Natalie Cutten

Dear Valued Patient,

Natalie Cutten is a specialist musculoskeletal practice conveniently located in Sandton/Morningside.

Natalie Cutten physiotherapy has a 5 star ranking on google reviews!

We look forward to treating you with the latest FDA/CE approved MedTech INNOVATION EXCLUSIVELY AVAILABLE AT THIS PRACTICE from USA & Germany. Our hands on approach is based on evidence from the British Journal of Sports Medicine.

We work collaboratatively with Doctors and Radiologists ensuring immediate diagnosis and pain relief.

Services offered:
- Initial consultation
- Follow-up consultation
- Shockwave therapy FDA approved EMS Dolorclast
- Deep Oscillation Therapy PhysioMed Germany
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Special interests:
- Musculoskeletal physiotherapy
- Sports injuries
- Neck & Back pain
- Movement analysis and rehabilitation
- Difficult ankles
- Shoulders
- Lung(chest) physiotherapy
- Oncology men and woman
- MedTech Innovation

Please reach out via whatsapp for more information. We love questions!

200 Rivonia Road, Morningside, Sandton, South Africa
North Tower first floor

Online bookings: http://nataliecuttenphysiotherapy.bookem.com

Practice owner & specialist musculoskeletal physiotherapist

Natalie has 17 years of experience as a physiotherapist. I have worked at Linksfield and Parklane hospitals as well as in Oslo, Norway. She completed my BSc in Physiotherapy in 2006 at Wits; and the South African Society of Physiotherapy (SASP) yearlong sports physio modules (SPT1).

Xiluva Mabasa

Senior Physiotherapist

Xiluva graduated from Wits with a Bachelor of Science in Physiotherapy in 2019. She has 4 years' experience in orthopedics and ICU from Morningside Hospital. She has a special interest in the treatment of shoulders, having completed courses in manual therapy and management of shoulder pain. Her treatment style is very gentle.

Shockwave Therapy EMS Swiss Dolorclass

USA

EMS Swiss dolorclass shockwave therapy is the only FDA approved shockwave machine. At Natalie Cutten Physiotherapy we have the same model used by the Springbok rugby team, and the only SWT unit in Sandton. Shockwave Therapy is a physical force that remodels soft tissue by bringing in fibroblast cells to lay down new muscle fibres. Clinical trials show EMS Shockwave significantly improved the tensegrity of soft tissue structures. Whats great about EMS Shockwave Therapy is there is no downtime. Post shockwave patients should load the affected injury to achieve maximal effect of EMS Shockwave Therapy.

Deep Oscillation Therapy

Germany

Deep Oscillation Therapy from Germany is CE approved, and works collaboratively with Shockwave Therapy. The electrostatic current penetrates 8cm deep, and physically moves inflammation out of an area. The electrostatic current changes the permeability of cell membranes, which is incredibly complex. The treatment feels soothing, results are evident within 2 days. Indications we have used the device for at the practice are significant and chronic swelling post-Achilles rupture surgery, post-surgical swelling of shoulder replacements, and lymphedema in oncology patients.

Myofascial & soft tissue release

The fascia is a tensile web like structure that envelops all of our organs. It is a connective tissue that groups entire muscle complexes together. Physiotherapy restores parallel alignment of the collagen fibres, restoring tensegrity; the ability of the fascia to absorb physical forces. Soft tissue release is the process of creating a mobile scar. My method of mobilising soft tissue is dynamic. Mobilising a muscle occurs in 3 phases. Firstly with the muscle off the stretch, progressing to working on the muscle on the stretch. Rehabilitation is completed with soft tissue release of the muscle whilst contracting the muscle. Movement is dynamic, therefore we need to align the collagen fibres of a muscle in a dynamic manner.

Movement re-education and targeted strengthening

Following an injury, especially a severe one like an injury to the spine we can become fearful of moving the affected area. Due to this we may also employ compensation strategies by overusing other areas of our body. Where I come in is to re-establish safety of movement, illiminate compensation, and then progress to targeted strengthening. This entails strengthening prime movers in an acceleratory or deceleratory way. Strengthening may also entail core stabilisers of the neck or lumbar spine if indicated.

Joint mobilisation

Mulligans mobilisations, or mobilisations with movement are backed by clinical evidence to provide immediate relief. They are painfree physiotherapy techniques that provide instant outcomes, and long lasting effects. Joint mobilisations entail correcting minor positional faults causing loss of joint range of movement. Repositing joint surfaces to achieve pain free resolution of musculoskeletal problems. Physiotherapy is indeed an art, not a science.

Physiotherapy adjuvants

Dry Needling & taping

Dry needles are used to aid pain caused by trigger point referral. Needling works by flushing a trigger point with nutrients, contributing to accelerated healing. Kineseo taping is used to contribute to alleviating inflammation by lifting the skin. A lattice taping can be used to massively accelerate bruise healing, and contusions. Clinical evidence shows that taping with the fibres of a muscle stimulate contractility of a muscle, whereas taping perpendicular to muscles fibres inhibits muscle fibres.

Neck pain

Each patient is unique, and circumstances unique. Common pathologies I see are wry neck, or discogenic/facet joint related pain. These would need to be diagnosed based on movement. Another culprit that I find is contributing significantly in our busy lives is upper crossed syndrome. This occurs when sitting in a static position for many hours. We present with a poking chin, and elevated tight shoulders. Causes of this are weak neck eccentric (deceleratory) core stabilisers, elongated and weak lower trapezius muscles, overactive and tight upper traps, as well as overactive and tight pectoralis muscles. I can assist you by going through a quick practical exercise program with you. Clinical evidence shows 6 counts of 6 reps of core stabilisers exercises 3 x a week is the bare minimum to provide stability. This is certainly manageable!

Lower back pain

Pathology of the lumbar spine includes disc bulging, facet joint immobility, and radiculopathy of certain pathways of the sciatic nerve. However, what is a commonality regardless of the pathology, is associated movement disorder of either bending forward or backwards. My flexion rehabilitation program entails cognitive rehabilitation, and eccentric control of the paraspinal muscles. It also encourages feeling safe during flexion movement. Two flexion patterns occur, either you move with the spine as a rigid board, or due to a lack of hip hitching resulting in excessive lumbar spinal flexion. I work with you doing simple exercises to correct these movement disorders, which illiminates pain immediately. Pain on leaning back (extension) follows a similar situation of fear of movement, resulting in a rigid spine, and excessively tight paraspinal muscles. By going through my guided extension mobility exercises, we can rehabilitate this pattern of movement. Current clinical evidence shows that rehabilitation of these movement patterns instead of core stability exercises is producing brilliants results in pain illimination immediately.

PHASE 1: INFLAMMATION

The inflammatory phase lasts 3 days provided you rest, and get the inflammation under control. However, the more you irritate the injury, the longer it can take. The immune system is in process of repairing the injured tissues, making them more sensitive. During this phase you should do general unloaded movements to clear out the swelling.

PHASE 2: MATURATION

After 72 hours, we enter the fibroblastic phase. Fibroblasts are your builder cells that lay down new fibers, rebuilding the tensegrity of the tissue. This phase lasts more or less 3 weeks. In this phase, you can begin more movements for mobility, appropriate loading, and strengthening. Starting this as soon as possible ensures the tissue doesn't become rigid.

PHASE 3: REMODELING

This stage can be as short as 3 weeks, however; for serious injuries the remodelling can continue for up to a year. Thats why a guided return to sports can be helpful with you physio. Phase 3 is all about rebuilding the tissues capacity through guided resistance training. The time frames mentioned are generalised guidelines for injury type averages. Completing phase 3 guidelines for the appropriate amount of time ensure a return to your sport of choice with the tissue integrity that has remodelled to ensure no risk of re-injury.

Ankle

- Calf and Achilles pain - plantarfascitis - plantar nerve entrapment - Ankle sprains - Shin splints - Bunion - Achilles Rupture: diagnosis and rehabilitation - Tendonapthy -

Knee

-Knee pain -Knee instability -Patellar tendinopathy -Osteoarthritis - Osgood Schlatters - Ligament tears and sprains - Meniscus tears

Hip

- General hip pain - Nerve pain - Hip flexor pain - hamstring pain - groin pain - quadriceps tendinopathy - Rectus femoris rupture - CAM and pincer hips (femeroacetabular impingement) - Gluteal bursitis - Labral tears (sharp pain in front of the hip or groin)

Shoulder

- Shoulder instability - Frozen shoulder - Biceps tendinopathy - Biceps complete rupture - Rotator cuff injury - Rotator cuff tear - shoulder bursitis - pain when reaching away from the body overhead - pain at the front or side of the shoulder - Labral tears (helmet of the humerus) - ligament tears - enthesopathy

Elbow

- Tennis elbow - Golfers elbow - Triceps tendinopathy - flexor muscles rupture - ligament tears and rupture of medical collateral and lateral collateral ligament - esenopathy -

Wrist

- Carpal tunnel syndrome - wrist sprain - wrist fractures - De Quervains tenosynovitis (thumb pain) - triangular fibrocartilage tear (pain on pinky finger side of the wrist)

How much is a physiotherapy session?

We charge Discovery rates. This means we charge a set rate by Discovery, without including a premium. Sessions are 45 minutes long. As per the industry standard rate set by the industry leader Discovery Healthcare, sessions vary between R 750 to R1300.

Are you contracted to medical aid? or Do you submit to medical aid?

Yes! this practice is contracted to ALL medical aids. Yes, we can submit to medical aid for you, provided the following conditions are met:

1. You have a comprehensive plan that covers physiotherapy benefits.
2. You have funds available in your plan as per point 1.
3. A sports Injury Benefit has been activated as per your GP consultation (for 4 sessions). We can motivate for this.
4. You consent to the practice of submitting to claim from your savings.

How do you decide the price of the treatment?

After assessment, as Physiotherapists we consider which treatment modalities (e.g. massage, shockwave therapy, joint mobilisation, etc.) will provide the best outcome for your condition. Our joy as physiotherapist is ensuring you recover quickly, with the best outcome. Each treatment modality (e.g. massage) has a treatment code and specified rate as per Discovery rates. To prevent patients from experiencing financial toxicity, only certain combinations of treatment codes can be used together, so that the total amount for the treatment is never unreasonable.

Do I have to stop exercising after treatment?

NO! Please go to gym after your physio session with us! The latest clinical evidence shows us that protected loading in a CRITICAL part of healing of from a significant injury. Protective loading whilst healing from an injury has statistically superior outcomes as opposed to resting, and then resuming training.

PHYSIOS