Meet the Team – Chris Chen

Hi everyone, my name is Chris Chen and I am a Senior Accredited Exercise Physiologist at Absolute Balance.

Exercise has always been something I am passionate about since I was in high-school. I spent a lot of time reading up and watching videos about how to get stronger, how to get leaner, what food burns fat and anything else you can think of that relates to something to do with health and fitness.

Additionally, soccer is a sport that runs rich through my family as my Dad has been playing since his own primary school days and my brother and myself grew to love it as well.

However, during a high-school match I suffered a devastating injury to my left knee and completely ruptured my ACL. I wasn’t sure what was going on at the time and I continued to exercise at the gym as I believed that if I kept my muscles strong, I’d be able to recover. Unfortunately, I was a naïve teenager and didn’t realise that ligaments aren’t able to repair on their own.

I realised soon after that the exercises I was doing in the gym appeared to be working and I didn’t feel like my leg would give-way anymore and that’s when I began my journey into Exercise Rehabilitation.

I ended up doing a degree in Exercise Physiology at Murdoch University after deciding I wanted to learn more about how exercise can be prescribed as medicine and how I’ll be able to help others who have had to go through similar circumstances.

Exercise has allowed me to continue doing all the things I want to do, and I still get to put on my soccer boots from time to time.

Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist

Meet the Team – Leigh Ashmore

Hi everyone, my name is Leigh Ashmore and I have recently joined the Absolute Balance family as a Senior Accredited Exercise Physiologist in the Workers’ Compensation team. Although new to Absolute Balance, I cannot say I am a ‘newbie’ to the industry having worked as an AEP in Occupational Health for almost 15 years…my how time flies!


Over this period, I have seen tremendous growth in (and recognition of) the Exercise Physiology profession, particularly with the strong evidence for active-based treatment modalities proving so pivotal in improving injury recovery times. Over the years of my career, I have had the pleasure of helping many different people with a wide range of complex and challenging injuries achieve their recovery goals.


Winding back – my childhood years were somewhat unique. I spent time growing up in the Central Wheatbelt of Western Australia on a Wheat and Sheep Farm which was approximately 6500 acres, give or take! As you could imagine, this environment enabled fantastic opportunities to develop my love of outdoors and living an active lifestyle.


Since I was young, I always had a keen interest in sport, regularly playing for the local footy and basketball teams. Due to the geographical isolation of our farm, it would not be unusual for our family to travel more than 3 hours for training and games, particularly when I was lucky enough to gain a WAIS scholarship as a teenager. Due to my interest in exercise, I naturally gravitated towards completing an Exercise and Sports Science degree, ultimately specialising in Exercise Rehabilitation.


Jumping forward to the present, my beautiful wife Nikki and I have three wonderful kids, Caleb (8), Aidan (6) and Chelsea (3) who are such a blessing in our lives but they definitely ensure life is busy and there’s never a dull moment. Now things have come full circle and it is me driving my kids to their respective sports continuing the encouragement of an active lifestyle for optimal health and wellbeing.

Leigh Ashmore BSc(Sports Science) PGradDip (Exercise Rehabilitation)

Senior Accredited Exercise Physiologist



Frozen Shoulder

Frozen shoulder, also referred to as adhesive capsulitis is a condition indicated by pain and stiffness in the shoulder joint. There is no known answer to exactly why frozen shoulder may occur, however, people who experience extended periods of shoulder immobility generally are at a higher risk of developing frozen shoulder. Immobility of the shoulder joint may occur because of a rotator cuff injury, broken arm, direct impact to the shoulder joint or during the recovery from surgery. Typically, associated symptoms will worsen over time and can take up to one to three years to fully recover.  Although, each individual case of frozen shoulder may differ and time periods to make a full recovery can change dramatically.


The common symptoms of frozen shoulder are categorised into three main stages over the recovery period.

Freezing: Freezing is the first stage of frozen shoulder and is generally the stage whereby pain increases gradually over time, making movement through the shoulder joint harder and harder. During this stage it is noted that pain may be more prominent during night-time. On average this stage can last anywhere from 6 weeks to 9 months.

Frozen: During the second stage pain generally dose not increase however the shoulder remains stiff and movement may be restricted for 4 to 6 months.

Thawing: During the final stage movement begins to ease, the shoulder starts to return to normal and pain begins to fade. This stage can take anywhere between 6 months and 2 years.


The main goal during the treatment of frozen shoulder is to preserve as much range as possible whilst keeping pain to a minimum. Although there is no gold standard when it comes to frozen shoulder there are several methods for treatment. Typically, steroid injections will be administered in the early stages to help maintain mobility and decrease pain however, there is the option of shoulder manipulation or surgery should it be necessary.

Benefit of Exercise Therapy

In 90% of cases frozen shoulder will improve with non-surgical treatment such as physical therapy. The main aim of physical therapy is to increase or restore range of movement to the affected shoulder joint. A series of simple exercises can be completed in your own home which can drastically improve the overall function of the shoulder. Exercise and movements should be conducted within the limits of a person’s pain threshold and can be completed multiple times per day. The key to a full recovery from a frozen shoulder is patience and persistence.

Cameron Galati

Accredited Exercise Physiologist (AEP, AES) (ESSAM)

Lateral Epicondylitis – Why can it linger, and what is the best rehab for it?

Lateral Epicondylitis, commonly known as Tennis Elbow, is a very common chronic inflammatory condition of the elbow that is normally placed into the category of an ‘Occupational Overuse Syndrome’ (OOS). Lateral Epicondylitis is caused by repetitive loading with twisting activities of the forearm and wrist, it can also be caused by activities such as repetitive typing, keyboard, and mouse usage. The lateral epicondyle is the Common Extensor Tendon Origin (CETO); there are five key tendons that attached at this point including the Extensor Carpi Radialis Brevis (ECRB) and Longus (ECRL), Extensor Digitorum (ED), Extensor Digiti Minimi (EDM) and Extensor Carpi Ulnaris (ECU); all of which form the Common Extensor Tendon (CET).  The ECRB is frequently the main cause of symptoms and makes up the largest component of the CET, and often becomes the main focus of a rehabilitation programme, however, the smaller tendons may often be overlooked and may become the underlying culprits causing an extended recovery from the injury. We quite often hear from our patients that they have had multiple failed attempts at conservative rehabilitation with the focus being solely on the ECRB, and when provided rehabilitation exercises that target the smaller muscles and tendons we regularly see a great response and significant improvements in their symptoms.

When assessing function of the hand wrist and forearm for a client with LE, it is important to assess ALL functions of the fingers, hand, wrist, and forearm which are associated with the CET. I also find it helpful to assess functions including pronation and supination of the forearm with the elbow in a fixed position to determine if there are any biomechanical discrepancies outside of the normal range and function of the elbow. Covering all your bases in the assessment will assist in finding any functional gaps that can be worked on throughout the rehabilitation programme. It is promoted and supported by the literature that LE is treated conservatively, with interventions including activity modification and exercise (Bisset, 2006). A good exercise rehabilitation should combine range of motion and stretching exercises, concentric and eccentric strengthening exercises, and fine/gross motor control and grip strengthening exercises. A systematic review conducted by Menta et. Al, 2015, concluded that clinic-based strengthening exercises were effective for short-term improvements in pain reduction and have a better longer-term outcome for patients with persistent LE.

If you or a patient are struggling with an ongoing and painful elbow injury, a referral to an Accredited Exercise Physiologist may be the appropriate next step in the treatment timeline to attain a positive outcome. Absolute Balance have a caring team of skilled Accredited Exercise Physiologists’ that can help get your rehabilitation back on track, with comprehensive assessments and exercise programming designed with the goal of attaining full pain-free function front of mind. If you would like further information on this topic, or would like to contact the team you can email or visit our website

Alixe Marion (B.Sc. Exercise Physiology)

Senior Accredited Exercise Physiologist – Complex Claims Specialist



Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B BMJ 2006 Nov 4;333(7575):939

Menta R, Randhawa K, Côté P, Wong JJ, Yu H, Sutton D, Varatharajan S, Southerst D, D’Angelo K, Cox J, Brown C, Dion S, Mior S, Stupar M, Shearer HM, Lindsay GM, Jacobs C, Taylor-Vaisey A J Manipulative Physiol Ther 2015 Sep;38(7):507-20

Femoroacetabuler Impingement’s

The hip is a rather complex ball and socket joint where the femur (thigh bone) meets the pelvis. It forms a connection from the lower limb to the pelvic girdle, and thus is designed for stability and weight bearing rather than a large range of movement, particularly when compared to the shoulder joint. Of course, a healthy hip can still provide a relatively large range of motion with up to 125⁰ of flexion, 115⁰ in extension and 45⁰ during abduction. There is a myriad of reasons for restricted movement of the hip and this blog will be talking about Femoroacetabular Impingements (FAI).

FAI is a motion disorder of the hip where the head of the femur prematurely makes contact with the pelvis during movement. This contact is due to excess bony structures originating either on the femur or pelvis that causes reduced range of movement – most commonly internal rotation of the femur. Long term abnormal contact can lead to degenerative changes and osteoarthritis if left untreated. Two types of Femoroacetebular Impingement have been identified, these being Cam and Pincer types.

This figure illustrates the difference between the two morphologies: a cam lesion is a deformity of the ball (head of femur) and a pincer impingement is a deformity of the socket (acetabulum). It is estimated that 85% of patients with FAI have mixed morphology, meaning both cam and pincer types are present. Primary symptoms reported with this condition is hip or groin related pain in certain movements or positions. Pain may also be reported in the thigh, back or buttock. Additional symptoms such as stiffness, clicking, catching, locking, or giving away may be reported.

Treatment of hip impingements is varied, ranging from rest and behaviour modification to medication and in some circumstances, surgery. In both cases of surgical and non-surgical intervention, exercise is crucial to strengthen and support the joint. Your Exercise Physiologist will prescribe activities that strengthen hip flexors, external rotators, adductors, and abductors. The more nuanced result of exercise is adaptations in neuromuscular control and movement patterns. Quite simply, poor proprioception, abnormal movement patterns and muscular imbalances of the core, hip and lower limbs can exacerbate symptoms and accelerate degenerative changes.

Regardless of the type of impingement diagnosed (Cam and/or Pincer) and symptoms present, exercise should form the cornerstone of a quality treatment plan. Whether surgery is required or not, physical activity can provide a reduction in symptoms and accelerate a return to normal activity.

Absolute Balance aims to make exercise the answer for all health conditions. So if you are looking for further information, we recommend you speak to your doctor and an Accredited Exercise Physiologist for a tailored programme.

Ed Daccache

B.Ex.SpSc, Grad.Dip.Ex.Sc (AEP, AES) (ESSAM)
Accredited Exercise Physiologist




Fowler Kennedy. Conservative Management for Femoroacetabular Impingement (FAI). Retrieved from

Ganz.R., Parvisi.J., Beck.M., Leunig.M., Notzle.H., Siebenrock.K. (2003). Femoroacetabular Impingement: A Cause for Osteoarthritis of the Hip. Clinical Orthopeadics and Related Research. 417; 112-120. DOI 10.1097/01.blo.0000096804.78689.c2

Physiopedia. Femoroacetabular Impingement. Retrieved from

Fit & Healthy Over Fifty

More than ever before, people of all demographics particularly those over fifty, are getting into the habit of staying in shape and maintaining decent levels of physical fitness. Studies have shown that exercise is something we can all do for ourselves to help us live longer and enjoy healthier lives, no matter the age.

It is always important to stay consistent and committed when beginning an exercise programme and the results will eventually pay off. As they say, you get what you put in.

Exercise is great for both the body and the mind and can help a great deal with stress-management and levels of alertness, which is highly beneficial in this fast-paced society we continue to live in. It has been known to improve quality of sleep so that we fall asleep quicker and wake up less frequently throughout the night to truly get the rest we need.

It’s no secret that it’s hard to find time to dedicate to exercise when our lives can be so busy and demanding, yet it plays such a crucial role in keeping us all stronger and healthier for longer.

For those who may feel like they’re constantly against the clock, a home workout could be just what the doctor ordered, beginning with as little as 10 minutes a day, two or three times a week and slowly increasing the duration as you become more comfortable with infusing it into your weekly routine.

You don’t necessarily need a big, fancy gym or resistance machines in order to have a great workout. There are countless exercises that require nothing more than our own bodyweight and a little bit of creativity. Resistance bands or “therabands” are great and simple fitness tools which can effectively strengthen the entire body and you can pick them up in most sports stores. The way they work is through constant tension supplied by your own muscles to provide resistance, unlike free-weights which rely on gravity.

Here are a few exercises you can try at home.

Try performing 2 sets of 10 repetitions to begin with.


This one is simple but effective. Simply sit in a chair with your feet about shoulder-width apart and stand up without using your hands. Focus on pushing your weight evenly through the heels and contract your glutes as you come up. This exercise is excellent for improving lower limb functional strength and we can increase the difficulty by holding weights in each hand or even performing the exercise with one leg (for those looking for an advanced challenge). If dumbells aren’t readily available, you can be creative and use things found around the house such as water bottles or unopened cans.


Tried-and-true, we’ve all done this exercise at some stage in our lives and the benefits are tremendous when it comes to increasing our functional strength through full-body activation. As you perform this movement, all the major muscle groups (biceps, triceps, anterior deltoids, core, lower body muscles) are activated and therefore can be considered a full-body workout alone. We can modify this exercise by performing the movement on the knees or against a wall if upper limb strength has been compromised by injury or general de-conditioning.

Standing Row With A Resistance Band

For this exercise, tie a resistance band to something stable like the leg of a table or a pole. Grab both ends of the resistance band and pull back keeping your forearms parallel to the ground and your thumbs facing up. Be sure to keep your shoulders back and down and try to open-up the chest as you pull.

This exercise is great for strengthening the muscles that draw the shoulder blades back and is beneficial for those with lower back pain. It is beneficial for those who have a job-role that requires spending a lot of time sitting in front of a computer and as a result have a compromised posture and possible muscular imbalances. This exercise may also be performed in a seated position on a chair or a swiss ball to enable more engagement of the core.

Single-Leg Balance

Not only is it simple to do but the benefits that come from practicing are significant and will give you an idea about how good your balance is. The benefits of unilateral exercises such as this one includes isolating and correcting muscle imbalances, utilizing the core muscles and injury and falls prevention.

Exercises with a focus on balance are great for improving proprioception, which is described as the ability to sense one’s body position in space. Start off with trying to balance on one leg for 20 seconds and increase duration as you get more comfortable.

Home workouts are a great way for time-poor individuals to stay in shape and provides positive benefits including being able to do it in whatever setting you desire, whether that’s in the living room in front of the TV, outside in the sun or in the comfort of your bedroom. It’s also affordable and requires little to no equipment to provide both physical and psychological boosts to your body.


Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist



Anatomy of Exercise for 50+: A Trainer’s Guide to Staying Fit Over Fifty (Book by Hollis Liebman)

Exercise does not “wear” down cartilage

It’s common to hear my patients say to me at the initial assessment that their knee joint is having cartilage issues or “bone on bone” problems due to doing too much activity when they were younger, such as sports, running or manual labour roles. My patient will always then begin to say that they have avoided therapeutic exercise because of this as they believed it would make their symptoms worse and they would be in too much pain the following day. While this seems to make sense to them it is always important to reiterate to my patient that not only has exercise and activity has been safe for articular cartilage (Bricca, 2018) but it may actually protect the joint cartilage through a reduction in inflammation (Fu, 2019).

I always make sure to point out to my patients that many factors mediate whether our joints wear or arthritis develops beyond joint loading such as inflammation, other health conditions, genetics etc all play a role and it normally can’t be narrowed down to just one factor.

When talking to my patients about this during the initial assessment I make sure I reassure them that exercise does not harm articular cartilage and exercise has compelling evidence for helping prevent at least 35 chronic conditions and treat at least 26 chronic conditions. Furthermore, highlighting the importance and safety of consistent appropriate exercise and the benefits it has for managing and improving osteoarthritis in the knee joints.

The initial exercise prescription needs to reflect a client’s mindset or fear avoidance of specific exercises, initial exercises to prescribe for clients managing knee pain and have doubts about exercise need to be light and non-aggravated so the client is not fearful of movements. Initial exercises can include fit ball squats, sit to stands, standing knee bends, modified split squats.


Jason Peschke

Accredited Exercise Physiologist (AEP, AES) (ESSAM)



“Mechanical loading inhibits cartilage inflammatory signaling via an HDAC6 and IFC-dependent mechanism regulating primary cilia elongation” in 2019

Bricca A, Juhl CB, Steultjens M, et al

Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials

British Journal of Sports Medicine 2019;53:940-947.


Progress of Pain Theories

Working within the workers compensation industry pain is something that exercise physiologists come across on a regular basis. Sometimes pain can be easily understood with a source that can be treated and then the pain eventually disappears. In other cases, pain can be much more of a complex issue with multiple factors influencing the source of the issue.  It is important to remember that pain is an essential component of the body’s ability to heal, it is the body’s way of telling us there is an injury, and we need to do something about it to ensure that healing occurs. It is also important to take into consideration that one patient’s pain is not the same as another patient’s pain, even if they have experienced similar injuries. In order to understand what elements can influence pain it is important to look back on how our understanding of pain has progressed over the years.

Pain theories go all the back to ancient Greek times with the Athenian philosopher Plato and The Intensity Theory. In his work Timaeus, Plato defined pain not as a unique experience, but as an ’emotion’ that occurs when the stimulus is intense and lasting. Moving forward to the 17th century one of the first alternative scientific pain theories was introduced in 1644 by the French philosopher Renee Descartes. This theory, Cartesian dualism theory of pain. hypothesized that pain was a mutually exclusive phenomenon. Pain could be a result of physical injury or psychological injury. However, the two types of injury did not influence each other, and at no point were they to combine and create a synergistic effect on pain, hence making pain a mutually exclusive entity.

In 1965, Patrick David Wall and Ronald Melzack announced the first theory that viewed pain through a mind-body perspective, The Gate Control Theory of pain states that when a stimulus gets sent to the brain, it must first travel to three locations within the spinal cord. In the Gate Theory  pain signals are transmitted to the brain, the pain messages encounter “nerve gates” that control whether these signals are allowed to pass through to the brain. In some cases, the signals are passed along more readily and pain is experienced more intensely. In other instances, pain messages are minimized or even prevented from reaching the brain at all. Wall and Melzack’s research also suggest there was an additional control mechanism located in other regions of the brain responsible for the effects of cognitive and emotional factors on the pain experienced. Current research has also suggested that a negative state-of-mind serves to amplify the intensity of the signals sent to the brain as well therefore if someone is sad or depressed, they may be more likely to feel pain.

As Pain Theories progress from Ancient Greece to the 20th century it is evident that pain has multiple elements that influence it. When treating pain as an exercise physiologist we take into consideration all of these influences and assess patients using a biopsychosocial approach – stay tuned for my next blog on how Absolute Balance use this biopsychosocial approach to treat pain.

Claire Hills
Senior Accredited Exercise Physiologist (AEP) (ESSAM)




Trachsel, L. A. (2020, July 10). Pain Theory. Retrieved from

Cherry, K. (n.d.). Gate Control Theory for Pain Signals to the Brain. Retrieved from


Eating Habits

Maintaining your physical health while trying to balance work and life commitments is a constant challenge, especially with many returning to full-time working hours and a likely increase in workload due to the recent Covid-19 pandemic. During this transitioning period, it can be very difficult to develop a regular exercise routine due to the constant change in our environment. This irregularity can be a hindrance to our ability to maintain good physical health. A simple yet effective way you can maintain your health is by having regular mealtimes and eating habits. Having good eating habits can be a simple way for you to control our energy intake, which will assist in maintaining or improving current weight and/or body composition.

Regular Mealtimes

Infrequent mealtimes are shown to be associated with weight gain, increase hunger hormones, and metabolic disturbances that may lead to cardiovascular risk. Trying to maintain a consistent time for eating will allow your body to absorb and use energy more effectively. Sticking to eating 2-3 times a day instead of sporadic eating 5-6 times a day will allow your body to release hormones responsible for metabolism at optimal times, leading to greater physiological function. This will also ensure energy levels throughout the day will be maintained and “crashes” can be avoided.


Although the most commonly skipped meal of the day, eating breakfast (and a big breakfast) is shown to reduce hunger, cravings, and post-meal release of ghrelin (“hunger hormone”) which can assist in preventing weight gain. Eating breakfast regularly can:

  • increase satiety (feeling of fullness)
  • reduce total energy intake
  • reduce blood lipid levels (reduce risk of CHD)
  • improve insulin sensitivity (reduce risk of type 2 diabetes)

Healthy Choices

Choosing meals and foods that are nutrient-dense can reduce the need for constant snacking or eating throughout the day to meet recommended dietary intakes. Foods such as sweet potato, kale, legumes, quinoa, nuts, and fish (particularly salmon) are smart and healthy choices that can be included in your meals. Foods high in protein can help you feel “fuller” for longer, increasing time between meals (allowing for controlled insulin release). Reducing the amount of processed foods which have high salt, sugar, and cholesterol content will help to control blood sugar and lipid levels, as well as prevent “crashes” in blood sugar levels throughout the day.

While trying to return to regular exercise and adjusting to new or previous work schedules, your physical health can be maintained by forming these healthy eating habits. With some tweaking these habits can also help you see better results in your exercise performance and results in the gym.

Bastien Auna

Accredited Exercise Physiologist (AES, AEP) (ESSAM)


Kahleova, H., Lloren, J., Mashchak, A., Hill, M. and Fraser, G., 2017. Meal Frequency and Timing Are Associated with Changes in Body Mass Index in Adventist Health Study 2. The Journal of Nutrition, p.jn244749.

Paoli, A., Tinsley, G., Bianco, A. and Moro, T., 2019. The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting. Nutrients, 11(4), p.719.

St-Onge, M., Ard, J., Baskin, M., Chiuve, S., Johnson, H., Kris-Etherton, P. and Varady, K., 2017. Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement from the American Heart Association. Circulation, 135(9).


Meet the Team – Callan Smith

After 2 full years at Absolute Balance I think it is time to shed some light on my mysterious, dangerous and intriguing past that helped shaped me into the brilliant and well rounded AEP you will meet as you walk through the clinic doors (who may or may not SLIGHTLY embellish the truth..).

I have always been a Perth boy, growing up around the Ballajura area. Mum and Grandad saw to it that I would be brought up a West Coast fan, and for that I am forever grateful (how great was 2018!). Surprisingly I actually played soccer for a couple of years before switching to footy for the rest of my (limited) sporting career. Between the age of 15-16 I had a recurring hip injury that really hampered my playing time. As an AEP who deals with rehabilitation, I can look back now and know I did almost everything wrong with my rehab. I continued to try and train with the injury before it was ready, as well as all the other dumb schoolyard activities a teenager does that kept me from being fit and mobile a lot longer than it should have. Learning from past mistakes is critical, and I’m thankful I am in a position where I can impart both my clinical reasoning as well as my PERSONAL experience to empower, empathise and encourage others in their own rehabilitation.

After four great years of cheap Tuesday pizza’s at Slice of Italy, I graduated from Edith Cowan University with a Bachelor of Science in Exercise Science and Rehabilitation. I started full time with Absolute Balance two months after graduating, where I was given the opportunity to positively influence people and improve the quality of their mobility, physiology and their general day to day lives. Both my parents are living in different states now (not sure what drove them away, I am delightful!) and so my brother and I had a BIG learning curve as we began living by ourselves and learned how to juggle work, study, renovation AND usual house chores (there were a couple last-minute loads of washing at 10pm on a Sunday night). My career with Absolute Balance provided me the life skills to handle this life transition with positivity and confidence.

Working in a dynamic job role where I am constantly learning new skills as well as being able to implement my passion for wholesome health and mobility to improve someone’s situation is extremely rewarding. I believe exercise is medicine, and I am dedicated to using my knowledge and experience as an AEP for the benefit of others. The experiences I have gained and great clients I have worked with over the last two years have helped me grow as an AEP.

Callan Smith

(B.Sc. Exercise& Sport Science, B.Sc. Exercise Science & Rehabilitation)

Accredited Exercise Physiologist (AEP) (ESSAM)