Ankle Sprains

Ankle sprains are of the most common biomechanical injuries that we can sustain in our sporting lives. An ankle sprain occurs when the ligaments that uphold the structural integrity of the ankle joint are stretched beyond their normal barrier causing the fibres to undergo microscopic tears.


There are two main groups of ligamentous structures that hold the ankle joint together. These are the medial and lateral ligament complexes (inside and outside of the foot respectively). In the majority of sporting scenarios that result in an ankle injury, the ankle will roll outwards, resulting in an ‘eversion sprain’ and damaging the lateral complex. This occurs more commonly than an ‘inversion sprain’ (rolling inwards) due to the strength of the medial complex.

Within the lateral complex is the anterior talofibular ligament (ATFL), which is found to be the weakest and most commonly injured ligament.

Signs and Symptoms

Following an injury to the ATFL ligament, we can expect:

  •  Pain to occur immediately at the time of injury depending on the severity of the damage. This pain can present in local tenderness in the area or more vast throughout the entire foot. Our body creates pain as a way of restricting our movement in order to maximise healing potential.
  •  Swelling of the ankle joint over the site of injury as the body begins the inflammatory healing process.
  •  Inability to weight-bare threw the joint whilst standing, walking, running or jumping, depending on the severity of the sprain. 
Osteopathic Treatment 
Following the occurrence of an ankle sprain, best practice suggests resting the ankle for the first 48-72 hours and applying the PRICE protocol (protection, rest, ice, compression and elevation). 
From this point, an Osteopath will begin by assessing the severity of the injury through a thorough examination of the ankle and all anatomical structures which may have been affected in the injury. 
If indicated, the Osteopath may refer the patient for imaging to rule out potential fractures amongst other more sinister injuries.

Treatment of the ankle will include techniques including soft tissue, myofascial release, joint articulation and manipulation with an aim to restore the ankle to it’s normal function. Lymphatic drainage techniques may also be used to reduce the swelling within the ankle.

Following treatment, your Melbourne osteopathy will prescribe management exercises for the patient to perform in their own time to progress their rehabilitation.


Author: Dr. Kristian Ciciulla (Osteopath)

City Osteopathy



Eisenhart, A. W. (2003) Osteopathic Manipulative Treatment in the Emergency Department for Patients with Acute Ankle Injuries. The Journal of the Osteopathic Association.

McGovern, R. P., & Martin, R. L. (2016). Managing ankle ligament sprains and tears: current opinion. Open access journal of sports medicine, 7, 33–42. doi:10.2147/OAJSM.S72334

Melanson, S. W., Shuman V. L. (2019) Acute Ankle Sprain. Treasure Island (FL): StatPearls Publishing. Available from:

Polzer, H., Kanz, K. G., Prall, W. C., Haasters, F., Ockert, B., Mutschler, W., & Grote, S. (2012). Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthopedic reviews, 4(1), e5. doi:10.4081/or.2012.e5

Plantar Fasciitis


I’m sure you’ve all heard someone complain about it, and know it has something to do with the foot. But what actually is Plantar fasciitis?

Plantar Fasciitis is an overuse condition affecting the plantar fascia. The plantar fascia is a layer of soft tissue that stretches along the bottom arch of  the foot, . It helps to provide stability to the arch of the foot and is similar in make-up to a tendon

If too much stress is placed on this structure, over time the tissue can degenerate, weaken, and start to cause pain.


– Runners

– People who are overweight with a sedentary lifestyle

– People with poor footwear

– Those that have suddenly & significantly increased their training load



– Pain at the bottom of the heel

– Pain that appears as a gradual onset

– Pain felt first thing in the morning (i.e. taking those first steps out of bed in the morning is classic!)

– Pain that increases with activity and pain felt at night (latter stages)

– Pain felt after periods of prolonged rest during the day

– Tight muscles that help to support the arch of the foot

– Stiffness through foot and ankle joints



Due to its poor blood supply which is due to being the furthest distance from the heart, Plantar fasciitis is a tricky condition to treat which may require ongoing treatment from a few weeks to several months.

Your Osteopath will give you some strengthening exercises, release off the tight muscles, aim to improve the range of motion of the foot and ankle as well as providing you with appropriate training and management strategies.

What is Magnesium && What Are The Benefits?



  • Magnesium is a mineral that you need every day for good health.
  • Magnesium helps you take energy from food and make new proteins.
  • It is also an important part of your bones, and helps keep your muscles and nerves healthy.
  • Some people find that magnesium-rich foods or supplements help to reduce their cramping and muscle soreness.
  • The best sources of magnesium are legumes, nuts, seeds, fish and whole grains.


How much Magnesium should I aim for?

Daily target

Men 19-30yrs


Men 30+yrs


Women 19-30yrs


Women 30+yrs



How can I get enough Magnesium without taking supplements?

The following is a list of food sources that are rich in magnesium.

Almonds, Bananas, Brown Rice, Cashew Nuts, Tofu, Pumpkin Seeds, Weetbix.

Dr Daniel Castellano

Melbourne CBD Osteopath

City Osteopathy

Patella Tendonitis


What is Patellar Tendonitis?


Also known as Jumpers’ Knee

Patellar tendonitis occurs when there is pain and dysfunction in the patellar (knee cap) tendon – the small tendon that links the thigh muscle to the knee cap and shin.

It most commonly affects jumping or kicking athletes.

Activities that may cause pain.

  • Jumping
  • Running
  • Kicking a ball
  • Skipping
  • Changing direction quickly
  • Standing up after sitting for a long time
  • Walking stairs/hills


Why do I have it?

Patellar tendonitis is a gradual and progressive condition, therefore it commonly occurs from overload. Which basically means doing too much activity & placing too much load on the patellar tendon.


How do I make it better?

If overload is what makes tendons worse – careful loading is what also makes them better. So a tailored and specific strengthening and rehabilitation program for the patellar tendon and knee are required which should include some isometric exercises.  Hands on treatment may also be beneficial to address any other symptoms such as tight quadricepts or hamstring muscles which may be contributing.  Your osteopath will prescribe specific exercises to improve your function, strength and the sport you play. E.g. if you are a basketballer – agility drills and shooting/ jumping drills.


Time Frame?

This does often vary from patient to patient but a general timeframe is 3-8 weeks + Tendons have a slower healing rate than muscles due to the reduced bloody supply so it is important to be patient with your tendonitis.

Posture Hack!


Improve your desk posture. Easy. Open your palm and bring your shoulder blades together, we call that shoulder retraction. Perform high reps with controlled movement to build strength and stability in the upper back and shoulders. So easy, and so effective. Thanks to Dr Sarah Cust, our resident exercise guru at City Osteopathy! Video from Shane Heslop

5 Tips to help stretch and strengthen your hands

Have you been experiencing some pain in your wrists or hands?
We’re hear to point you in the right direction : )
 Try massaging between your thumb and pointer finger, you can do this by making an L shape with the affected hand. Use your other hand to grip the area on both sides massaging in circles.
 Try making on O shape between your thumb and each finger. Have the tip of your thumb and tip of each finger touch to create the letter O. Touch each tip of the finger with your thumb one at a time.
3. Wrist movement – Figure 8’s
Try moving your fingers in each direction like you’re making a figure 8. Repeat this movement a few times.
4. Spikey Ball –
Try pressing your hand and forearm muscles on a spikey ball to work through some of the tender points in the muscles.
5. To finish let’s stretch out our wrists. Have your palms facing the ground bend your hand so that your fingers are pointing down. Repeat this exercise with your fingers pointing to the sky. You may gentle add extra pressure with your opposite hand, be careful not to push too hard.
Talk to your osteopath Melbourne at City Osteopathy about any hand/wrist pain.