Monthly Archives: August 2022

Carpal Tunnel

Carpal Tunnel median nerve impingmenet

The carpal tunnel is a narrow passageway in the wrist that opens into the hand. The median nerve runs through the carpal tunnel and gives feeling to the 2nd through the 4th finger (the medial half of it). Carpal tunnel is a condition that affects any gender, and the prevalent of people affected by this condition, are people who do repetitive movements with their hands and arm. Carpal tunnel Symptoms Numbness Pins and needles in the hand Pain, particularly at night Darting pains from the wrist Radiated or referred pain in the arm and shoulder Weakness of the hand The little finger and half of the ring finger are unaffected. Causes of Carpal Tunnel Presentation Occasionally there is no clear cause for Carpal Tunnel. Said so, sometimes there is a combination of factors such as: Arthritis – C.T. is a consequence of inflammation and swelling Pregnancy – During the pregnancy period, given the increase of hormones, the body tends to retain more fluid, which can compress the median nerve and replicate CT symptoms. Genetics – some people can have smaller carpal tunnel Overuse injury – as previously mentioned, repetitive movement and overload of the wrist can lead to CT syndrome Treatment options Along with different treatment options, massage is the first non-invasive approach someone can try for carpal tunnel. As soon as the symptoms show up, it would be wise to go and see a massage therapist. Techniques such as Remedial Massage, Myotherapy can easily address the problem and alleviate the pain. Depending on the presentation and the cause of the carpobual tunnel, even Applied MLD (manual lymphatic drainage) can be an ideal treatment option. Along the physical therapy, rest is highly recommended, and exercises, as often happen, play the main role. To prevent pain from wrist movement, a splint can help. Other treatment options. Surgery is a standard alternative option for Carpal Tunnel. It is a common intervention and can be done on both hands simultaneously. The patient can choose to go for local or general anaesthesia. Surgery for Carpal Tunnel involves a cut along the palm and the wrist. The surgeon then cuts the ligament to reduce pressure on the underlying median nerve. Once the skin gets stitched back, the ligaments heal themselves, and the new scar would not put so much pressure on the median nerve. Even though the surgery is easy, it can have some complications, like swelling and damage to the median or ulnar nerve. Also, if the ligament was not cut completely, it would still apply pressure on the Median Nerve, and a second surgery would be needed.      

Dry Needling

Dry needling session on the patient's back

Myofascial Dry Needling (MDN) treats sore muscles and trigger points. How does Dry Needling work? As discussed in another blog post, muscles are made of many individual fibres. As the fibre contract and stretches, this does give the muscle the ability to have strength and elasticity. Along with repetitive movements and lack of posture, the muscle fibres can accumulate tension that we generally call knots. Those “knots” are also known as trigger points. This is one of the many theories behind the formation of trigger points. Said so, a trigger point is a terminology used to describe a painful spot. And still, nowadays, there is no exact explanation for how trigger point forms and what exactly they are. But what we know for sure is that not everyone develops trigger points in the same spot. Now, to release the tension out of the trigger points, we can either apply external pressure, with the thumb or the elbow, in case of a Remedial Massage or even the knee or the heel of the foot with a Thai Massage, or we can break the fibres from within by using a needle. What a needle is like? The needles used in this practice have a diameter from 0.15 to 0.25mm, so really thin needles. Whereas the length can vary from 15mm to 90mm. Depending on the target muscle, the length of the needle is different. So, as we penetrate the muscle with the needle, we brake the fibre, and we recall an inflammatory response from the patient’s immune system. Which drives more blood and nutrients to the target area. As discussed further in this study published on PubMed, Dry Needling is effective for chronic non-specific neck pain 1. Is dry needling safe? Yes, it is, as long as the practitioner offering the service is qualified for it, and well knows the anatomy of the muscles. Said so, when you receive dry needling, there are a few things that you may want to consider. Firstly you better not have any metal allergy. Also, Dry Needling is not recommended if you have just done any strong physical activity or training, as the muscles would be in an acute inflammatory stage. In addition to this, other contraindications are: If the patient is on a blood thinner Diabetes type 1 The area is affected by Lymphedema The patient is unable to give the consent The patient would not be able to stay still as the needle is in the body Book now, your next Myotherapy session at Melbourne Massage and Treatment, Fitzroy North Clinic. How long the needle stays in the body? Depending on the area needing treatment, the needle may stay in the body for 3 to 10 minutes. And always based on the target muscle that needs to be treated would also depend on the type of treatment. Indeed, the needle could be placed in the muscle and left there to sit and create the physiological response needed, or it could even be partially extracted, moved around and placed back. This type of technique is called “peppering”. Peppering along a dry needling session allows the therapist to target other fibres around the muscle fibre area.     1. Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Muñoz M, Mayoral-Del-Moral O, Lluch-Girbés E, Prieto-Valiente L, Falla D. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016 Sep;157(9):1905-1917. DOI: 10.1097/j.pain.0000000000000591. PMID: 27537209.  

Lymphedema Melbourne

Leg with Lymphedema

Lymphedema is a health condition that develops when the lymphatic system gets dysfunctional. Compared with lipoedema, Lymphoedema presents disproportional swelling in 1 limb per side. As stated above, what’s behind the swelling is a malfunctioning lymphatic system that leads to an increased amount of protein below the skin (lymph liquid). As already discussed in a previous post about MLD, the lymphatic system has the function of taking away the lymph liquid and pass it on to the bloodstream. Indeed, from the bloodstream, it will all get filtered from the organs such as kidneys and liver to be disposed of. The lymph liquid is mainly made of water, protein and dirt. How MLD works? The Manual Lymphatic Drainage technique stimulates the lymphatic system that can also be boosted by muscular movement. Indeed a 30-minute to 1-hour walk can speed up the Lymphatic System to double speed. This happens due to the capillary (pre-collector) of the lymphatic system, which constantly opens and closes to suck away the lymph. The faster the opening and closing of the doors of the capillary, the quicker the suctions would be. How may lymphedema develop? Where things can go wrong is when the lymphatic system stops working or doesn’t work strong enough in one or more than one area of the body. The reason why the LS stop working and cause lymphodema is as follow: Missing lymph nodes can happen after surgery for cancer removal Genetics missing lymph nodes as per genetic Parasites Surgery damages the pre-collector/collector or lymph nodes with invasive surgery. Radiation due to cancer treatment Are there risk factors? Older age Excess weight or obesity Rheumatoid or psoriatic arthritis When Lymohodema starts developing, an intervention of a professional carer is essential. Here is a link to a Manual Lymphatic Drainage therapist worldwide that can help you with that. Seeing a GP is also recommended. For intervention, I refer to MLD as a manual technique to boost the lymphatic system, compression bandaging and garments wear. The consequence of letting go of Lymphodema is quite severe. As the skin keeps swelling, it will stop receiving oxygen from the bloodstream sooner or later. As per result, the skin would start drying out, cracking, and possibly getting infected. Said so, the consequence can be even more severe and lead to Cancer too. MLD at Melbourne Massage and Treatment Regarding my training as an MLD therapist, I can’t treat clients with Lymphodema yet. My skills within the MLD technique are limited to working with a patient with an intact and fully functioning Lymphatic System. But don’t hesitate to contact me if you need more information about Lymphodema, as I can put you in touch with a therapist who can help.    

Lipedema

Lipedema is a condition that causes excess fat to accumulate under the skin, either in the lower or upper part of the body. Said so, it is a condition that affects mainly women. It manifests itself just after hormonal changes, such as puberty, post-pregnancy or in older age, after even major surgery. The condition does not affect the hands or feet. Regarding the symptoms and presentation, Lipedema can be mistaken for lymphoedema. Even though those are different conditions, lipedema can lead to lymphedema. What is the cause of Lipedema? Well, it is not known what can cause lipedema. As mentioned above, it manifests itself often when there is hormonal change, so hormones can play a role in it. What is known is that it runs in families, so it has a genetic component and, most of the time, affects women. Obesity is not a cause either, even though most of the people who suffer from Lipedema suffer from obesity too. Lipedema Symptoms are like: A fat build-up in the thighs, buttocks, calves, and occasionally in the upper arms. Feet or hands, unless the patient has chronic venous insufficiency or lymphoedema, do not swell. Pain. Walking ability can decrease as the condition worsen. Condition of Anxiety and or Depression can develop as the person feel an imbalance in their body appearance. Fat accumulation under the skin can block the Lymphatic System, causing Secondary or lipo-Lymphoedema if the lipedema is not looked after. What can be done if you suffer from Lipedema? There are several approaches to the problem, depending on the severity of the case. The earlier the lipedema gets diagnosed, the better. For diagnosing Lipeedema, you may want to talk to your GP or visit a therapist from the Vodder Academy who has a LEVEL III certification. Here is a link to find a practitioner to help you with that. Regarding massage, there is not much that Remedial Massage, Myotherapy or Thai Massage can do. Specifying diet can help too, and you may want to talk to your GP about it. Also, surgery such as liposuction would help, even though those are better at the early stage. Specifically, manual therapy like MLD (Manual Lymphatic Drainage) can help. But MLD itself is not enough in most cases, especially if the Lipedema did create a Lipo-Lymphodemia. Read more about MLD by following this Link. Indeed, in addition to MLD compressed bandaging and compressed garments wear are essentials. Those two practices can allow the work initiated by MLD therapy to be maintained and amplified.  


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