pain, and on top of that, feeling like no one actually believes you. That mix eats away at resilience.

And it’s not just personal attitudes. Some workplaces don’t make accommodations. Some health providers are slow to listen. And culturally, we still hold an unhelpful idea that stoicism is synonymous with strength.

Where Do We Go From Here?

Okay, so the picture looks grim. Rising costs. Stigma. A health system under pressure. But there are practical ways people can navigate this intersection of money and pain, even if it’s not easy.

• Utilise free or low-cost exercise options, such as walking, home-based bodyweight workouts, or community facilities like council gyms. Movement matters more than perfection.
  
  
• Prioritise sleep: It sounds basic, but better sleep reduces pain sensitivity. Free tools, such as mindfulness apps or structured bedtime routines, can also be helpful.
  
  
• Seek early help: Even one session with a physiotherapist or chiropractor can provide direction before things escalate. ACC covers many injuries in New Zealand, which can significantly reduce costs.
  
  
• Nutrition swaps: Beans, oats, and frozen vegetables stretch a budget further than many processed options and support better energy.
  
  
• Community support: Wellington has a surprising number of free or subsidised wellbeing services, everything from support groups to health advice clinics.
  
  

No single strategy fixes everything, but layering them together creates a buffer. And in a city where both housing and pain rates are climbing, even small buffers matter.

Why This Conversation Matters

It might sound like a niche topic, money and pain — but it’s not. It’s about quality of life. When people can’t manage pain, they lose not just health but connection. They stop joining friends for dinner, they pull back from weekend sports, and they gradually lose parts of themselves that make life rich.

And when people are stuck in that loop, the whole community feels it. Lost productivity, increased demand on healthcare, and heightened social strain are all interconnected.

How We’re Adapting At Severn Clinics

At Severn Clinics, treatment isn’t one-size-fits-all. We understand that ongoing pain is already expensive, so we match care plans to both clinical need and financial realities. If someone has reached the point where their pain completely wears them down, advanced technology can often bring fast relief. Options like shockwave therapy and high-power laser machines are designed to cut through stubborn pain quickly, sometimes in only a few sessions. But these tools come at a higher cost.

For those who need to manage expenses more carefully, we often lean on proven, hands-on therapies. Cupping, guasha, myofascial release, and chiropractic adjustments can deliver meaningful results while keeping treatment fees almost half of what high-tech options demand. We also integrate approaches that reduce the need for frequent visits. Brainwave entrainment, also known as Deepwave, helps regulate the stress response that often fuels pain. Calming the nervous system eases the cycle of tension and flare-ups, resulting in fewer sessions over the long term.

Closing Thoughts

Living in Wellington means juggling beauty and hardship. You get the harbour at sunrise, but you also get the sting of a rental market that feels relentless. You get the creativity of Cuba Street, but you also get power bills that seem to arrive faster each month.

What we often forget is how deeply those economic realities seep into our physical bodies. Stress tightens muscles. Financial worry delays treatment. Poor diet fuels inflammation. Pain costs money. And round it goes.

The cost of living conversation isn’t just about budgets, it’s about bodies. If we can start seeing it that way, maybe we can create solutions that care for both.

Because honestly? Pain is expensive not just in dollars, but in lives half-lived. And Wellington deserves better than that.

TMJ Pain in Wellington? You’re Not Alone

It usually starts with a click. Or a crunch. Or a dull ache near your ear that flares when you yawn. Maybe your jaw locks, or you catch yourself massaging the side of your face without realising it. If any of that sounds familiar, there’s a good chance your temporomandibular joint, your TMJ, isn’t all that happy.

Here in Wellington, we see a surprising number of people with TMJ dysfunction. It’s more common than you’d think, and thankfully, it’s usually treatable. So, let’s talk about what’s going on behind that clicky jaw and what physiotherapy can do to help. It might feel like something you can put off, but leaving it too long can mean more discomfort and a longer recovery. Jaw pain might not be life-threatening, but it has quality-of-life consequences, from eating comfortably to sleeping soundly.

What Is TMJ Dysfunction Anyway?
Your TMJ is the sliding hinge that connects your jaw to your skull. You have one on each side, and together, they do a lot of work: talking, chewing, yawning, and even expressing emotion. When something goes wrong with that joint or the muscles around it, we call it TMJ dysfunction (or TMD, which stands for temporomandibular disorder).

Now, TMD isn’t just one condition. It’s a bit of a catch-all term. For some people, it’s about joint inflammation. For others, the issue lies with the surrounding muscles. Then, there are people with displaced cartilage or degenerative changes within the joint. Some unlucky folks get a bit of everything.

And here’s something worth knowing: TMJ dysfunction doesn’t always show up right after the cause. You could injure your jaw and only start noticing symptoms months later. Or you might be dealing with something like cervical spine tension that’s quietly contributing to the issue. It’s often a slow burner.

What Causes It? More Than You Think
Sometimes, there’s a clear cause: a knock to the jaw, dental work that left your mouth open too long, or even a nasty whiplash. But just as often, it’s something more subtle: chronic teeth grinding, poor posture, long-term stress. And here’s the kicker: how you hold your neck or shoulders can quietly mess with your jaw, too.

If your head tends to jut forward after hours hunched over a laptop, you’re creating extra tension in the muscles that connect your jaw, neck and shoulders. Over time, that tension builds up and starts pulling on the jaw awkwardly. That’s when the pain, clicking or locking begins.

There’s also a link with sleep quality. Poor sleep posture, teeth grinding at night, or even breathing through your mouth can all place extra stress on the jaw. For some people, fixing their pillows or adjusting sleep positions makes a surprising difference. It’s all connected.

Hormones may also play a role. Some studies suggest that women, particularly in their reproductive years, may be more likely to experience TMJ dysfunction. Oestrogen is thought to influence joint laxity and pain sensitivity, although the science is still evolving. Either way, it’s one more piece of the puzzle.

So What Are the Symptoms?
TMJ dysfunction can be sneaky. It doesn’t always scream, “Hey, I’m a jaw problem!” Sometimes, it shows up as:

• Headaches that wrap around your temples
• Earache  or a blocked ear feeling (without any ear infection)
• Clicking, popping or grinding when you open your mouth
• Jaw pain when chewing, talking or yawning
• Limited jaw movement
• Facial tenderness
• Pain that radiates into your neck or shoulders

   

And yes, it can be worse during stressful periods. Many people first notice it during exams, a rough patch at work, or after a breakup. Our jaws are brilliant at bottling stress.

For others, the issue doesn’t feel like pain so much as weirdness: a jaw that moves unevenly or a sense of imbalance in the face. Some describe it as fatigue in the facial muscles, especially after eating. All of that counts.

In more stubborn cases, you might also notice that your bite feels “off” or that one side of your jaw does more work. This unevenness can lead to wear patterns in the teeth or discomfort while eating. These small signals are often ignored.

How Physiotherapy Helps
Let’s get this out of the way. If someone tells you TMD is just about clenching or stress and leaves it at that, get a second opinion. Clenching is a symptom, not a diagnosis. We need to look at the whole picture: joint mechanics, muscle patterns, posture, sleep habits, and dental health, before jumping into treatment.

At Severn Clinics, our approach is tailored. After a proper assessment (including checking jaw movement, muscle tone, neck alignment, and even your bite), we figure out what’s happening. Then we get to work.

Common physio treatments for TMJ dysfunction include:

• Gentle joint mobilisation (yes, even the jaw)
• Soft tissue release  for tight jaw and neck muscles
• Postural retraining 
• Specific jaw exercises to retrain movement patterns
• Dry needling  (when appropriate)
• Sleep position advice
• Education  around chewing habits and things like overuse (chewing gum, big bites, nail-biting)
• HPL (High-Powered Laser Therapy)

We also talk a lot about habits—the kind that doesn’t feel like much but matters. Are you sleeping with your jaw clenched? Do you rest your chin on your hand when thinking? Do you hold your breath when concentrating? These small things build up.

And yes, we collaborate—dentists, GPs, and even psychologists in some cases. TMJ dysfunction can be multifactorial, and sometimes, the best results come when everyone works together. Don’t be surprised if we suggest touching base with your dentist or tweaking your daily stress management routine.

Do You Need a Splint?
Some people do. Some don’t. Splints or bite plates can help reduce pressure through the joint, especially at night. But they’re not magic fixes. If you have a joint derangement or disc issue a splint might help protect the area while we work on muscle balance and joint movement. But we recommend conservative care first unless a dentist has flagged something specific.

One thing to note: splints work best when paired with active rehab. Wearing one without addressing the root cause might mask symptoms without fixing the problem. We want to get the jaw moving better, not just quieter.

Is It Ever Something More Serious?
Sometimes, yes. It’s why we’re careful with diagnosis. Jaw pain can mimic or be mimicked by other conditions: sinus issues, ear infections, nerve pain, or migraine syndromes. In rare cases, it could point to joint degeneration or inflammatory disease. That’s why you want someone who knows what they’re looking at. We’ll always refer to it if things don’t add up.

And if you’ve been seeing different professionals for jaw, neck, or headache symptoms but haven’t had anyone put the pieces together, that’s a red flag, too. TMJ dysfunction often hides in plain sight.

Does It Go Away?
In many cases, yes. Most people respond well to treatment. If we catch it early and get on top of it, symptoms can settle in a few weeks. It might take a bit more time for longer-standing issues, but it’s still very manageable.

It also depends on how much change the person is willing to make. We can treat the joint, loosen the muscles and give you a plan. But if the same habits and postures return unchecked, so can the symptoms. That’s why education is a massive part of what we do.

The good news? It gets easier once you learn how to move your jaw correctly, manage strain, and notice your triggers. And you don’t need to give up chewy food forever. Maybe you can save the toffee for special occasions.

Final Thoughts
Your jaw isn’t just there to help you talk and chew. It plays a massive role in how you interact with the world, how you express yourself, manage stress, and sleep. TMJ dysfunction can sneak in quietly but create a loud impact on daily life.

If you think your jaw isn’t quite right, trust your gut. Book in, get checked and find a treatment plan that works for you.

At Severn Clinics, we treat TMJ problems every week. Whether it’s a stubborn case of jaw tension, a click that won’t go away, or a lock that’s messing with your meals, we’re here to help with the right tools, the right team, and the right amount of curiosity to figure out what’s going on.

Want to chat more? Reach out. Your jaw will thank you.

Pregnancy is a time of immense change. Your body is growing a whole new human, and with that comes shifts in posture, weight distribution, and hormone levels that can affect every joint and muscle in your body. For many women in Wellington, pregnancy brings excitement, nerves, joy, and discomfort all rolled into one. And while every experience is unique, one thing is true: your body deserves support. That’s where women’s health physiotherapy comes in.

Why Prenatal Physiotherapy Matters

You might hear people say, “It’s just part of pregnancy” when talking about back pain, pelvic pressure, or feeling unbalanced. But normal doesn’t always mean necessary. Physiotherapy  during pregnancy can help prevent and manage the discomforts that many women endure silently. It’s not about pushing your limits or preparing for a marathon. It’s about helping you feel more comfortable, mobile, and confident as your body adapts to the changes of pregnancy.

We don’t treat symptoms in isolation. We consider how your posture shifts, pelvic floor  responds, and energy levels fluctuate. We tailor treatment to you—not just to a textbook pregnancy.

The Physical Demands of Pregnancy

From the first trimester, your body starts preparing for birth. Hormones like relaxin begin to loosen ligaments, which is essential later on but can also make your joints feel less stable. Add a growing bump that shifts your centre of gravity, and you have the perfect setup for backaches , hip tension, and pelvic floor strain.

A lot of women notice changes early: fatigue,  nausea, sore breasts, or that weird stretching feeling in the pelvis. Then come the mid- and late-stage changes. Sleeping comfortably becomes a mission. Standing too long makes your lower back throb. You might even feel a strange heaviness down below or notice some bladder leakage when you sneeze.

Physiotherapists trained in prenatal care know what to look for, what’s typical, and what’s not. More importantly, they know what to do about it.

What Can a Prenatal Physio Help With?

There’s a long list of things we can help with, but here are some of the most common:

• Pelvic girdle pain : Sharp or dull pain across the hips, pubic bone, or lower back.
• Round ligament discomfort : Those quick, stabbing groin pains that catch you mid-step.
• Postural issues: As your bump grows, your spinal alignment shifts. We help keep you balanced.
• Pelvic floor support : We teach you how to activate, strengthen, and relax these crucial muscles. 
• Preparing for birth : Breathing techniques, perineal massage, and positioning advice for labour.
• Incontinence: Bladder leakage during pregnancy isn’t inevitable. It’s manageable with the right approach.

Pregnancy can sometimes feel overwhelming, and having a physio who understands the physical and emotional shifts can help reduce stress and restore balance.

Safe Movement and Exercise During Pregnancy

There’s a fine line between keeping active and pushing too hard. A physiotherapist can help you find that sweet spot. Whether you are a pre-pregnancy gym-goer or prefer casual walks, we build plans that suit your life, goals, and trimester.

You might do:

• Low-impact cardio  (like walking or swimming)
• Stretching to ease tight hips, calves, and hamstrings
• Strengthening   for the back, core, and legs
• Breathing exercises  for labour preparation

Some movements are best avoided or adapted, especially as you progress through your third trimester . We’ll show you how to modify activities and ensure that your body mechanics are working for you—not against you.

What to Expect During a Session

Your first session will involve a thorough chat about your health history, pregnancy progress, symptoms, lifestyle, and goals. We might assess posture, check core strength, and evaluate pelvic floor function. Every session is private, respectful, and completely tailored.

We’ll never push you beyond what feels safe or appropriate. This is about guidance and support, not pressure. If something feels off, we’ll adjust. If you’re feeling good and want to stay that way, we’ll help you maintain it.

When Should You Book In?

Any time is a good time to start physiotherapy. Some women come in early to prevent issues before they arise, while others wait until symptoms appear. We also offer a Pregnancy Warrant of Fitness check for around 20 weeks to assess pelvic floor engagement, back health, and movement habits. Later in the third trimester, a 35-week check can help you prepare for birth with perineal massage education, postnatal care tips, and gentle movement strategies for recovery.

And if you’ve already given birth, it’s never too late. Postnatal WOF sessions assess healing, check for diastasis recti and support your return to movement safely and confidently.

A Word About Pelvic Floor Health

The pelvic floor does a significant amount of heavy lifting, literally and figuratively, during pregnancy. These muscles hold up your bladder, bowel, and uterus and take a massive hit during labour. Learning to control and coordinate them can mean a smoother birth and a stronger recovery.

We teach:

• How to engage the pelvic floor  without bracing or breath-holding
• When to contract and when to relax
• How to protect these muscles during labour and postpartum 

It’s not about doing a thousand Kegels. It’s about working smarter, not harder.

You Don’t Have to “Put Up With It”

Pregnancy is a big deal, but discomfort, leaking, and pain don’t have to come with the territory. With the proper support, you can feel stronger, more informed, and more ready for what’s next. Whether it’s your first baby or your fifth, whether you’re having twins or navigating complications,  our team at Pōneke Physiotherapy is here for it.

Book a session with one of our women’s health physios and take a step towards a more comfortable, confident pregnancy.

You’re growing a baby. Let us help you support the body that’s doing all the work.

Shoulder pain is one of those things that sneaks up on you. Maybe it starts as a dull ache after a long day. You may feel it when you reach for the seatbelt or lift a bag overhead. And maybe, before you even realise what’s happening, simple things like getting dressed or lying on your side start to feel unbearable. If that story sounds familiar, there’s a decent chance you’re dealing with shoulder bursitis.

Now, here’s the good news. For most people, shoulder bursitis is treatable. And one of the most effective treatment paths? Physiotherapy. Let’s unpack shoulder bursitis, its causes, and why your physio might be your shoulder’s best ally.

First Things First: What Is Shoulder Bursitis?

The shoulder is full of small fluid-filled sacs called bursae. These act like cushions between bones, tendons, and muscles to prevent friction. When one of those sacs becomes irritated and inflamed, it’s called bursitis. The most commonly affected shoulder is the subacromial bursa, which sits between the top of your shoulder blade and the rotator cuff tendons.

When it’s working correctly, the bursa  lets your tendons glide smoothly. But when it’s inflamed, it creates swelling and pressure, and that turns even basic shoulder movement into a painful task. Overhead motions, in particular, tend to flare things up.

So What Does It Feel Like?

The most common symptoms include:

• Pain in front  on the outside or front of the shoulder
• Discomfort when lifting your arm above shoulder height
• Difficulty reaching behind your back or fastening a bra
• Pain lying on the affected side
• Swelling  or a visible lump (in more severe cases)
• Limited range of motion or stiffness

People often describe it as a sharp pain when they move, with a lingering ache at rest. For many, it’s worse at night, especially when sleeping on the sore side.

What Causes It?

There’s no single cause, but shoulder bursitis often develops because of overuse. Repetitive overhead movements (think painting, swimming, lifting kids, or overhead pressing at the gym) stress the bursa over time.

Other factors can also play a role:

• Poor posture that narrows the space in your shoulder joint
• Weak rotator cuff or scapular muscles
• Shoulder impingement or tendinopathy
• A fall or trauma to the shoulder
• Age-related  wear and tear
• Autoimmune conditions such as rheumatoid arthritis

Sometimes bursitis is secondary to another issue, like rotator cuff tendinitis or a frozen shoulder. So it’s essential to look at the whole picture.

How Is Shoulder Bursitis Diagnosed?

Diagnosis usually starts with a thorough assessment. A physiotherapist will ask about your symptoms and daily activities, then test your shoulder’s range of motion, strength, and function. Special tests help identify whether it’s the bursa, tendons, joint capsule, or a combination.

In some cases, imaging like ultrasound or MRI is used to confirm the diagnosis or rule out other conditions. X-rays may show calcification in shoudler if the bursitis is chronic.

Can Physiotherapy Fix It? Absolutely.

Physiotherapy is considered the first-line treatment for most cases of shoulder bursitis. The aim is to reduce inflammation, restore movement, build strength, and prevent flare-ups.

Here’s what that might look like:

1. Managing the Inflammation. In the early phase, your physio will help you settle the pain. This may involve:

• Relative rest and activity modification
• Ice to reduce swelling
• Taping or bracing to support the joint
• Soft tissue massage to ease muscle tension
• Education about sleeping positions and posture

2. Restoring Range of Motion. Gentle mobility exercises are introduced once pain levels are tolerable. These may include:

• Pendulum swings
• Table slides
• Band-assisted stretches
• Open book stretches (great for the thoracic spine, too)

The goal here is to keep the shoulder moving without aggravating the bursa.

3. Strengthening the Shoulder Weakness, particularly around the rotator cuff and scapula, contributes to poor shoulder mechanics. Your physio will design a tailored strengthening program. Examples include:

• Scapular wall slides
• Theraband rows
• Isometric holds for shoulder
• External rotation exercises

These exercises are progressed gradually, depending on your tolerance.

4. Addressing the Root Cause To prevent future flare-ups, your physiotherapist will examine broader movement patterns. Are your neck and thoracic spine moving well? Is your posture causing compression at the shoulder? Do you lack core or scapular stability?

This is where a good physiotherapist makes all the difference. They go beyond the painful shoulder and assess how your whole upper body functions.

5. Adjunctive Therapies In some cases, adjunct treatments like extracorporeal shockwave therapy or high-powered laser therapy may be used alongside physiotherapy. These can help accelerate healingby reducing inflammation, improving circulation, and stimulating tissue repair. While not always necessary, they can be helpful for persistent or recurring cases of bursitis.

Do You Ever Need a Cortisone Injection?

Sometimes, yes. If your pain is severe or not improving after a few weeks of treatment, your GP may suggest a cortisone injection to reduce inflammation. It can offer temporary relief, but the pain often returns after a few months. Repeated cortisone injections are not without risk. Over time, they may weaken tendons or lead to joint damage, so they’re best used sparingly and always in conjunction with a proper rehab plan.

When Is Surgery Needed?

In most cases, it’s not. Surgery is a last resort and is typically only considered if a structural issue (like a bone spur or tendon tear) has not responded to months of conservative treatment.

What’s the Recovery Time Like?

That depends. Mild cases can improve in a few weeks with rest and rehab. More persistent or chronic bursitis may take 6 to 12 weeks to settle fully. The key is not to rush. Loading too early or too aggressively often sets things back. Your physio will guide the pacing based on your symptoms and response to treatment.

Why Physiotherapy Is the Smart First Step

Medication might take the edge off, but it rarely solves the problem. Physiotherapy, however, focuses on what is causing your pain. It gives you a clearer understanding of your body and practical ways to manage it, not just now but in the future too.

And it is more than just doing a few shoulder exercises. It is about picking up on those small clues your body gives you and adjusting everyday habits that add up, like tweaking your desk setup, carrying your bag differently, or finding a better sleep position.

Wellington’s Approach to Shoulder Bursitis

At Severn Clinics, we see shoulder bursitis week in and week out. Every case is a little different. Some people are dealing with it for the first time after an injury, while others have had shoulder pain come and go for years.

Our first step is a thorough assessment to determine what is actually causing the problem. Once we know that, we build a rehab plan tailored to you. Everything we do is straightforward, backed by research, and focused on your goals. We explain things in plain language and make sure decisions are made together.

Some people need manual therapy, others need a clear home program. Sometimes, we link up with your GP or sports doctor. Whatever the path, we stay with you the whole way.

Final Thoughts

Shoulder bursitis can be incredibly frustrating. It interferes with sleep, work, workouts, and even basic self-care. But it’s also very treatable.

With early assessment and the right rehab plan, most people see significant improvement without injections or surgery. So if your shoulder is grumbling, don’t wait and hope it goes away.

Get it checked. Take action. And give your shoulder the chance to move the way it should.