Chronic Disease Management Plans

Exercise Physiology with a CDM Plan

Medicare’s chronic disease management plan (CDM) is designed to support individuals to manage chronic diseases and/or musculoskeletal injuries.

A CDM plan is prepared by your GP and is designed to manage chronic disease, defined as a medical condition or injury, which has been experienced or is likely to be experienced for 6 months or longer.

Medical conditions typically covered under the CDM program include (but are not limited to) the following:

  • Cancer
  • Stroke
  • Diabetes (Type 2)
  • Asthma
  • Cardiovascular disease
  • Musculoskeletal conditions

Your GP will determine the type of practitioner support for you, which may include a maximum of 5 Medicare rebated services (one hour sessions) per each calendar year for services like Exercise Physiology. The rebate at the time of writing this is $52.95 per session that you can claim back from Medicare to meet part of your out of pocket costs of the sessions.

How do I obtain a CDM Plan for Exercise Physiology sessions for my rehabilitation?

Your GP determines your eligibility based on your medical history so you should discuss the CDM program with your treating GP and its potential benefits.

If eligible, your GP would then make a referral to Aspire Fitness and Rehabilitation for Accredited Exercise Physiology services via the CDM Medicare referral form.


If you require further information or assistance regarding rebates available for Accredited Exercise Physiology Services through Medicare or Private Health insurance contact our friendly administration team at Aspire Fitness and Rehabilitation on (07) 3310 4969. Click here – to download a copy of the CDM Medical referral form to take to your GP.

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Rowing Flexibility

– with Sports Physiotherapist Ivan Hooper

Over the next few months, rowers both young and old will be increasing their early morning training. Schoolboy rowing will be in full swing in Term 4 while Masters rowers prepare for the classic Head races.

Rowing is a sport that requires a unique mix of fitness, strength and skill. It requires the athlete to get into challenging positions that demand flexibility. The catch position where the athlete places the blade into the water requires a compression of the hip, thigh to chest. To achieve this position the athlete needs flexibility of the hamstrings, hip flexors and gluteals amongst other muscles.


The catch pictured above – shins at 90 degrees

Whether young or old, it is very common to see rowers with deficits in flexibility in these key muscle groups. This will have the effect of limiting hip compression. A consequence of this can be the athlete reaching further through the spine to get their stroke length. This places the spine into a weaker position and could lead to overload of spinal structures.

As rowers start to build their training volume, it is important to incorporate regular stretching into the weekly routine. A routine of 10-15 minutes repeated 2-3 times a week should produce gains. Stretches are best done when warm after activity. Hold the stretches for 20-30 seconds and repeat three times on each side. Improving the flexibility of the hamstrings, gluteals and hip flexors will assist in achieving better positions during rowing, helping with both injury prevention and performance.

Below are some stretches for rowers recommended to incorporate into your weekly training routine. If you would like a more thorough assessment of your flexibility and how it relates to rowing our physiotherapy team at QSMC can assist with a musculoskeletal screening.


Hold your leg tight in vertical position with both hands. Keep your ankle and foot relaxed. Straighten your knee until you feel a stretch in the back of the thigh. If you can fully straighten the knee with the thigh vertical, repeat the stretch while the thigh is closer to your chest.

Alternate Hamstrings – Long 

Lie in a doorway with one leg through the door and the other straight against the edge of the door. Position your hips a distance away from the door so that you feel a mild hamstring stretch. Hold this for up to 5 mins per leg. If your leg gets sore or goes numb, break up the time into smaller blocks.


Positioned on the ground with one leg behind you and one bent out in front with the knee in line with your trunk, lean forward while keeping your pelvis square to the ground. 

Hip Flexor & Quad – Hip Flexor and Lateral Trunk Extension 

Kneeling with your front shin vertical, tighten your stomach to keep your lower back flat. Tuck your bottom under to tilt your pelvis backwards. Lunge forward so that you feel a stretch in the front of the hip. A variation that an help stretch the outside of the hip and side of your trunk is to add a side bend, with arm over head. The stretch should move to being a bit higher and lateral to the previous stretch.

Quadratus Lumborum

Sitting with the left leg straight and right heel tucked into your groin, place your left hand on your right knee and use this to pull your trunk into rotation. Your shoulders should align with your straight leg. Place your right arm over your head and bend towards your left knee. The stretch should be felt in your lower back.  

Maximise your Mobility – *New Group Program*


– with Accredited Exercise Physiologist Huw Darnell

At Aspire we believe that everyone should be able to move their body to the best of its ability without pain and discomfort. Our modern lifestyles demands us to move less, perform repetitive activities and lose touch with how good our body should feel when we move well.

The ‘Maximise your Mobility’ program blends several mobility concepts and systems to provide a weekly class to help improve your movement capacity, develop a deeper level of body awareness, enhance your recovery and improve your posture and performance.

The Maximise your Mobility program starting on Thursday 26th October at 12.30pm will run for 1 hour per week for a 6-week period. The program will involve aspects of self-myofascial release, mobility, body control and mindfulness

Is this program right for me?

The human body should be able to achieve and perform in many different positions and environments. Some key positions that we believe are important for overall joint health and athletic performance are listed below.

Each of these 5 movements contain an easy to perform assessment that you can check off at home and identify some areas for movement improvement that the Maximise your Mobility class can help you with.

If you have trouble achieving one or more of these movements pain free, then your mobility or performance may be suffering. If you have to STOP for any of the reasons listed in the direction or you suffer pain from the movement you have not achieved the movement successfully. 


1.  The Deep Squat – The deep squat encompasses a multi-joint lower body movement that requires us to express full ROM at the ankle, knees, hips and spine to achieve an ideal body position. This is a movement that almost all children can perform easily. However, as we age and we spend less time in a deep squat, alter our daily habits and spend extended periods of time in poor postures we generally lose the ability to do so.

DIRECTION:  Stand with your feet just outside shoulder width apart. Squat down as low as you can while you maintain a neutral/flat spine. STOP if your knees cave inside the line of your feet, your heels lift off the ground, your chest drops down or if you lose balance.

The first picture below is correct positioning, the second is incorrect.

Deep Squat - GoodDeep Squat - Bad

2.  Toe Touch and Hip Hinge – being able to bend over and touch your toes pain free is a movement everyone should possess (with a few exceptions). Being able to move freely through your hips and achieve 80-90 degrees of hip flexion (i.e. touch your toes) is also very important for any activity that mimics this (especially loaded) e.g. deadlifting or lifting heavy objects from the floor. If an individual cannot achieve this through pure hip flexion the body may then flex through the lumbar spine and overload this area and potentially increase the risk of injury.

DIRECTION TOE TOUCH: Start by standing with feet shoulder width part, squeeze your quads so that your knees stay locked out. Bend at the waist toward the floor and see if you can get your palms flat on the ground. STOP when you cannot keep your knees straight or the tension in the back of your legs stop you.

The first picture below is correct positioning, the second is incorrect.

Toe Touch - Good Toe Touch - Bad

DIRECTION HIP HINGE: Repeat the same as above only this time stand with slightly bent knees and keep your back straight as you lean forward form the hips (like a hinge rotating at the hips). STOP when you cannot maintain a neutral/flat back.

The first picture below is correct positioning, the second is incorrect.

Hip Hinge - GoodHip Hinge - Bad

3.   Lunge – no movement screen would be complete without including some sort of single leg component because most movements in everyday life require us to be able to move well and produce force from one leg. This movement also gives us insight into someone’s ability to maintain an extended hip while moving through range, think running – if someone lacks the ability achieve full hip extension they may transfer the load up stream towards another joint (e.g. their low back) and overload this area of the body.

DIRECTION:  To get into the start position in the lunge, stand with your feet shoulder width apart. Then step back with your right leg the length of your shin. As you lower your back knee towards the floor see if you can keep your glute squeezed on the back leg and your front foot flat on the floor. Repeat stepping back with left leg. STOP if your front heel comes off the ground, your knee tracks inside the line of your foot and/or you cannot maintain tension in your glute.

The first picture below is correct positioning side on view, the second is incorrect side on view. The third is correct positioning from a front on view and lastly incorrect positioning front on view.

Lunge - GoodLunge - Bad

Lunge Front - GoodLunge Front - Bad


4.  Wall Shoulder Flexion (Overhead position) – can you get your arms overhead without any compensation at other joints throughout the body e.g. over-arching your low back to get your hands up over your head? This is a very common dysfunctional movement pattern that people present with. You may think this isn’t important, however if you perform any strength work or repetitive activity above head, e.g. chin ups, overhead activities at home, swimming, throwing etc it is important to be able to achieve this position.

DIRECTION:  To get into the starting position stand with your feet about 1 foot length away from the wall, keep your low back pressed flat onto the wall (keep it here throughout movement) and do not let your head move away from the wall. Raise both arms and try to reach the wall with your hands. STOP if you compensate by arching your low back off the wall, bend your elbows or your head moves off the wall.

The first picture below is correct positioning, the second is incorrect.

Overhead - GoodOverhead - Bad

5.  Press Position – if someone lacks the ability to achieve full shoulder extension (lifting your arms behind your body) and regularly goes into this position they may end up injuring the shoulder or neck. This may seem insignificant but if you are rowing, doing push-ups, or a bench press without a properly functioning shoulder you may end up with shoulder injury or pain.

DIRECTION: To set up lay down on the floor in a push up position i.e. with your chest touching the ground and your palms flat on the floor in line with bottom of your chest. Move your forearm into a vertical position and see if you can maintain a flat or slightly posteriorly tilted shoulder blade (Think about the wings of the plane on takeoff e.g. facing the sky).

The first picture below is correct positioning, the second is incorrect.

Press - GoodPress - Bad

If you had trouble achieving one or more of these movements, it may be time for our ‘Maximise your Mobility’ program! To register for this 6 week program contact our friendly reception team by emailing or call (07) 3310 4969.

Exercise for people living with Diabetes


Diabetes Mellitus is a chronic metabolic disease characterised by deficiency of insulin leading to hyperglycaemia (high blood sugar levels). Insulin insufficiency reduces the body’s ability to use glucose as fuel and transport to muscles, therefore it accumulates in blood. Research has shown that even light to moderate resistance training can have a large impact upon blood glucose control for people living with Type 2 diabetes. It promotes uptake of the glucose from the blood to be utilised by exercising muscles, having a similar physiological effect on the body as insulin. These benefits not only last for the duration of exercise, but for several hours afterwards. Therefore, regular physical activity is encouraged to help people living with Type 2 diabetes reduce their blood glucose levels with less reliance upon medication. Management of Type 2 Diabetes Mellitus generally includes a combination of regular exercise and healthy eating.

So what are some of the benefits?

  • Prevention of diabetes related complications (retinopathy, neuropathy, fatty liver, heart/blood vessel)
  • Improved cardiorespiratory fitness
  • Increased strength
  • Improved oxygen delivery
  • Reduction in blood pressure
  • Reduction in blood glucose
  • Improved insulin sensitivity
  • Weight loss
  • Improve blood lipid profile
  • Increase muscle hypertrophy and capilerisation to improve circulation (as people living with diabetes may tend to have poor blood flow).
  • Whilst exercise cannot rectify Type 1 Diabetes Mellitus cell damage, it can:
  • Affect the response of muscles to insulin and blood glucose level post exercise
  • Affect how glucose is processed back to muscles irrespective of insulin levels and
  • Deliver a lower dose response of insulin needed by improving the body’s response to insulin.

People living with Type 1 Diabetes Mellitus with minimal diabetic complications, can take on most types of physical activity and exercise (with medical clearance).

How to get started:

  • See your GP and get a clearance to exercise
  • Ask your GP about the best time of the day for you to exercise and any other medical considerations specific to you that you will need to pass on to your exercise professional
  • Ask your GP about Medicare’s Chronic Disease Management Plan program – this can assist you with meeting some of the costs associated with getting an exercise program underway
  • Get some supportive shoes and well-fitting socks to prevent foot ulcers:  Regular foot checks are also recommended
  • Consult an Accredited Exercise Physiologist to expertly prescribe a program for you specifically, that will address your personal health needs.

Our Accredited Exercise Physiologists design tailored, individual exercise intervention programs to help those living with diabetes increase their physical activity levels and promote adherence to exercise in a supportive environment. The aim is to provide a structured and safe atmosphere for the completion of resistance and aerobic exercise to keep people living with diabetes healthy.

To make an appointment with one of our Exercise Physiology team to discuss our diabetes and exercise programs and if they are right for you, feel free to book online, email or call 07 3310 4969

Rugby Strength and Conditioning

Specialised and Individualised is best

Having been the Strength and Conditioning Coach for UQ Rugby for the past 5 years, Accredited Exercise Physiologist Adam Garred is no stranger to the finer points of formulating and delivering successful programs for Rugby athletes. ‘Rugby is a high intensity impact sport, requiring a balance of strength, power, speed, and agility to absorb contact forces. It is vital that players have a sport specific strength and conditioning program that progressively develops these qualities, as this is paramount in the development of rugby players at any level’ advised Adam.

Adam also noted that a specific S&C program can also help the rugby athlete reach their developmental goals such as increased lean muscle mass or reducing skinfolds, all while providing strength training to avoid potential injuries and aid in recovery.

Aspire Fitness and Rehabilitation programs provide a professional and structured training environment to develop rugby specific physiological qualities. The programs have a major emphasis on developing core lifts and efficient movement mechanics. Specific structures such as the neck, shoulder girdle, core/hips, knee and ankle are targeted. Strategies are implemented and aimed at strength and stability of the musculoskeletal system, in order to prevent rugby related injuries.

To book an appointment with Adam, or one of our Accredited Exercise Physiologists contact our friendly reception team by email or calling 07 3310 4969. We also now take bookings online. 


Exercise more effective than medication in treating cancer fatigue


Recent research released and published in ‘JAMA Oncology’ studied four most commonly recommended treatments for cancer-related-fatigue; exercise, psychological, the combination of exercise and psychological, and pharmaceutical.

The results found that exercise (in combination with psychological treatments) reduces cancer-related fatigue during and after cancer treatment. In contrast, pharmaceutical interventions do not improve cancer-related fatigue to the same extent, and clinicians should prescribe exercise as a first-line treatment for cancer-related fatigue. This research puts exercise at the forefront of patient management in relation to cancer related fatigue as opposed to standard pharmacological pathways.

Exercising during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments. Chemotherapy side effects can sometimes make exercising tough, but it’s recommended to try to be as active as possible during treatment. It is essential for exercise programs to be individualised to your treatment status, functional capacity, physical limitations, exercise history and preferences. Accredited Exercise Physiologists can play an integral role in any patient’s recovery.

To make an appointment with one of our Accredited Exercise Physiology team to discuss cancer and exercise program options, and if they are right for you, feel free to book online, email or call 07 3310 4969


Thoracic Mobility


Artboard 2

Why Do You Need Thoracic Mobility?
Lack of thoracic mobility forces your body to function in ways it was not designed for. Lack of thoracic mobility also forces your lower back and/or neck and shoulders to compensate. These can increase the risk of injury.

Do You Lack Thoracic Mobility?
Lie with your back on the floor. Place your feet and buttocks flat on the floor. Bring your arms straight overhead (not the side). Keep your elbows locked and don’t hyper-extend your lower back. If you can’t touch the floor with your wrists, you lack thoracic mobility. You can improve it using the recommended exercises.

To assist, try maintaining a good posture by doing the following:

  • Keep your head erect.
  • Lift your chest up from the sternum.
  • Activate the muscles between your shoulder blades, and then release- the trick to this is practice many times a day.
  • Look after your posture at the office; have a good chair with a firm back support.
  • Maintain good posture at the gym. Keeping your chest up on Squats & Deadlifts prevents lower back rounding.  Improving thoracic mobility makes it easier to keep your chest up.

Also, try some of the following exercises and perform them a few times a day:

  1. Shoulder StretchRelease the shoulder blades as you sit or stand, by taking your clasped hands behind your back, extending your head back at the same time. Hold 20 seconds, repeat 5 times.
  2. Back ArchLie face down. Lift your shoulders by drawing your shoulder blades together, hold for 10 seconds, and then relax. Repeat 10 times.
  3. Cobra Stretch with rotation Lie face down. Lift from the waist, and rotate your upper trunk from side to side so that you feel a tight stretch in your back. 10 rotations each way.
  4. Broom – handle stretch & swing – Place a long rod, such as a broom handle, behind your neck, grasp it as shown and rotate your body from side to side, reaching maximum stretch. Perform 10 rotations each way.
  5. Thoracic Foam Roller – Lie back on the floor. Put the foam roller under your thoracic spine. Hug yourself so your shoulder blades shift to the side or stretch your arms above your head. Place your feet and buttocks flat on the floor. Roll back & forth. Stay away from your neck and lower back. Continue for 5 minutes, but take a break when needed. Your goal is to “arch” your thoracic spine. Try to wrap your upper-back around the foam roller. You alternatively can use two tennis balls in a sock, or taped together. Stay away from your lower back & neck.

Thoracic Foam Roller

To make an appointment with one of our Exercise Physiology team to discuss your thoracic mobility book online, email or call 07 3310 4969