While a bunion and a Morton’s neuroma are two different foot conditions, if they are co-existing, they can sometimes influence the way the forefoot is loaded, causing delays or difficulties in the recovery process. Starting with the bunion, which medically is known as hallux valgus, changes the position and function of the big toe and first metatarsophalangeal joint. On the other hand, Morton’s neuroma is a painful condition involving one of the common plantar digital nerves, most commonly between the third and fourth toes. If you present with both conditions, treating the neuroma without considering how the rest of the foot is functioning may not always address the mechanical factors contributing to your symptoms. This is what this blog is going to analyse: Can a bunion make it harder for a Morton’s neuroma to settle? The answer is not as simple as saying that a bunion causes a neuroma, as there is not enough evidence for it. But what we know is that hallux valgus can alter how load is distributed through the forefoot, and this may be relevant when managing a sensitive or irritated interdigital nerve. What is the relationship between a bunion and a Morton’s neuroma? As mentioned above, a bunion does not automatically cause a Morton’s neuroma. That said, both conditions can be influenced by the way forces are distributed through the forefoot. Indeed, Hallux valgus can change the position of the big toe and first metatarsal, which are sitting more laterally than they should be, and alter normal walking mechanics. We know, in fact, that while walking, the big toes should be the primary driver and taker of the body weight at the toe level, and if pushed to a lateral position, it can’t take such load; therefore, the body weight is then redistributed along the phalangea box and other toes. But to be more specific, and by following what the data show, we better understand this 2025 systematic review and meta-analysis involving more than 6,000 feet found that hallux valgus was associated with reduced hallux loading when measured inside footwear. But evidence that hallux valgus consistently increases loading beneath the central metatarsals was inconclusive. And this is important because it gives a distinction between bunion and Morton’s neuroma formation, as neither is the consequence of the other. Basically, the correlation and causation effect. Indeed, foot mechanics are individual. Your symptoms can be influenced by the shape of your foot, footwear, activity, walking pattern, joint mobility, strength, and how you distribute your body weight while moving. How can a bunion affect Morton’s neuroma recovery? Now that we clarify the distinction between the correlation and causation of Morton’s neuroma from hallux valgus, we can dig more into how the bunion can affect Morton’s neuroma recovery. Morton’s neuroma is a condition that can not be recovered by only exercises or some other external interventions, but, to start with, it needs rest. By rest, we mean reducing stress on the structure involved, not no movement at all. This is why footwear modification and pressure redistribution are commonly used in Morton’s neuroma management. Therefore, the bunion may become relevant because hallux valgus can alter the way the forefoot loads during walking. For example, some people with hallux valgus develop a tendency to move the centre of pressure away from the first metatarsophalangeal joint during late stance. Research has demonstrated this lateral shift in people with bilateral hallux valgus. As a result, if the big toe can not contribute effectively to propulsion, the body may find another way to complete the movement. So again, this can overload the neuroma site, limiting rest and slowing recovery. Think about the whole foot, not just the painful spot When dealing with a painful presentation, I always invite my client to stop focusing only on the painful spot, and start to understand that nothing work in isolation. Therefore, if someone has a neuroma, it can be tempting to focus entirely on the area between the toes. But a better approach would be asking: Why is this area becoming irritated? The answer is often made up of a combination of factors, which may include: Footwear used Training load or walking volume Forefoot structure or movement Possible pre-existing injury So that’s why treating the neuroma alone may not be enough if the mechanical contributors are still present. Can bunion exercises help reduce stress on a Morton’s neuroma? The short answer is yes, but it is not always as simple. Evidence suggests exercise can improve pain and some measures of hallux valgus, particularly in mild-to-moderate cases. However, this is different from saying that bunion exercises have been proven to treat Morton’s neuroma. So what we can therefore assume is that by improving the foot mechanics and load, we may reduce stress on the neuroma site, assisting the body’s natural recovery. Exercises may include: controlled big-toe movement exercises to improve intrinsic foot muscle control toe spreading exercises strengthening exercises for the foot controlled calf and ankle exercises balance exercises progressive weight-bearing exercises exercises that improve the way the foot controls load during walking And there is no one-size-fits-all. What we should focus on too is the ability and capacity of the individual, and then work on what they are missing out on. As an example, forcing the big toe into a position with a toe separator simply because someone has a bunion is not necessarily appropriate, and it may not create the desired change anyway. The aim is not to “push the bunion back into place”. The aim here is to improve the available movement and control of the foot and help the person tolerate load more effectively, yes, starting from the big toe, if a bunion is present, but the focus has to be also on the other toes, as well as the ankle. Can big toe mobility affect pressure on a Morton’s neuroma? For what we know, the big toe plays an important role during walking, particularly during the later part of stance. For simplicity, we expect […]
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Bunion and Morton’s Neuroma: Can a Bunion Affect Neuroma Recovery?
While a bunion and a Morton’s neuroma are two different foot conditions, if they are [...]
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Knee Pain in Coburg
Knee pain is a common form of injury and can affect people of all ages [...]
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Post-Surgery MLD Melbourne – Vodder MLD Therapist
Any form of surgery is an invasive procedure for the body to deal with, and [...]
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Hip Pain in Coburg: Causes, Symptoms & Treatment
In the many presentations I get to see here at Melbourne Massage and Treatment in [...]
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Lymphatic Walking: Let Me Tell You Why It Is Another Trend
Lymphatic Walking is another trend that you really don’t need to overthink. But let me [...]
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Sep
Knee pain is a common form of injury and can affect people of all ages and activity levels. Common mechanisms of action that lead to knee pain include an intense increase in load training, repetitive activities, osteoarthritis, a sudden change in direction during a sport activity, muscle or tendon tears, ligament injury or irritation around the kneecap. If you are experiencing knee pain in Coburg, the first step is understanding what may be contributing to your symptoms rather than simply treating the painful area. At Melbourne Massage and Treatment in Coburg, I use a combination of clinical assessment, hands-on treatment and exercise to help manage knee pain. Depending on your presentation, this may include Remedial Massage, Myotherapy and a progressive exercise program. What can cause knee pain? “Knee pain” is a symptom, not a diagnosis. As with any joint pain presentation, first thing first, we want to rule out whether what we are looking at is a joint pain presentation or a muscle-related injury type of pain. To do so, we need an extensive understanding of the mechanism of injury, like how/when the pain started and how/when the pain increases or decreases. That information can start giving us some clues about what type of injury we may rule in or rule out Here is a list of common areas or presentations to which knee pain can refer to: Pain around or behind the kneecap Patellofemoral pain Knee osteoarthritis Patellar tendon pain Quadriceps or hamstring-related problems Pain following an increase in running, walking or gym training Knee pain following an injury Pain associated with changes in lower-limb strength or movement Stiffness and reduced knee function To give you a better understanding of how each area of the knee can correspond to a specific injury, let’s look at patellofemoral pain, which commonly becomes more noticeable during activities that load the knee, including squatting, stairs, running, jumping or prolonged sitting. But your pain, perhaps, could also be from an ACL injury, and it may present at the anterior portion of the knee, and this is why I don’t use a one-size-fits-all approach to knee pain. Unless we can pinpoint why you are in pain and what structure is responsible for it, going for a random treatment plan would not help. Knee pain assessment in Coburg During a Myotherapy appointment, I look at more than just the painful spot. The assessment can include your symptoms, medical history, previous injuries, training or work demands and the movements that reproduce your pain. Other things we may look at include: Knee range of motion Hip and ankle movement Quadriceps and hamstring function Hip strength Single-leg movements Squatting and stepping movements Running or other sport-specific activities How your symptoms respond to different loads Along with that information collection and movement pattern, I will ask you to go for, we can better understand what the structure that gives you pain is: a meniscus or a ligament, as per a quad tendon or a hamstring tendon. The purpose of this assessment is not simply to find something that looks “out of alignment”. It is to understand what may be contributing to your symptoms and determine what can be changed. How can Remedial Massage help with knee pain? Remedial Massage is an ideal hands-on treatment to reduce pain and stress on muscles that surround the knee joint, which may be contributing to your symptoms. Then, based on your individual presentation, treatment may include work around the quadriceps, hamstrings, calf muscles, gluteal muscles and other relevant areas of the lower limb. What is important to notice, on the other hand, is that massage does not directly “fix” every cause of knee pain, and it should not be considered a replacement for rehabilitation when exercise is required. Research on massage therapy for knee osteoarthritis suggests that massage may provide short-term improvements in pain, stiffness and function, although the evidence is limited and the longer-term effects are less clear. [2] This is why I see Remedial Massage as one part of a broader treatment plan when appropriate. Myotherapy for knee pain Among the services that I do offer here at my Coburg clinic, Myotherapy takes a broader clinical approach to musculoskeletal pain. Rather than simply massaging the knee or surrounding muscles, treatment can combine: Assessment → hands-on treatment → movement → exercise → gradual loading` The exact approach depends on your symptoms and goals. Hands-on treatment may be used to help manage pain, muscle sensitivity or movement restrictions. Exercise can then be introduced or progressed according to what you need to return to. For someone who has knee pain when squatting, for example, the goal may not be to avoid squatting forever. Instead, we can look at how much load you currently tolerate and gradually build your capacity. For someone who has knee pain when running, the approach may involve modifying training temporarily while building strength and tolerance before progressively returning to running. Exercise is an important part of knee pain management Exercise is one of the most important components of managing many types of knee pain, and probably any form of pain. From research to clinical experience, I support exercise therapy for knee osteoarthritis and any form of knee pain with different types of load and forms of exercise, including resistance training, cycling and other exercise approaches showing benefits for pain and function. [4] Why exercise is the way to go is because we want you to be functional and capable of loading your knee with as little trouble as possible. So, by increasing the load gradually and exposing your knee joint to positive stress as a controlled load, it works in favour of our long-term goal: you being pain-free. And of course, based on your presentation, we may need to change the type of exercises, especially in the early stage, when the inflammation is still acute, the level of sensitivity is still high, and the structure it may not be ready for any random load. Therefore, the important point is that […]
Sep
Any form of surgery is an invasive procedure for the body to deal with, and finding yourself with oedema post-surgery, pain, sensitivity, stiff scars and/or fibrosis is a natural process and consequence. Those presentations indeed are also the result of a temporary effect on the body’s tissues and the lymphatic system. This is one reason Manual Lymph Drainage (MLD) may form part of a post-operative recovery plan. But there is an important distinction that is often missed: MLD is not simply a “lymphatic massage”. Indeed, when I work with clients who specifically have undergone procedures such as liposuction, abdominoplasty, breast surgery, body contouring and other cosmetic procedures, I have to explain that MLD is performed using the Dr Vodder method, which gently stimulates the swollen areas to direct the fluid towards the nearest lymph node. And not just pressing hard or applying some oil on the skin and starting to massage it in the hope of some relaxation. Because if you are someone who is recovering from cosmetic surgery, that difference matters. What happens to the lymphatic system after cosmetic surgery? Surgery is a controlled injury to the body. As a consequence of this procedure, tissues may experience inflammation, disruption of small blood and lymphatic vessels, changes in tissue pressure and temporary impairment of normal fluid clearance. Post-operative oedema is therefore not necessarily a sign that something has gone wrong. In fact, swelling is a normal part of the body’s healing response, although the amount and duration can vary considerably between individuals and procedures. Recent research has highlighted postoperative oedema as a common consequence of aesthetic surgery and has also drawn attention to the need to better understand lymphatic complications following these procedures. That’s where, as a clinician, I don’t only think of: “How do I get rid of the swelling?” But I also look into: “What is happening to this person’s tissues and lymphatic drainage at this stage of recovery?” And that’s where clinical assessment becomes important. MLD is not about squeezing swelling away As cosmetic surgery is becoming more and more popular, and many Melburnians are heading overseas to get their surgery done, I was quite shocked the first few times I had someone call for MLD post-cosmetic surgery and asked how I would push the liquid out of their body. My response was as clear as it could be: MLD is not about squeezing liquid out of your body. This is not only a dangerous and illegal procedure here in Australia, but it is definitely not how Dr Vodder MLD is designed to work. The original Dr Vodder method uses gentle, specific skin-stretching techniques applied with appropriate pressure, direction and speed. The technique is intended to assist lymph flow and drainage of tissues. This is particularly relevant after surgery because recently operated tissues are not the same as healthy, uninjured tissue. In fact, more pressure is not necessarily better. That’s where post-operative treatment needs to respect the stage of healing and the condition of the tissues being treated. Why the treatment cannot be exactly the same for everyone No single “post-cosmetic surgery MLD protocol” fits everyone. Consider the difference between someone recovering from: liposuction of the abdomen abdominoplasty breast surgery a combination of procedures body contouring liposuction of the thighs or arms The surgical areas, incisions, tissue trauma and areas of swelling can all be different. And after a few years of experience, I can tell you, I got to work with people who did a few of those surgeries all at once, and coming up with a clinical reasoning on how to move the fluid was a good challenge. On the other hand, there is to consider that there can be variation between patients, based on their general wellbeing and health status. Two people may have the same procedure but very different presentations. One person may have relatively mild swelling and good tissue mobility. Another may have significant oedema, restricted movement, areas of tenderness or developing tissue firmness. This is why post-operative MLD should be individualised rather than treated as a routine massage sequence. What Do We Look At As a Vodder Therapist? Before commencing an MLD treatment, even with a returning client, we start with more than simply locating the swollen area. First thing first, we consider the person’s overall presentation and the stage of recovery. Depending on the situation, this may include considering: The procedure What surgery was performed? Which tissues were affected? Where are the incisions and treated areas? The stage of healing Post-operative tissues change considerably over time. A technique that is appropriate at one stage may not be appropriate at another. The distribution of swelling Swelling is not always confined to the area that was operated on. The lymphatic pathways MLD is based on understanding lymphatic anatomy and drainage pathways rather than simply rubbing towards the closest lymph node. The condition of the skin and tissues Changes in tissue texture, sensitivity, mobility and firmness can provide useful information about how recovery is progressing. The person’s symptoms and function Pain, tightness, restricted movement and discomfort may influence how treatment is approached. Compression and movement MLD is not necessarily an isolated treatment. Depending on the individual’s situation, compression, appropriate movement and other elements of recovery may also be relevant. And again, this is one reason why seeing a therapist with specific lymphatic training can be different from booking a generic “lymphatic massage”. Why the direction of MLD matters The lymphatic system is a complex network, not a simple pipe running directly from the swollen area to the nearest lymph node. Indeed, when performing MLD, we use specific manual techniques and treatment sequences to influence lymphatic drainage. Our aim as MLD therapists is to direct the fluid from the congested area, away from and across the watershed (an imaginary line that divides the body into quadrants, from which the lymphatic system vessels start), aiming for the fluid to reach the lymphatic duct (the connection between the lymphatic system and the bloodstream in the […]
Sep
In the many presentations I get to see here at Melbourne Massage and Treatment in Coburg, hip pain is quite a common one. When we talk about hip pain, though, we refer to a variety of presentations which can be defined primarily by the site of pain in the hip area. So it can be the frontal side, including the groin, or the side of the hip, near the femoral head, or even the gluteal area, upper or lower. Hip pain, like any form of pain, can be debilitating, and as with other conditions, like back pain, it can make everyday activity more difficult and challenging, as the hip is a joint we use for basically any movement, and even while sitting or lying down can still be uncomfortable. That said, “hip pain” does not always mean that the problem is coming directly from the hip joint. Pain around the hip can involve muscles, tendons, ligaments, nerves, the sacroiliac joint (SIJ), or structures around the outside of the hip. Conditions such as femoroacetabular impingement (FAI), gluteal tendinopathy and greater trochanteric pain syndrome can also produce different patterns of hip pain. At Melbourne Massage and Treatment in Coburg, assessing where your pain is located, what movements aggravate it and how your hip and surrounding areas move can help determine what may be contributing to your symptoms. What Can Cause Hip Pain? As briefly mentioned above, there are many possible causes of hip pain. Below, we are going to go through some of the most common hip pain presentations I get to see at my Myotherapy clinic in Coburg. Ligament Tear Ligaments are soft tissues that connect bones to bones and help provide stability around joints. Even though the hip joint is most often well supported via those 3 ligaments Iliofemoral, Pubofemoral, and ischiofemoral a significant force, sudden movement, or sporting injury can damage a ligament around the hip or pelvis. When we said that most often, the hip is well supported by those 3 types of ligaments, we refer to the fact that genetically we all have different presentations, and someone who was born with hip dysplasia may present naturally with less stability at the hip joint. Moving forward, a ligament injury may cause pain, tenderness and a feeling of reduced stability. The gold standard diagnostic method for a ligament tear, lastly, would not be a basic hands-on assessment, but a magnetic resonance arthrogram (MRA). Muscle Tear The muscles surrounding the hip are among the bigger and stronger muscle groups in the body; let’s think of the quadriceps muscle group or the hamstrings. Those muscle groups, on top of being really important for overall hip functionality, are also really important for hip stability. But, as with any muscle group, a sudden increase in load, sprinting, jumping, changing direction, or an unexpected movement can result in a muscle strain or tear. Depending on the muscle involved, you may feel pain around the front, side, or back of the hip. Muscle tears can range from relatively minor strains to more significant tears, which result in severe pain, swelling, and bruising and may require a longer rehabilitation period. Hypermobility Hypermobility is a condition that involves many of my clients and is about having more laxity in the ligament tissue. However, being hypermobile does not automatically mean having an injury, but it means that more strength in the hip muscle group is needed to avoid injuries. This is because the hip ligaments, in a hypermobile presentation, are less capable of holding the femur head into the hip socket. Therefore, the goal is not necessarily to restrict movement at your hip joint, but to improve strength, control and tolerance to load. Femoroacetabular Impingement (FAI) Femoroacetabular impingement, commonly called FAI, is a condition that can affect even fairly active people, including athletes. It is characterised by extra tissue that can grow on the femoral head or on the hip socket, which may get irritated when the hip goes into flexion. Symptoms may include pain around the groin or front of the hip, particularly with certain positions involving hip flexion and rotation. In contrast to a hip ligament tear, imaging findings do not always explain someone’s symptoms on their own. A clinical assessment is needed to understand how the hip structure, movement and symptoms relate to each other. But, commonly, in ligament tears, the strengthening of muscle groups that cross the hip joint is quite important, including quads and adductors. Femoral Nerve Pain Even though femoral nerve pain is less common than sciatic nerve pain, it is still quite relevant to the topic of hip pain. A common cause of femoral nerve pain is Meralgia Paresthetica, a nerve entrapment at the inguinal ligament that can cause numbness and pain at the anterior portion of the thigh. Furthermore, femoral nerve pain can also result from back injury or nerve entrapment at the spine level, specifically L2, L3, and L4. To differentiate which pain comes from where, a tailored assessment is needed, including a clear understanding of the mechanism of injury and changes in body mass (especially if it happens in a short period of time) and, where needed, a scan can also be helpful to rule out either one or the other condition. Sacroiliac Joint (SIJ) Discomfort The sacroiliac joints are a complex structure that connect the pelvis with the sacrum and are located near the back of the pelvis. SIJ pain can present with different levels of discomfort and in different locations, including the sacral area, upper gluteal area, or, if nerve entrapment is present, pain can refer all the way down the shin via the sciatic nerve. Because symptoms from the lower back, pelvis and hip can overlap, identifying the exact source of pain can be difficult without an appropriate assessment. Gluteus Medius Bursitis / Greater Trochanteric Pain Syndrome When pain is present on the outside of the hip, it can be described as “hip bursitis” or “Greater Trochanteric Pain Syndrome”. A bursa is a sack […]
Aug
Lymphatic Walking is another trend that you really don’t need to overthink. But let me introduce myself first. My name is Giovanni, and I am a clinical myotherapist specialised in Manual Lymphatic Drainage (MLD). I work with client who has an intact Lymphatic system but even with client who have Lymphatic System pathology, like Lymphoedema. In this blog, I am going to share the basic knowledge and explanation of why Lymphatic walking is a nonsense term, but you should still walk. Walking is good for you. It gets your muscles moving, supports cardiovascular health, improves fitness and can be an easy way to stay active. But recently, you may have heard of lymphatic walking. Your lymphatic system is already working, no matter what. So no, you don’t normally need a special walking technique to “switch it on.” The lymphatic system is a complex transport network that continuously moves fluid, proteins, fats and immune cells through the body. Lymphatic vessels have their own pumping mechanisms, while movement of surrounding tissues, breathing, and other mechanical forces can also influence lymph transport. Does walking increase lymph flow? Yes. And with this, we already gave enough credit to this trend. Any form of movement can help the lymphatic system work more and can help your body feel less bloated and tight. This is because any form of muscle contraction is going to directly stimulate your lymphatic system capillaries to collect more liquid and therefore move more fluid. Now, walking is a perfectly reasonable activity for supporting normal circulation and lymph transport, because the primary movers in the body for walking are your legs. Legs contain the biggest muscle group of the body, and are a body area where the fluid has to travel the most, in a proximal direction, to reach the clavicle, where the lymphatic fluid is then dumped into the bloodstream (at the subclavian veins). But again, there is nothing particularly magical about “lymphatic walking.” Again, your lymphatic system responds to many forms of movement. Walking, cycling, swimming, resistance training, climbing stairs and ordinary daily activities all involve muscular contractions and changes in pressure that can contribute to lymph movement. In other words: You don’t need to learn a special walking pattern to make your lymphatic system work. But what I really want to make sure we all understand is that there is nothing inherently wrong with doing them. Just don’t confuse a different walking technique with a medically necessary way of “activating” your lymphatic system. Do you need to boost your lymphatic system? Ok, this is another big topic that I often find myself talking to my clients about here at Melbourne Massage and Treatment in Coburg. If, overall, you are a healthy person, no, you don’t need to boost your lymphatic system. And the reason is quite simple. Your lymphatic system, like many body systems, works fine just by you doing the right thing. If you keep yourself in motion- yes, in this case, even just walking- your lymphatic system works even stronger than usual. This is why phrases such as: “Your lymph is stagnant” “You need to activate your lymph” “Your lymphatic system is blocked from sitting” “Do this walk to detox your lymph” “You need to flush your lymph” should be treated with some scepticism, as are a bunch of nonsense words. That said, there are, of course, genuine lymphatic disorders. People with conditions such as lymphoedema can experience impaired lymphatic transport and may require appropriate assessment and management. Exercise and movement can form part of lymphoedema management, but that is very different from saying that everybody needs to perform a special walking routine to prevent their lymphatic system from becoming “stagnant.” What if you have lymphoedema? This is where we need to sit and talk. Medically talk, no social media trend chat. If someone has lymphatic dysfunction, simply telling them to “walk more to boost their lymph” is not an adequate treatment plan. In fact, exercise can be beneficial for people with lymphoedema. But when someone presents with Lymphoedema, we need to take into consideration the bigger picture, which is their medical and clinical history. Therefore, management of lymphoedema may involve several components, depending on the individual, including exercise, compression, skin care, education, self-management and appropriate manual techniques. That is very different from following a social-media video promising to “flush out toxins.” Lymphatic massage is not the same as Manual Lymphatic Drainage Something that I already touched on is the topic of lymphatic massage and what’s the difference between Lymphatic Massage and MLD. A massage advertised as “lymphatic” is not automatically Manual Lymphatic Drainage (MLD). MLD is a specific manual technique with particular principles and techniques. It should not simply be used as a marketing label for any gentle massage that claims to “drain toxins.” Understanding this distinction is particularly important if you are looking for treatment for an actual lymphatic condition. But also, if you are looking to find a therapist who can tell you more about your lymphatic system needs, if any, and not just grab your money promising a healthy trend. So, what is MLD? Manual Lymphatic Drainage is a specialised, gentle manual technique that increases lymphatic fluid transport. Vodder Academy is the world academy that has a patent for MLD as a technique and treatment modality. That’s the academy I studied with for my Applied MLD, Lymphoedema Management and Cosmetic Surgery recovery specialisation. That said, there are other schools that offer training for other lymphatic treatment, but personally, with extended research, I found that the Vodder Academy was the best school to study with. Not only because they hold the gold standard for Lymphoedema treatment, but also because the training doesn’t stop at the course; there is a real network of teachers and students who spend time sharing resources and experiences from all over the world. Can healthy people have MLD? Yes, of course they can. If you are overall healthy and not suffering from any lymphatic condition, you can still receive […]
Aug
Shoulder pain is a common presentation I get to see and treat here at my Myotherapy Clinic in Coburg. It ranges from clients who have difficulty reaching overhead to those who have no mobility issues but a constant pain or ache along the shoulder blade area. Myotherapy treatment can help with this presentation, settling the pain once and for all, by guiding you on what structures need tension relief and which ones need strength. So if you are looking for shoulder pain treatment in Coburg, it is important to understand that shoulder pain does not always come from one specific muscle or structure. The shoulder works as part of a larger movement system involving the neck, upper back, shoulder blade, rotator cuff and the rest of the arm. What Can Cause Shoulder Pain? Let’s start by pointing out what structures can create shoulder pain. Some people notice pain after lifting weights, playing sport or performing repetitive movements. Others develop shoulder pain gradually without a clear injury. Common factors associated with shoulder pain can include: Repetitive overhead movements Sudden increases in training load Poor tolerance to certain movements Reduced shoulder mobility Reduced strength or endurance Rotator cuff-related pain Irritation following an injury Neck and upper-back problems contributing to symptoms Changes in activity or training Prolonged periods of inactivity Cervical facet joint irritation Bursitis The tricky bit with any pain, including shoulder pain, is that the painful spot does not always tell you exactly which structure is responsible. That’s why, along with our Remedial Massage or Myotherapy treatment, an initial consultation always comes with an assessment first. We want to pin down, at best, what structure is responsible for your pain. A classic example is: muscle or joint pain? Shoulder Pain Is Not Always Just a Shoulder Problem As briefly explained before, your shoulder does not work alone, as it takes part in a more complex mobility and stability joint complex system. That said, the shoulder is also one of the weakest and most exposed joints in the body, given that it has to have really major mobility capacity, but it is also required to play a strong, stable role (scapular/thoracic joint). So what actually can influence your shoulder capacity and load; therefore, what can also influence your shoulder pain is your neck, your thoracic spine, and even your elbow area. For example, reaching overhead requires coordinated movement between the shoulder joint and shoulder blade. Your upper back and neck also influence how this movement occurs. This is why two people with similar shoulder pain may require completely different treatment approaches. One person may need to improve shoulder strength. Another may need to work on mobility. Someone else may need to gradually rebuild their tolerance to lifting or overhead activity. Common Types of Shoulder Pain From what I get to experience as a practitioner here at Melbourne Massage and Treatment in Coburg, shoulder pain can present in many different ways. I did see clients who present with shoulder pain while: Lifting the arm at any degree Pain reaching overhead Pain when reaching behind the back Pain when sleeping on the affected side Pain during gym exercises Shoulder stiffness Reduced range of movement Pain around the front or side of the shoulder Pain extending towards the upper arm Shoulder pain associated with neck tension That said, we have to be aware that some shoulder problems can also develop gradually, while others occur following a specific injury. What I would suggest about your shoulder pain is that if you experience severe pain, following a significant trauma, and having major weakness or loss of movement, appropriate medical assessment may be required. So do not hesitate to book in a Myotherapy session, and let’s start understanding how serious your presentation is. What About Rotator Cuff Pain? The rotator cuff, which is a group of muscles that surround your humerus head and give stability to the humeral head, is important for shoulder health, but occasionally it can be overlooked and blamed for your shoulder pain. While this group of muscles needs to be strong in order to minimise the chance of shoulder pain, we have to consider that, taken alone, they are not going to be the only muscles you want to focus on for your shoulder health. Therefore, let’s not automatically label it as a “rotator cuff injury” simply because it hurts during a particular movement. A proper assessment considers your symptoms, movement, strength, training history and how your shoulder responds to different loads. Can my Shoulder Pain be Part of Menopause Symptoms? Yes, it can. Menopause, as discussed in many other blogs, is a life-changing experience that women experience at an average age of 52 years. Along this transformational journey, as estrogen starts fading away, conditions like Frozen Shoulder (Adhesive capsulitis) are quite common. In a more recent study by MD Jocelyn Wittstein, women who were suffering from this condition and took HRT saw their symptoms drastically improve. More information about menopause and Frozen Shoulder is available from this article. How Can Myotherapy Help Shoulder Pain? At Melbourne Massage and Treatment here in Coburg, when someone presents with shoulder pain and wants to get on top of what the problem is, I do offer Myotherapy treatment as a form of pain relief but also as a form of strengthening program for the shoulder complex. So I would treat shoulder pain in Coburg with a combination of: Movement assessment Hands-on treatment Soft tissue techniques Myofascial techniques Joint mobilisation where appropriate Dry needling where appropriate Mobility exercises Strengthening exercises Education about activity and load management My aim, again, as a clinical myotherapist, is not to make you feel better only after the treatment, but to give you tools to empower yourself and to make you stronger and live better, possibly pain-free. To do so, in the longer term, we need to understand what may be contributing to your symptoms and gradually improve your ability to move and load the shoulder. Shoulder Mobility Is Important — But […]
Aug
Lower back pain is a leading cause of disability in Australia. That said, not everyone who experiences lower back pain has to end up with debilitating pain for months or years, and so how can we prevent that? Therefore, to prevent severe musculoskeletal pain, including back pain, movement is our best option. That said, we have to be aware that even pros who do regular movement can occasionally suffer from lower back pain. As we will see in more detail soon, pain is a brain response to a stimulus, which can be physical but also psychosomatic or from a rise in stress or lack of sleep and/or more. So, for many people, lower back pain improves with time and appropriate movement. However, persistent or recurring pain can interfere with work, exercise, sleep and everyday activities. Then, if you live or work in Coburg and are experiencing lower back pain, understanding what may be contributing to your symptoms is an important first step to ensure your presentation doesn’t become a chronic one. What is lower back pain? Let’s start with a better definition and understanding of what lower back pain is. Lower back pain refers to pain experienced in the area between the bottom of the ribs and the buttocks. It can feel different from person to person, and it may be really local to this area, or it can refer to your leg, within the anterior portion (femoral) or the posterior portion (sciatica). Other than what you may experience: A dull ache or soreness Sharp or sudden pain Stiffness Muscle spasm Pain when bending or twisting Discomfort when standing up after sitting Pain during lifting or exercise Occasionally, someone may experience symptoms associated with nerve irritation, such as pain, tingling or numbness travelling down the leg. All of this said, when talking about what lower back pain is, we have to touch base on the meaning of “non-specific back pain”, which means there is no single identifiable structure that can be confirmed as the cause of the pain. In fact, this is very common and, and that’s what we briefly talked about earlier. Pain can, yes, be associated with physical damage or a physical impairment, but it is not always the case. So, education and understanding of what pain is and how it comes to be is a really important step to take when suffering from chronic pain conditions. What can cause lower back pain? As a clinical myotherapist here in Coburg, I often have to explain to my client who suffer from lower back pain that it is not as simple to find the reason for their lower back pain. Indeed, your lower back works as part of a larger movement system (mobility and stability joint chain) involving the hips, pelvis, abdominal muscles, legs and upper body. How these areas move and how much load they are exposed to can influence how your back feels. Therefore, we may want to look at some common factors associated with lower back pain, which include: Sudden increases in physical activity As someone who loves to do and promote physical activity, I also warn my clients to be aware when starting their moving journey, step by step. Indeed, a common situation that can cause lower back pain is doing more than your body is currently prepared for. Here are some common case scenarios on how this can happen: Start a new gym program Increase your running distance Return to exercise after a long break Lift something unusually heavy Spend a weekend doing physical work Increase your training volume too quickly A sudden increase in load can temporarily make the lower back more sensitive. Prolonged sitting The reason why so many people nowadays may suffer from aches and pain, including lower back pain, can definitely be attributed to a sedentary lifestyle. Indeed, long periods of sitting, particularly when combined with little physical activity throughout the day, can contribute to stiffness and discomfort. This is because not using the body for what it was designed for in the first place leads to a loss of function. The typical “use it or lose it” situation. But let’s be clear, we are not saying that sitting does damage to your back. But what we are saying is that if you do a job that involves long hours sitting or standing at a desk, you should take regular breaks from that position and do a bit of movement that can maintain your body functionality throughout the day. Taking regular movement breaks and changing position throughout the day can also be helpful to keep your brain active and more productive, due to more blood flowing through the full system, including the central nervous system (Brain). Reduced physical activity Again, as with the whole body, even your back is designed to move. When you become less active because of pain, fear of movement or a busy lifestyle, you may gradually lose confidence and capacity with certain movements. This can create a cycle where movement becomes uncomfortable, so you move less, which makes returning to normal activity more difficult. What we need, indeed, is an equilibrium between movement, load and rest. Lifting and repetitive movements As already mentioned in the blogs that talk about tendinopathy, repetitive movement, which in the case of lower back pain can be bending, twisting, lifting and/or carrying, can place significant demands on the tendons and tissues around the lower back. And again, let’s stay firm on the fact that any of those movement are absolutely safe to do, as long as the load applied to it is gradually introduced and increased, and not suddenly placed there. Because that’s the typical case of the seasonal Coburg gardener: when the spring season kicks in, they start working hard and harder in the garden without proper training or warm-up, ending up with lower back pain. Strength and conditioning Strength is one part of the bigger picture. Your ability to tolerate lifting, running, bending, carrying and other activities depends […]
Aug
If you have been living in Coburg and the surrounding area, like the Merri Bek or Darebin councils, you probably notice how Coburg is a suburb full of movement. From people cycling along Merri Creek, walking around Coburg Lake, training at local gyms, playing community sports, or simply trying to stay active despite busy work and family commitments, movement is a big part of everyday life in Melbourne’s northern suburbs. As a Myotherapist based in Coburg, I see many different people who share one common goal: They want to move better, feel better, and get back to doing the activities they enjoy. And this can be due to recovering from an injury, managing ongoing pain, or improving physical performance. That’s where Myotherapy can play an important role in supporting your body and wellbeing. Why Active People Often Experience Injuries One of my mottos here at Melbourne Massage and Treatment Myotherapy and Lymphoedema Clinic in Coburg is: “Move More, Live Well”. But being an active person doesn’t mean you are never going to be in pain or experience some discomfort. Indeed, pain is a complex neurological response, and movement, in some way, is what is needed to alleviate the pain or change this neurological response. On the other hand, if your level of activity is not constant but sporadic- so after a long period of no load, you increase the load suddenly- that’s where the injuries happen. And here are some common presentations I see in my Coburg clinic that are related to overloaded movement: Calf strains and tightness Achilles tendon pain Hamstring injuries Shoulder and neck pain Lower back discomfort Hip and knee issues Overuse injuries from repetitive activities These problems can affect anyone. It could be someone preparing for a running event, a cyclist spending hours on the bike, someone returning to exercise after a break, or simply someone who spends most of their day sitting at a desk. Myotherapy Is More Than Just Massage One common misconception is that Myotherapy is simply a stronger form of massage. Well, let me tell you, it is not. Indeed, hands-on treatment is part of a Myotherapy treatment, and it is an essential component of creating trust between me, the therapist, and you, the patient, but what really is going to fix your pain, or reduce it the most, is movement under the right load. And that’s what really Myotherapy is. Massage, load, and Education about your wellbeing. My approach combines: Clinical assessment Hands-on treatment Movement analysis Exercise advice Education about your condition In fact, our goal is not just to temporarily reduce symptoms, but to understand why a problem may have developed and what we can do to improve your long-term movement. And of course, every person is different, which is why I don’t believe in using the same treatment approach for everyone. Helping Coburg Residents Stay Active If there is something that really attracted me to come back to Coburg to run my clinic, it is the variety of people I get to meet. Some clients come to me because they are dealing with an injury that is stopping them from doing what they love. Others come because they want to improve their mobility, strength, or recovery. For example: A runner may need help managing recurring calf tightness. A cyclist may need support with hip mobility and lower back discomfort. A gym enthusiast may need assistance returning safely after an injury. Someone working at a desk may need help with neck, shoulder, and posture-related discomfort. The treatment approach may be different for each person, but the goal remains the same: helping you move with confidence again. Recovery Requires More Than Rest Along with the educational protocol I put in place in my clinic here in Coburg, I explain to my clients when rest is needed and for how long it is needed. I dedicate a full blog to the inflammatory response. And understanding this concept allows you to regain confidence in your movement as early as possible. Because resting for too long may cause you to lose muscle mass and confidence in movement. Therefore, depending on your presentation, this may include: Improving mobility Building strength Gradually increasing load Learning better movement strategies Again, the body adapts to the demands we place on it. The challenge is finding the right progression, not just resting for too long or rushing to load more quickly. This is where Myotherapy, exercise prescription, and education can work together. Supporting the Coburg Community and Surrounding Suburbs Moving forward from what Myotherapy is and how it really works, being located in Coburg allows me to support clients not only from Coburg itself, but also from surrounding Melbourne northern suburbs including: Brunswick Pascoe Vale Preston Reservoir Fawkner Thornbury Essendon The clinic at 325A Moreland Road is easy to reach by car and public transport. Indeed, you have plenty of car parking along Haig Avenue next to the clinic or Moreland Road (with some parking limitations in terms of time) or a bus stop (BUS 510) which stops right in front of the clinic, or a walking-distance tram (6, 19, 58) and train stop (Moreland Station, Upfield Line). These options make it convenient for people looking for Myotherapy, Remedial Massage, Manual Lymphatic Drainage, and lymphoedema care in Melbourne’s north. My Approach: Move More, Live Well Why I started looking into Myotherapy as a form of treatment is because teh movement is a key component of this type of therapy. Indeed, Move More, Live Well, do really match the essence of this form of therapy. I don’t believe that someone has special powers or magical hands that can fix your pain. I do believe that the right therapist can have the right clinical reasoning to help you overcome your pain and show you the right movement underload that can help you overcome your pain, but also help you understand your body, improve your movement, and give you the tools to stay active. Again, whether you are recovering from an […]
Aug
If you live in Coburg or the surrounding area, you’ve probably come across both Myotherapy and Remedial Massage. Have you ever wondered what the difference is? While those treatment modalities share some techniques, they have different goals. Therefore, choosing the right treatment depends on whether you’re dealing with pain, recovering from an injury, improving your movement, or simply looking to relax. At Melbourne Massage and Treatment in Coburg, I do offer both services and understanding the difference can help you get the most appropriate care for your needs. Quick Look at Remedial Massage and Myotherapy Differences Myotherapy Remedial Massage Pain & injuries Relaxation & recovery Assessment Massage Exercise prescription No rehabilitation program Long-term function Short-term muscle relief Acute & chronic conditions General muscle tightness Healthcare treatment Therapeutic massage What is Remedial Massage? Remedial Massage focuses on relieving muscle tension, improving circulation, and promoting relaxation. Although it can help reduce muscle soreness and stiffness, the primary aim is to help your body recover from everyday stress or physical activity rather than managing complex injuries. Remedial Massage is an excellent choice if you want to: Relax tight muscles Recover after exercise or sporting events Prepare muscles before competition Reduce general muscular tension Improve flexibility Support overall wellbeing Many active people also include regular Remedial Massage as part of their maintenance routine to help manage training loads. What is Myotherapy? Myotherapy is a treatment modality, evidence-based, offered by a healthcare professional who focuses on: Assessing, Treating, Managing musculoskeletal pain and movement dysfunction. As a Clinical Myotherapist in Melbourne, I also tend to specify that Myotherapy as per TAFE education and a Bachelor of Health Science is different. Goes without saying that someone who trained in a bachelor setting has better knowledge and clinical reasoning than someone who trained at TAFE level. Back to what Myotherapy is about, it is not only treating sore muscles, but it aims to identify why your pain or injury has developed. Then, treatment often includes a combination of hands-on techniques movement assessment exercise prescription education to help improve long-term outcomes. Myotherapy is suitable for people experiencing: Acute injuries Chronic pain Sporting injuries Neck and back pain Headaches related to muscle tension Tendinopathies Shoulder, hip, or knee pain Reduced mobility Muscle weakness following injury Indeed, the goal isn’t simply to reduce pain today, but the goals are: Short term: reduce the pain and possibly improve range of motion Long term: become stronger, and reduce the likelihood of the problem returning. The Main Difference The biggest difference between Remedial Massage and Myotherapy is the treatment goal. Remedial Massage essentially focuses on relieving muscle tightness and promoting recovery and relaxation through massage techniques. This is possible because while we massage a body part, we stimulate the nervous system and other body systems, which react with biological responses such as mild inflammation and relaxation. Myotherapy, on the other hand, focuses on understanding the cause of pain or movement limitations and creating a treatment plan that may include exercise, rehabilitation, and education alongside hands-on treatment. Therefore, if your goal is to overcome an injury, improve movement, or build strength, Myotherapy is generally the better option. If your goal is to unwind, recover after exercise, or enjoy a therapeutic massage, Remedial Massage may be exactly what you’re looking for. Now, Myotherapy May Be the Better Choice If You Have: Ongoing neck or back pain A recent sporting injury Tendon pain Joint stiffness Recurring muscle strains Pain affecting work or daily activities Weakness after an injury Goals of returning to sport or exercise safely Where treatment during a Myotherapy session may include: Soft tissue therapy Joint mobilisation Dry needling Trigger point therapy Exercise prescription Strength and rehabilitation programs Movement assessment Education about your condition So, to conclude about what Myotherapy is about, Myotherapy is to improve function, not just reduce symptoms. Remedial Massage May Be the Better Choice If You Want To: Relax after a busy week Reduce muscle soreness after training Prepare for a sporting event Recover following a marathon or competition Reduce general muscular tightness Enjoy regular maintenance treatments Therefore, when we look at Remedial Massage, we are looking at a treatment modality that helps your muscles feel looser and more comfortable while supporting recovery from physical activity. Can You Have Both? Of course you can. As mentioned earlier, while we do deliver a Myotherapy session, we will still use hands-on treatment, the same treatment option that we would use for Remedial Massage. And indeed, many of my clients here at Melbourne Massage and Treatment use both services throughout the year. For example: You may see a Myotherapist while recovering from a shoulder injury. Once you’re pain-free, you may continue with regular Remedial Massage to help maintain muscle health and recover from training. The two treatments complement each other well depending on your goals. Which Treatment Does Giovanni Recommend? At Melbourne Massage and Treatment in Coburg, I recommend treatment based on your goal, not only on my opinion. If you’re experiencing persistent pain, recurring injuries, reduced strength, or difficulty moving, Myotherapy is usually the most appropriate starting point. If you’re feeling generally tight after work, training, or simply want to help your body recover and relax, Remedial Massage is often the better choice. And if you are unsure which service is right for you, please do not hesitate to ask Giovanni what would work best for you. During your initial consultation, we’ll discuss your symptoms, assess your movement, and recommend the treatment that best suits your needs. My goal, as an Allied Health practitioner, is to help my clients move more and live well. And this can start with a massage, and move on too exercises and fitness class. Myotherapy vs Remedial Massage Coburg Cost and Prices Cost and prices of Myotherapy or Remedial Massage at Melbourne Massage and Treatment, for simplification, are the same. Find below a table with the prices: Myotherapy vs Remedial Massage Coburg – Price Initial consultation – 60 mins – $125 Return consultation – 45 mins – $115 […]
Jul
There is no worse way to start the day than with a wry neck. Wry neck is a common term used to describe a painful neck that limits the way you can move. Medically speaking, we call the same presentation acute torticollis. At my Myotherapy clinic in Coburg, Melbourne Massage and Treatment, I get to hear clients often telling me: “This has happened on and off for years.” And this is the first piece of the clinical history that tells me we’re probably not dealing with a simple muscle spasm, and that’s where we start looking for why the neck keeps becoming irritated in the first place. Wry Neck Is Often Acute on Chronic The first misconception we need to clear away is that wry neck comes out of nowhere. The reality of the fact is that many people have developed underlying dysfunction over months or years. Therefore, the neck has been compensating until one day something relatively small, sleeping awkwardly, reaching for something, reversing the car or even sneezing, is enough to trigger the painful episode. The acute pain is simply the last straw that broke the camel’s back. So the million-dollar question is: Why did your neck become vulnerable in the first place? That’s where an initial consultation is important, and that’s why I spend my time investigating during an assessment. A Previous Whiplash Injury Could Still Be Affecting You A common overlooked cause for wry neck that I get to see here at my clinic is a previous whiplash injury. Indeed, while someone may recover fine from this type of incident, others develop subtle changes in how their neck moves and how the muscles coordinate movement. So yes, it can be either a physical strain or irritation of the ligaments, or even neurodegeneration at the muscle level. That’s why, even years later, the body may continue protecting certain joints while overloading others. Research by Woodhouse and Vasseljen (2008) has shown that people with chronic whiplash often demonstrate altered cervical motor control, reduced movement quality and persistent dysfunction long after the original injury. That’s why, if you’ve ever had a rear-end collision, even if it happened ten years ago, even if it was due to a contact sport injury, it’s worth mentioning during your assessment, as it is an important piece of information. Hypermobility Can Also Play a Role Another presentation that I come across in my clinic, for people who suffer from wry neck, is hypermobility. Indeed, being flexible isn’t always an advantage. This is because if some joints move excessively, your muscles have to work much harder to provide stability. Over time, these muscles become overworked and fatigued, especially around the neck and upper back, which is an area where muscles already work hard most of the time, as they have to ensure we can stay straight while we stand or sit. When stability can’t keep up with mobility, the body often responds by developing muscle guarding. That’s when the neck suddenly “locks.” On the other hand, the lack of stability also creates an overload of joints, which may get easily irritated, and then initiate the pain response. Your Neck Doesn’t Work Alone Another important thing to be aware of is that we should stop focusing only on where the pain is, as the source of the problem. In fact, the cervical spine is part of a much larger movement system. So, poor movement through the upper back, reduced thoracic mobility, rib restrictions, shoulder dysfunction or altered control through the lower spine can all change the workload placed on the neck. And this is a long time game, not something that happen in one night of bad sleep. A way to conceptualise this is: If one link in a chain doesn’t move well, another link has to move more than it should, and eventually that overloaded area becomes painful. That’s why my assessment as a myotherapist doesn’t stop at your neck. I look at how your entire spine works together. The goal is to improve the balance between mobility, where mobility is needed, and stability, where stability is required. And this can only be done and maintained via exercises. Can a Better Pillow Fix a Wry Neck? I did already dedicate a full blog post about the pillow topic, but it is worth it to touch base about it even here, as this is probably one of the most common questions I get when talking about wry neck. A supportive pillow can certainly help reduce stress on your neck while you sleep; however, a pillow doesn’t: Change how your joints move. Improve muscular control. Restore stability. Correct movement patterns that have developed over the years. Therefore, think of a good pillow as something that is improving the environment rather than fixing the cause. If the underlying issue is poor movement control or spinal dysfunction, changing pillows alone usually won’t stop the episodes from returning, and it can end up being an expensive search. Your Workstation Might Be Causing the Problem Another issue that I get to see mostly with office workers is for those who work with multiple screens, like two or even three computer screens. This setup becomes a problem when the main screen isn’t positioned directly in front of you, and you end up spending eight or more hours each day with your head slightly rotated toward one side or the other. Now, try to think about what that means for your joints and muscles on that side. Until you repeat that position every day for months or years. The muscles on one side of the neck become overloaded because they are constantly contracted, while the muscles on the other side are constantly stretched. One of the simplest changes you can make is ensuring your primary monitor sits directly in front of your body, or if that’s not an option, then make sure to swap your screen software-wise. So you end up having even days looking at right, and uneven days, looking to the […]