All posts by Emily Billiau

Part 2: How much is my claim worth? – Care Costs

Emily Billiau


Care costs can be the single most significant component of a claim. 

Particularly when the injured party doesn’t work (therefore doesn’t have significant income loss) but is seriously injured.

How much is my claim worth?

It's a big question.

And one that is asked by every claimant we see.

Unfortunately, the answer is never straightforward – mostly because there are many factors that significantly influence the overall amount awarded. 

The amount of compensation that a person receives is known as quantum.

As we learn through this four-part series, there are a number of areas under which you can determine what your quantum is and in turn, discover how much your claim is worth.

The second topic we will be covering is care costs.

Be sure to read our first article on future economic loss first.

What are care costs?

Care costs relate to an injured party inability to complete daily living tasks.

The idea is the amount of money received under this head of damage will pay for another person to assist with daily living and maintenance task.

The care can be provided to you by friends, neighbours or relatives, or you may have engaged paid services to undertake the tasks you could not perform yourself due to your injury.

Legislation in Queensland imposes threshold care requirements in cases of motor accident injury or public liability claims, and there are increased restrictions on care claims when claiming for a work injury.

How much can you get for it?

Again, this is dependent on the level of care that is required based on your unique circumstance.

What factors influence it?

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    The extent of injuries and their lasting impact on your ability to complete daily tasks
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    What daily tasks you completed before the accident
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    The ability to PROVE the above two factors

Example 1 – Bicycle Car Accident 

Jack was an 25-year-old, training for the cycle leg of an upcoming triathlon. He was riding in the streets close to Mt Cootha and as he crossed an intersection with a green light, a car sped through a red light and straight into Jack. 

Jack was left quadriplegic. For the rest of his life, will require assistance with feeding, toileting and bathing. All movement around his house, getting in and out of bed, and any daily errands will need help from another person.

His claim for compensation included daily care to assist him in completing tasks as well as home maintenance, garden care and driving services. His care cost totalled $2.5 million.

Example 2 – Inferior Infrastructure Accident

Angie was cycling along a bike path on her way to work. Angie slowed as she approached a stretch of the path that she knew was slippery due to the surface material. She had heard of other cyclists having accidents at that same spot before.    

Despite her efforts to stay safe, Angie's wheels had slipped on the surface. Angie instinctively held her arms out to catch herself. By doing so, Angie fractured both her wrists. She required surgery to correct her fractures and her surgeon indicated that recovery would likely be slow. Because of her injuries, Angie could not longer complete household and personal care tasks. She relied on her husband and as well as some commercial help in the form of a cleaner for around 8 months. 

Angie’s claim for care totalled $35,000. The money covered the cost of her cleaner and compensated her husband for his time assisting Angie. 

What care is covered?

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    Domestic tasks – such as general household chores such as cooking, cleaning, mopping, vacuuming, taking out rubbish, changing bed sheets, laundry, ironing, cleaning windows or mirrors, dusting, scrubbing out bathroom areas, grocery shopping etc.;
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    Personal care tasks - such as helping you out of a chair or bed, or helping you to the toilet, helping you bathe, helping you dress, changing bandages or cleaning wounds, helping with hair care, obtaining your medications or medical aids for you, cutting your toenails or shaving, even providing you with massages to relieve pain etc;
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    Travel tasks – such as driving you to appointments or helping you run personal errands. Even taxi services can be considered paid care where you are unable to drive due to your injuries.
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    Vehicle maintenance tasks - such as cleaning your car, or undertaking your car repairs or maintenance that you did yourself before the accident;
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    Home maintenance - such as cleaning down gutters or eves, washing down walls or outside windows and screens, house repairs and general maintenance to your home such as fixing gates or even changing light bulbs etc, as well as yard maintenance such as mowing the lawn, undertaking the gardening, weeding, whipper snipping, lopping back trees, pruning bushes etc.

Did you know you can also claim for the help your friends and family provide?

It’s known as gratuitous care.

Confusing title aside, it relates to any voluntary work of third parties (like your friends, family (including your partner), neighbours, and very kind strangers) who assist you in any of the above tasks.

IMPORTANT: Under legislation in Queensland, a person can only claim for gratuitous care if:

  • The care is different from any help previously provided
  • The care was/is provided for at least 6 hours a week and for at least 6 months.

Take for example....

If your mum helped look after your children one day a week while you work, and she continued to assist while you were off work recovering, that assistance could not be claimed for after the accident.


However, if she helped out an additional day (over 6 hrs of unpaid work) after the accident and that help continued for six months or more that care can be claimed for.

Emily Billiau


What evidence will you need?

You will need to prove that you completed the tasks before the accident.

For personal care tasks (such as showering, cleaning your teeth), it’s assumed you would have completed tasks those tasks yourself.

For jobs such as cooking, cleaning, garden care and child care, evidence is needed to show that you were responsible for some or all of these tasks within your household.

Equally so, you will need to put a monetary value on the work that you do. 

Some examples of evidence might include:

  • Testimony from partner, or someone living with you of the jobs you usually do around the house
  • Tax invoices and receipts for commercial care post accident
  • Quote for commercial care (such as a gardener, cleaner, nanny etc.)
  • Record of help provided by friends and time allocated
  • A medical note from a medical professional on your ability to complete daily tasks
  • Written testimony from friends and family of the hours worked and tasks that were undertaken.

Keeping a record of care provided since the accident is crucial

Keeping a record of the care and assistance provided to you due to your injuries is very important, as it can mean the difference between having a claim for care and assistance, or not having such a claim at all.

Keep a spreadsheet that details the following:

  • Type of care (paid or unpaid)
  • The service provider (company or person's name if unpaid)
  • Kind of service provided (i.e. mowing, laundry, cleaning)
  • Date and duration of service
  • Cost of service (if paid)
  • Will the service be required in the future and how often

To help ensure that you keep an accurate record, keep in mind the following helpful tips

  • Keep receipts for any services that you have paid for;
  • Photocopy or scan those receipts, in case they get lost or destroyed;
  • Consistently fill out the table as each service is provided;
  • Ask the service provider to give you an "Itemised Account" that details the dates and costs of each service when they are performed

No good compensation claim is without Future Economic Loss.

Like the saying – don’t put all your eggs in one basket - don’t forget to read the rest of the articles in this series on the other areas of compensation available to you.

Part 1: How much is my claim worth? – Future Economic Loss
Emily Billiau Principal ​Most people have heard of personal injury claims but very few would understand what quantum is. …and[...]
Part 3: How much is my claim worth? – Medical Expenses
Emily Billiau Principal Medical Expenses are a crucial part of all claims for compensation. Why? Well apart from the obvious[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal


Part 1: How much is my claim worth? – Future Economic Loss

Emily Billiau


Most people have heard of personal injury claims but very few would understand what quantum is.

…and they really should – behind liability, it's the second most significant determinant of a successful claim.​

You’d be forgiven for thinking quantum has something to do with physics. But it nowhere near as difficult to wrap your head around.

Simply put, quantum means an amount. So, it refers to the amount of compensation a person will receive for a personal injury.

As we learn through this four-part series, there are a number of areas under which you can determine what your quantum is and in turn discover how much your claim is worth.

The first topic we will be covering is a person's future economic loss. This area often makes up the most significant percentage of your quantum.

[RELATED: Calculate your Future Economic Loss using our worksheet here)

What is Future Economic Loss?

Future Economic Loss relates to an injured person’s ability (or inability) to work after an accident.

Simply, it covers a person's reduced income.

For example, this area of compensation might cover a person’s:

  • Total inability to return to work
  • Fewer hours or a move to part-time work
  • Change in duties or job
  • Inability to progress career through promotions or job changes

..up until they retire.

How much can you get for it?

The amount awarded for future economic loss varies considerably.

It depends on five major factors including:

  • The extent of injuries and their lasting impact on the ability to continue working
  • Pre-employment history
  • Likely career trajectory
  • The ability to prove the above three factors; and
  • Age at trial or settlement (how far you are away from retirement).

Example 1 – Bicycle-car accident, long-term soft tissue injury

Olly was on a bike when a car switches lanes and pulls in front of him. Olly runs into the back of the car, falls off his bike and hits the ground.  

Hospital X-rays show ligament damage to his injured ankle and a cracked left wrist, which is put in a cast. Despite having worn a helmet, Olly has a concussion and is kept in hospital overnight. Olly is advised to begin a physical therapy on his ankle and wrist once its removed from its cast. 

He misses out on a week of work. 

Two months of physical therapy has had little impact on his ankle.  He found he had continuing pain for many months but was mostly able to work through it.

At age 29, he has most of his working career as a Teacher ahead of him. While he never lost the ability work (beyond his week off), Olly felt he lost work opportunities because of his continual pain meant he couldn't go the extra mile in his job. This reduced the likelihood he would be picked for new job or promotions. As it's difficult to quantify missed job opportunities, Olly's lost future earning capacity couldn't be calculated mathematically.

As a result, the judge awarded a small estimated figure to compensate his loss. Olly was awarded $40,000 in lost future economic loss. This is largely due to his young age. Otherwise, his injury has had only minor impact on his future economic loss. 

Example 2 – T-Bone collision, permanent hard injury

Jane cycling to work one morning. As she rode alongside a row of parked cars the door of one car unexpectedly flew open. Jane was thrown over the front of her bike and head first into the door. Jane suffered severe whiplash, ligament damage to her left knee and broke both wrists as a result of the incident. Jane required surgery to stabilise her wrist fractures which required her to take three months off work.

Jane was 35 and worked a registered nurse. She was in line for promotions to managerial positions. Because of the injuries suffered in the accident, she has difficulties working for long periods of time. This means she is unable to put in the hours required for her promotion. She has also found that she struggles to complete her clinical duties and cannot accept overtime hours.

As Jane’s weekly income is reduced (because she cannot accept overtime), she is $300 worse off every week. Adding to that, had Jane been successful in her promotions she would have added $500 to her weekly wage.  Combining this and multiplying it by the number of weeks until her retirement, Jane's economic loss totalled $657,600.

What factors influence it?

How is someone's future loss of earnings calculated for personal injury claims?

Someone's future loss is usually calculated by looking at four things.

  • 1
    A person’s pre-injury weekly salary is compared with their pay at trial (or settlement). This difference will fairly quantity any reductions in work hours. Understanding weekly changes in your wage is important, particularly, if the injured person has had to move to part-time work or is no longer able to take overtime work. 
  • 2
    The person's maximum salary over the course of their career is determined. This decision will quantify any lost job opportunities.  A difference between maximum earning potential and the pre-injury wage is determined.
  • 3
    An amount is then deducted from your weekly earnings to compensate for the fact you are likely to accumulate interest on your salary. This deduction is known as applying discount rate (see below). In Queensland, we use 5% multiplier. 
  • 4
    Finally, the superannuation you would have lost is accounted for based on your maximum earning potential.

How future economic loss is calculated sounds complex, but if you follow our worksheet it breaks down the steps into easy to understand (and action) summaries.

Want to know how to calculate your future economic loss?

Our FREE guide shares the secret formula insurance companies use to discover what your future earning capacity. 

  • check
    step-by-step guide
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    clear examples
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    gives you evidence to support your claim that WILL stand up in Court.

Not downloading the guide may be the most expensive mistake of your life. 

In exceptional circumstances, calculations cannot be made.

When a person’s earning capacity is difficult to determine (such as in children’s cases, or where a person hasn’t taken time off work) a court will award a global sum.

This a blanket award of money determined by the trial judge. Such a case was evidence in example 1 above.

More on discount tables...

The discount rate relates to the rate of return that may be expected on money awarded in a lump sum settlement and is expressed as a percentage per annum.

A discount rate of 5% implies an expectation that the money, when invested, will achieve a return of 5% per annum.

Discount rates are used when assessing someone's future economic loss.

They are essential in determining how much needs to be paid now to compensate for amounts that would have been received in the future.

[RELATED: Calculate your Future Economic Loss using our worksheet here)

What evidence will you need?

Critical pieces of evidence required to prove your future economic loss include:

  • Pay summaries
  • Salary estimates or your current and future jobs
  • Examples of colleagues who have progressed and their wages
  • Average retirement age in your industry
  • Medical reports on your likelihood of returning to work
  • Pre-injury medical history

Next Steps...

Like the saying – don’t put all your eggs in one basket - don’t forget to read the rest of the articles in this series on the other areas of compensation available to you.

Part 2: How much is my claim worth? – Care Costs
Emily Billiau Principal Care costs can be the single most significant component of a claim.  Particularly when the injured party[...]
Part 3: How much is my claim worth? – Medical Expenses
Emily Billiau Principal Medical Expenses are a crucial part of all claims for compensation. Why? Well apart from the obvious[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal



The 1 thing no one discusses about near-misses

We don’t need to explain the phenomenon of near-misses.

They happen far, far too often on our roads.

We often hear stories of people too afraid to get back on the bike after a near miss.  

So much so we decided to ask for some expert advice on the matter.

Brisbane Psychologist Romana Bowd has put together a quick article on the mental impact near misses can have on cyclists.

Discover how to identify psychological trauma and what your next steps should be.

How is mental trauma related to near misses?

As a driver of a car, bike rider or even pedestrian we can be involved in a significant accident that can leave not only physical injuries but also psychological injuries.

However we can suffer psychological injuries due to a ‘near miss’ or even witnessing an accident. These injuries can leave emotional scars that are as traumatic as physical ones.

We refer to these emotional problems as Post Traumatic Stress Disorder (PTSD) if a person’s emotional state remains unstable many days or months past the original incident.

What is PTSD?

A person is diagnosed with PTSD if there are any emotional or environmental triggers that can bring back memories of the trauma accompanied by intense emotional and physical reactions.

Symptoms may include nightmares or flashbacks, avoidance of situations that bring back the trauma, heightened reactivity to stimuli, anxiety or depressed mood.

It also can include:

  • hyperalertness (exaggerated startle response),
  • sleep disturbance,
  • guilt related to the incident,
  • trouble concentrating,
  • avoidance of activities that replicate the incident in any way
  • avoidance of activities that previously were enjoyable; and 
  • worsening symptoms by exposure to events resembling the original incident.

Does PTSD affect everyone?

Often people do not consider themselves to be suffering from PTSD because it is often associated and most commonly reported in war veterans and just witnessing an accident or being involved in a ‘road accident’ is under-estimated by most of us as not serious enough to seek help.

However, health professionals consider that anyone subjected to severe or sudden stress needs to be treated seriously just as if they had a physical injury.

PTSD can occur in anyone of any age, gender, culture and socioeconomic background.

What should you do if you are suffering?

If you are suffering  from symptoms, then it is recommended that you go and see your GP.

Your GP and you can assess whether it would be helpful to see a psychologist, psychiatrist and/or start medication.

If PTSD is severe it does not just ‘go away’ often our brain cannot erase the memories of the incident and it is very important to seek help.

Thanks Romana

Romana is a qualified psychologist based in Brisbane. For any questions relating to this blog post, psychological trauma or other related issues, please contact Romana using the details provided below.

Dr Romana Bowd PhD, BSc(AppPsych), BSc(Hons), MAPS, CHP, Assoc. CCounsP

Taringa 7 Day Medical Centre

Phone: 3830 5999

Email: [email protected]

If you need immediate help, please contact emergency services on 000 or LifeLine on 13 11  14

Tips For Rehab After Knee Surgery From A Physio

Knee surgery. The concept can make even the strongest person cringe in sympathetic pain. 

We contacted Physiotherapist Martin Coote from Brisbane City Physiotherapy to discuss post operative management and tips for rehab after knee surgery improve the chance of a successful recovery. 

Read on to see his insights. 

How should someone prepare before their surgery?

The key to assisting your rehab after surgery is to have your knee as strong as possible prior to surgery. Some hospitals now provide “get fit for surgery” programs as this greatly assists with achieving the goals in the post-operative protocol.

Your Physiotherapist can help set this up and will usually need information on the type of surgery and your Surgeons post-operative protocol

What should I do immediately after surgery? 

Follow instructions. 

Usually you will leave hospital with specific instructions and advice on when it is appropriate to commence your rehabilitation and when you will have a follow-up appointment with your Surgeon.

Are there any exercises you can recommend post-surgery?

This will depend on the specific surgery and your Surgeon’s protocol. 

The general principles of rehabilitation are to regain range of motion and strength as soon as allowable (depending on the type of surgery).

Your Physiotherapist in conjunction with the Surgeon’s post-operative protocol can guide you on the specific exercises you need to do for your particular surgery.

When should I see the physio, and what will physiotherapy involve?

You should see your Physiotherapist as soon as possible after the Surgeon gives you the green light to commence rehabilitation.

Physiotherapy modalities may include massage, mobilisations, and specific exercises to help regain mobility and strength.

Furthermore, gait re-education is usually required to ensure a normal gait pattern is returned. 

Often an altered gait pattern can place undue load on the hip and back and be difficult to correct if the compensatory pattern is not corrected in the early phases of rehabilitation.

Thanks Martin.

Stay tuned for more articles from Martin and the Brisbane City Physiotherapy team. 

In the meantime, if you have any questions related to this article, surgery or other mobility issues, please contact Brisbane City Physiotherapy on (07) 3301 2345 or click the button below. 

How to eat your way to recovery – Part 2: Migration Stage

When you suffer an injury, your first thought might be to seek treatment from a doctor or physiotherapist. And while that's the correct action to take, people often forget to think about how their diet can impact their recovery process.

We sat down with nutritionist, Kate Jeffries from Katalyst Nutrition to talk through how you can eat your way to recovery.

Based in Brisbane, Kate holds a Bachelor of Behavioural Science (Psychology) and an Advanced Diploma of Nutritional Medicine and she uses her background in both of these areas to work to achieve optimal health and nutrition for her clients.

Read on to see her insights and find out what food you need to be eating and when.

If you missed Part 1 in this series, click here to view it. 

What are the signs and symptoms of this stage of recovery and how long does this stage last for?

Injury healing involves processes that (1) fill in, (2) seal and (3) shrink the wound or injury. 

These characteristics of healing vary in importance and duration dependent on the different types of injuries. 

Injury healing, following the inflammatory response, involves a process known as the migration or proliferation phase.  This phase begins 3 – 4 days after injury and continues from between 2 – 10 weeks dependent on the type and severity of injury. 

For example, a paper cut or sutured surgical wound will heal within a couple of weeks because the edges of the wound are in close proximity and the injured area has suffered minimal tissue loss. 

A fracture, on the other hand, can take up to 10 weeks in the migration phase as there are more complicated processes involved in an attempt to restore bone tissue and strength.  

Within 48 hours after an injury, a process called angiogenesis takes place in which new blood vessels begin to form from surrounding soft tissue which increases the blood flow to the site of injury.  Any dead red blood cells are cleared away and other cells known as fibroblasts infiltrate the injured area and start laying down collagen.

This is a vital component of this process as collagen is the most abundant protein found in our bodies and acts as the ‘glue’ that holds together the tissues of our:

  • joints,
  • muscles,
  • tendons,
  • bones,
  • blood vessels,
  • hair,
  • skin,
  • nails, and
  • Digestive system...

…the list goes on.  

What foods should you be eating at this time?

During the migration phase you will probably find that you are exercising less so your appetite decreases. 

Although your energy requirements during recovery are less than when you are consistently exercising, they are still higher than your day to day energy requirements when sedentary (your basal metabolic rate).  This is due to the work your body is undertaking to repair injured tissue.  Failing to meet these energy requirements by not eating enough coupled with lack of exercise may result in a loss in muscle mass as well an increase in fat stores.  

Proteins are the building blocks for all of the cells in our body so consuming adequate protein is vital during recovery.  The minimum amount of protein that should be consumed in a day is 0.8 gm of protein per kg of body weight. 

So, for a 70 kg person this equates to approximately 56 gm of protein each day. 

The needs of athletes are higher and they should be consuming closer to 1.5 – 2 gm of protein/kg of body weight each day. 

Your protein intake should be broken up over the course of the day and will ideally come from a variety of different sources. 


Protein sources include (but are not limited to):

  • meat,
  • tofu,
  • tempeh,
  • eggs,
  • nuts,
  • seeds,
  • nut or seed butters (almond butter, peanut butter, tahini etc),
  • lentils,
  • chickpeas,
  • beans or
  • a good quality protein powder. 

Healthy Fats

The inclusion of healthy fats such as:

  • extra virgin olive oil,
  • nuts,
  • seeds,
  • fish or fish oil,
  • avocado, and
  • flaxseeds/flax meal/flax oil

…remains important during this phase due to their anti-inflammatory properties (refer to previous post for more information).  


Minimally processed carbohydrates should also be included for energy from wholefood sources such as:

  • wholegrains,
  • pseudograins (quinoa, buckwheat etc.),
  • legumes,
  • fruits and
  • vegetables.  

Are there any other considerations we should be making at this time?

The main considerations during this period are ensuring you are eating enough each day to meet your energy requirements.

This may mean that you ensure you eat every 3 – 4 hours even though you may not be feeling that hungry. 

Avoiding inflammatory foods such as high amounts of animal protein, alcohol, caffeine, sugar and highly refined or processed foods will also support the recovery process. 

It is also important to include variety in your diet to ensure you are obtaining a wide range of different nutrients to optimize your health and functioning of the body. 

Thanks Kate. 

If you missed Kate's first article in this series, be sure to check it out below. 

Eat your way to recovery – Part 1: Inflammation
When you suffer an injury, your first thought might be to seek treatment from a doctor or physiotherapist. And while[...]

In the meantime, if you have any questions relating to this article or more general questions around nutrition, don't hesitate to contact Kate on 0423 493 330 or click the button below. 

1 Simple Exercise to relieve Neck Pain Now

If you have a neck injury which may have resulted from a motor vehicle accident, a fall or an injury at work you will know how persistent the pain and symptoms are and how encroaching they are on your daily life.

The pain and other symptoms, including headaches, can feel like it's ruining your life.  

If you have these issues you should be seen by a health professional for in depth assessment, treatment options and self-management information (including your own exercise programme).

While you are waiting to see your health professional or if you are searching for some more options to help yourself relieve the pain and symptoms of your neck injury this simple exercise from Sean McCoola of Maximize Health Group can kick start your return to normal life without symptoms.

Your One Simple Exercise.

In sitting or standing position, while stationery or travelling all you need to concentrate on is tucking your chin in.

That’s it! It’s so effective because it addresses the 3 major issues that continue neck pain and symptoms: poor posture, stiff neck joints, spasmed and irritated muscles and nerves.

Watch the video below for a demonstration.

Tips for the best result.

Sit or stand tall to begin. Check out Sean's video on how to perfect your posture and prevent postural pain here.

Concentrate on gliding chin straight back, as if dragging your chin on a flat surface. Use your pointer finger to push chin backwards. Leave pressure on for the whole hold times below if it helps.

Hold for 10 seconds at a time initially, build to 10 x 10 second holds and build this to complete repeatedly throughout the day. Aim to make this position your new “normal” over weeks and months

  • Accept there will be symptom changes, this is normal. However, do not let pain increase by more than a further 2 points on the 1 to 10 pain scale (eg if pain is at 4/10 do not go past 6/10). Do not let other symptoms, including headaches continue to increase after the initial positioning.
  • Accept that a double or triple chin may also arise. An added benefit of this exercise is that it will reduce the appearance of double chin as it is toning muscles around that problem area. Bonus!!

Bonus Tips

To help relax into this position, breathe in through your nose for 3 seconds and out through your nose for 6 seconds. Yes, this lasts almost the whole 10 seconds of the hold of position and can be repeated as you are able to hold the position for longer.

To improve the stretch and joint movement tilt head to one side and hold initially for 10 seconds

Thanks Sean. 

Stay tuned next month for another article from Maximize Health Group.

Check out Sean's other articles below. 

3 Simple Techniques to Get to Sleep with a Whiplash Injury
For this month's contribution from Maximize Health Group, we decided to get some advice on how to get to sleep[...]
Road to Recovery: Top tips to get back after an accident
For this month's contribution from Maximize Health Group, we decided to get some advice on accident recovery.  We have again enlisted[...]

In the meantime, if you have any questions regarding these tips, whiplash injury recovery or other health issues please do not hesitate to contact Sean on +61 7 3343 5494 or [email protected].

Part 3: What to do at each stage of your recovery: The final phase

Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful and uncomfortable process to repair itself. 

We sat down with Nick Marshall from Surf Life Physio in Miami, QLD earlier this month to get a better understanding of the recovery journey. Nick has over 17 years' experience as a physiotherapist, having practised both privately for his own practice Surf Life Physio and as a senior outpatient physio for Tweed Heads Hospital.

This article continues our injury recovery series. Read the first and second article on the first two phases of injury recovery. 

Nick gives his insights on the final recovery stage, known as the remodelling phase, of an injury and provides tips on how best to manage this stage.

What is the remodeling phase?

The remodeling phase is when the less mature Collagen fibres become thicker and stronger.

Depending on the physio rehab, these fibres then align themselves in a position so they are ready to absorb load and stress.

The most important component of the remodeling phase is that it cannot begin until the inflammation phase has come to an end and the area damaged no longer has elevated inflammatory markers.


In the analogy we are using of the house fire, the remodeling phase are the builders, the people instructed with repairing and re-building the damaged areas, and making sure the quality of the materials and the way they are assembled and constructed will withstand future issues thrown at it.

But as we discussed, in the human body, the remodeling can’t begin with the inflammation present, and neither can a builder start to re-build a house with the area still cordoned off by police and firemen still hosing the flames on the house down (remember the first stage, known as inflammation, is like emergency services).

This is often what happens in the presence of chronic inflammation and so the builders never get to build because the emergency servicers never move out and so the healing fails. 

Like wise the builders can’t start to rebuild the house if the house is still on fire and have people injured inside. This is what quite often happens in the body when a person takes an anti-inflammatory pill (or an anti-emergency services pill) too early in the acute injury model. By denying the area of an inflammatory or emergency services period there’s no possible way to progress and so again the healing of damaged tissues fails

How long does this stage last for?

Like building a house the remodeling phase can be slow and take time. In fact in some injuries especially to tendons and ligaments it can take a year.

How would the injury feel in this stage?

Generally, because this phase can’t start until the area is free of inflammation, this stage is pain free and the person will be almost back doing things without any discomfort. But that can be the danger. Because despite the absence of pain the structures haven’t been completely fixed and healed.

Do I need physio in this stage?

This is the most important period to get physio. It’s at this stage that you are adding exercises and stretches to the program to allow the structures to heal in the right way so to avoid re-injury and restore pre-injury function.

Thanks Nick.

If you missed the last two blog posts, click the links below. They are worth the read. 

Part 1: What to do at each stage of your recovery: The first 3 days
Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful[...]
Part 2: What to do at each stage of your recovery: The next 2 weeks
Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful[...]

This concludes our injury recovery article series. But be sure to stay tuned for more articles from Nick and the Surf Life Physio team. 

In the meantime, if you have any questions regarding these tips, injury recovery or other health issues please do not hesitate to contact Nick and his team at Surf Life Physio on (07) 5527 7830 or click the button below.

Knee Pain? You Should See a Chiro

If you have ever suffered a knee injury, you would be well aware that it feels like your knee never quite recovers.

Whether its lingering pain, loss of mobility, reduced function or general weakness, there is always a lasting symptom to remind you your knee just isn't quite up to scratch anymore. 

However, you do not have to decide to live with the pain, reduce your activity level, or start taking more pain medication to deal with your 'new' knee. 

We have reached out to leading chiropractor, Andrew Vincent from Andrew Vincent Chiropractic to explain how a chiropractor might help with knee pain and what happens during an initial consultation.

Andrew has been Director and Principal Chiropractor at Andrew Vincent Chiropractic for over 30 years and has led the way for the chiropractic industry as State President and National Representative of the Chiropractors' Association of Australia, Queensland Branch. 

Read on to see Andrew's insights and learn what goes on during a knee examination.

Andrew Vincent | Director and Principal Chiropractor at Andrew Chiropractor

Can you walk me through a knee examination?

Sure! Watch the video below and find out all that goes on in a knee (and leg) examination. 

What is the most common cause of knee pain?

Other than direct falls or hits, knee pain is usually a result of overloading the joint from an unusual angle with too many different movements or going beyond your muscle strength and moving with a poor technique…we have all headed off on our first run of the year and felt great…for about a kilometre…and then things go to custard!

Why should someone see a chiropractor if they have knee pain?

Chiropractors look at the knee as part of an overall structure, consisting of your back, pelvis, hips and feet.

Imbalances in the correct joint movement either in your feet or pelvis will change how muscles pull in your knee and could be painful.

So, rather than just managing a sore knee, a chiro will look for underlying causes in related areas…a bit like your mechanic checking your steering, wheel alignment and shock absorbers when you go there with a tyre that is wearing unusually.

What is your common treatment method for knee pain?

  • 1
    Pain relief is the first part of the plan.
  • 2
    Ice, stretch and reduced activity is first recommended, together with specific adjustments, or precise manipulation of the foot, ankle, knee or pelvis if these are found to be functioning unevenly.
  • 3
    Home advice on customised stretches together with pressure point work on muscles are taught for faster rehab.
  • 4
    Planned return to physical activity is then scheduled.

How important is stretching and strengthening exercises in your treatment methods?

Patients need to realise that nearly HALF of the results for knee pain recovery rely on doing your stretches and exercises. 

So how quickly you recover is really driven by commitment to home advice and actively modifying the way you do certain things that may be aggravating your problem.

Thanks Andrew. 

Stay tuned for another article from Andrew soon.  

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Andrew and the rest of the team by visiting the Andrew Vincent Chiropractic website.

Andrew Vincent Chiropractic offers massage and nutritional support alongside their chiropractic services to ensure a whole lifestyle change is possible. 

Other articles from Andrew Vincent Chiropractic

5 Office Exercises for Relieving Neck Pain

You wouldn’t go running, bench press or sit in a car for 8 hours continuously without a break or two to move around, would you?

So why do we find it perfectly normal to sit, hunched over, with muscles in constant contraction, straining our eyes as we stare into a fluorescent screen all day? It’s absolute madness…

Never fear however as help is at hand for relieving those aches and pain as well as tight neck muscles that leave you feeling sore, tired, heavy and at quite possibly with a splitting headache.

Fortunately we have some easy to do, take anywhere, anytime exercises that will get you loose as a goose and ready to face the afternoon slog towards 3:30-itis.

Stephen Bancroft | Physiotherapist at Queen Street Physiotherapy


Active Neck Rotation This is a great one for general loosening of the neck when it feels tight as well as practicing controlled, supported movement.

Starting in correct posture  which is sitting tall, shoulders slightly back and down, chin tucked in and head facing forward) slowly rotate the head to the left keeping the line of sight parallel to the ground (not looking up or down).

When you reach a position where the neck is slightly uncomfortable with the stretch pause for 1 second and then turn the head back through centre and to the right.

Repeat this in a slow controlled motion for one minute, take a short 30 second break and repeat.

2 sets of 1 min


Levator Scapulae Stretch - If this muscle could be renamed it would surely be the gremlin muscle.

When your neck and shoulders get tired you can trust good old levator scapulae to take over and try to hold things up but it comes at the cost of a tight neck, sore shoulders and even headaches.

To stretch it out place one arm by your side (or even tucked behind your back) and rotate your head to look the opposite way, gently look down and with your free arm reach over the head and apply a moderate pressure for 30 seconds then repeat on the opposite side.

Stretch both sides a total of three times applying slightly more pressure each repetition.

3 sets of 30 sec each


Neck Stretches - Now it’s time to stretch out all those tight muscles, particularly the upper traps that spend all day working overtime and your neck extensors which are under strain from crooning your neck forward to peer at the screen or look at the keyboard.

Flex your head to one side, reach over with same side hand and apply a moderate amount of pressure to increase the flex to the desired side.

Hold for 20 seconds and then repeat on the opposite side.

Stretch both sides twice before moving on to the back of the neck. Looking down, place both hands on the back of your head and lightly apply pressure in a forward motion and hold for 20 seconds (repeat this twice more).

Your neck should feel nice and loose now so let’s move on to posture.

2 sets of 30 secs each


Chin Retractions - Ever wondered why our neck gets tired and sore? Does it feel like you head weighs 100kilos by the end of the day? Chances are you’re spending your day with your head tilted forward and your chin jutting out which places huge amounts of strain on your neck. Looking straight ahead, raise one arm and shape your thumb, pointer and middle finger into a tripod. Place the thumb and middle finger on each collar bone and the pointer finger on your chin. This should cause you to retract your chin (make sure no one is looking as you instantly gain 3 chins) and engage to muscles as the upper back of your neck (where it connects to the skull). Hold this posture for 10-20 seconds and rest for the same period of time (Repeat 10 times)

10 sets of 10-20 sec hold


Isometric Neck Strength - Finally it’s time to make our neck resilient and robust.The idea is to apply only a moderate amount of force and match it in the opposite direction with your hand so that the head remains in the same place. Looking straight ahead, place either your right or left hand onto the side of your head and push into the hand meeting the resistance. Hold this for 5 seconds and relax (Repeat 10 times). Now swap to the opposite side and repeat. Finally, placing your hands behind your head similar to the neck stretch, push back into your hands and hold for 5 seconds (repeat 10 times).

1 set of 10 reps (5 sec hold) for each

Thanks Stephen. 

Stay tuned for another article from the Queen Street Physiotherapy team soon

In the meantime, if you have any questions regarding this interview, treatment of cycling injuries or other health issues please do not hesitate to contact Donovan and the rest of the team by visiting the Queen Street Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.

Check out other articles from Queen Street Physiotherapy

10 tips on preventing cyclist injuries from Queen Street Physiotherapy


... A sport I’ve tried my best to wrap my head around for a long time, but for the life of me I just can’t understand the appeal.

It’s a culture unto its own.

 From getting up at ungodly hours in the dark, squeezing into some brightly coloured Lycra (often leaving little to the imagination) and punching out a few hours on the road dodging cars, all before breakfast. 

I’ve tried my best but just can’t get into it, hats off to you mob that genuinely enjoy it. The only thing I can relate to is the post ride latte.

But hey, I’m all for exercise and getting people moving so if you fit the mould go for gold.

Donovan Baker | Physiotherapist at Queen Street Physiotherapy

That being said, cyclists tend to get a fair few injuries, and not just from the bastard neighbourhood magpie/plover. 

Any cyclical activity (cycling, swimming, running) has the potential for things to creep up slowly like compound interest. ​

Little niggles can build and build until merely the thought of your 1kg carbon fibre frame with wheels makes your knee ache. So to keep you on the road longer (much to the annoyance of local territorial birds) here are some tips to staying healthy.


Zipties in the helmet magpie repellent. I really don’t know the effectiveness of this, or if there’s actually any data to back it up, but I’ll be damned if you don’t look stylish in those helmets.


Make sure the bike fits you; have a PhysioBikeFit – Each person has a “window of function” regarding the shape and size of the bike, meaning there are no exact measurements. Some riders will need to change their set-up during a season as they get fitter and stronger. If the body fits the bike, and is well conditioned, there is less pain, overload, and need for recovery. With direction from your physio’s assessment, your body can be adapted and changed for the better.


Have a great pedalling technique – Efficient pedalling not only allows you to go faster for longer, but also shares the load, preventing specific overload of any one joint or area of tissue and minimising discomfort. Which means less energy spent, stronger and quicker rides and a reduced risk of injury. Win, win, win.


Vary your riding – There’s no need to ‘go hard or go home’ every day – There is a tendency for Australian cyclists to compete and ride hard all the time. Not even pros ride hard every day, nor should you. The day after a long, hard riding session should be easy, with high cadence, low resistance pedalling. Even at the end of a hard ride you should have 15-30 minutes of easy pedalling to recover your legs and flush out the lactic acid build-up.


Warm it up – If you are suffering from stiffness or soreness, your technique may suffer. Especially those chilly winter morning rides. Also, cold muscle is more likely to be injured. The best warm-up is to allow your blood to circulate, warming the tissues. Build easy into your cycle by pedalling easy to begin with.


Strength and Conditioning having a great well rounded strength program will compliment your riding immensely. Talk to your physio about a good program that includes both upper and lower body exercises, targeting any specific weaknesses identified


Lifestyle - Target sleep, stress, diet and alcohol, general health can really affect your ability to perform and recover. A lack of sleep increases the risk of stress fractures by 300%; stress makes you more likely to be injured, and slows recovery from injury and also those tough rides.


Diet – Eat to fuel performance. Our bodies can probably handle one hour without food, but from the second hour onwards it requires 50-100mg of carbohydrate per hour. Protein after a ride is a great idea for recovery.


Have a strong and consistent recovery routine – Muscles can become sore due to inflammation and tightening of the fibres, with lactic acid build up a by-product of exercise. Gentle stretching and self-massage helps to remedy this, a spikey ball and foam roller are essential. Using cold or hot-cold therapy, like walking in the sea or hot-cold showers.


Physio and Massage – Along with a good recovery routine, checking in regularly with your physio/massage therapist is a great way to keep on top of any niggles, aches and pains. And to make sure the body is functioning as it’s meant to.

If you or someone you know loves to punch out kilometres like Cadell Evans, be sure to take note of these tips. It could be the difference to being on the road or watching your bike collecting dust in the garage. With any sport it’s essential to stay as healthy and injury free as possible, otherwise what’s the point right? So take care on the road you crazy cyclists.

Thanks Donovan.

Stay tuned for another article from the Queen Street Physiotherapy team soon

In the meantime, if you have any questions regarding this interview, treatment of cycling injuries or other health issues please do not hesitate to contact Donovan and the rest of the team by visiting the Queen Street Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.

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