Category Archives: Blog

Chronic Venous Insufficiency and Swollen Legs: Compression Is The Way To Go

Chronic Venus Insufficiency on swollen leg

In Australia, Chronic Venous Insufficiency (CVI) affect more women than men, with a ratio of 25%–40% in women and 10%–20% in men (Al Shammeri et al., 2014). As a consequence of this condition, swollen legs are a common concern. CVI occurs when the veins in the legs struggle to return blood efficiently back to the heart, often leading to leg swelling, heaviness, aching, and visible varicose veins. At Melbourne Massage and Treatment in Fitzroy North, since I specialised in Lymphoedema therapy, I regularly support clients experiencing leg swelling related to venous conditions too. Understanding how to manage the condition can significantly improve comfort, mobility and long-term leg health. What Is Chronic Venous Insufficiency? Chronic venous insufficiency is a condition defined as chronic when lasting for more than 3 months. CVI develops when the valves inside the leg veins become weakened or damaged and stop acting as they should, which is why blood finds difficulty in flowing back to the heart. This results in swelling in the lower legs. Common symptoms include: Persistent swelling in the lower legs or ankles Aching, heaviness or fatigue in the legs Skin changes such as dryness or discolouration Varicose veins Tightness or discomfort after prolonged sitting or standing Without appropriate management, CVI can progress and increase the risk of skin complications or infection. The Different Levels of Chronic Venous Insufficiency  Find below a table that describes how Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classify chronic venous insufficiency. Stage Description C0 No visible/palpable signs of venous disease C1 Telangiectasias or reticular veins C2 Varicose veins C3 Oedema C4 Skin changes secondary to chronic venous disease (haemosiderin, lipodermatosclerosis, atrophie blanche) C5 Healed ulcer C6 Recurrent active venous ulcer The more advanced the stage, the more likely the hospitalisation of the patient for infections. This is not only a cost to the public health system, but to the Australia popolation too. Compression Therapy: A Key Part of Managing Swollen Legs The most effective way to manage swelling related to Chronic Vein Insufficiency is compression therapy. Compression garments are helpful as they apply controlled pressure to the legs, which supports the veins and encourages blood and fluid to move back toward the heart. Unfortunately, there is no quick fix for swollen limbs, and for many people with chronic swelling, compression becomes an essential part of daily management. But, you have to be aware that compression should always be prescribed and fitted appropriately. Indeed, the compression has to have the right gradient pressure, so stronger pressure at the bottom and weaker at the top; otherwise, we risk getting the liquid stuck in the leg and not moving. On the other hand, with certain arterial conditions, compression may not be suitable; therefore, it is important that you talk to your GP about getting a referral to a vein specialist to know what’s the best approach for your swollen legs. When Varicose Veins Are Present If varicose veins are present, low-level compression is often recommended initially. This provides gentle support to the venous system while remaining comfortable for everyday use. The goal is to: Support vein function Reduce fluid build-up Improve comfort during daily activities Help prevent worsening swelling In fact, each individual may require a different compression level depending on their condition and tolerance, but also the integrity of the skin. Compressions indeed are tight to put on, and for those with weak and fragile skin, it can be difficult to maintain skin integrity while wearing compression. Why Flat-Knit Compression Garments Are Often Recommended For clients with persistent swelling or changes in limb shape, flat-knit compression garments are frequently recommended. Flat-knit garments offer several advantages: They provide stronger containment for swelling They can be custom-fitted for better comfort and effectiveness – class 3 and 4 They help prevent fluid from accumulating in specific areas They are often more suitable for long-term management Because every leg shape and swelling pattern is different, proper measurement and fitting are essential. At Melbourne Massage and Treatment, Lymphoedema clinic in Fitzroy North, I provide assessments and measurements for your swollen legs, so that I can provide garments that fit you for your specific presentation. Accessing Compression Garments Through the SWEP Program (Victoria) If you live in Victoria, you may be eligible to access compression garments through the SWEP program (State Wide Equipment Program). SWEP helps eligible residents obtain essential medical equipment, including compression garments used in the management of venous conditions and lymphatic swelling. As a SWEP-registered therapist, I can guide clients through the process, including: Clinical assessment Measurement for appropriate compression garments Assistance with the SWEP application process Ongoing monitoring and adjustments The SWEP is free to access and does provide funding for 4 garments a year, specifically: $150 per garment if off the shelf $300 per garment if made on measurements For Chronic Vein Insufficiency, most often the off-the-shelf garments are the ones to go for. But still, you have to know what class would best work for you, and what size would best work for you. Movement: An Often Overlooked Therapy Movement, as per my favourite medicine, is another important component in managing swollen legs. In fact, blood flow, but even lymph flow, happens better when muscles contract and work. For the legs, the calf muscles act as a natural pump, helping push blood and fluid upward when we walk or move. When we remain seated or standing for long periods, this pump becomes less effective. Simple strategies include: Regular walking Gentle ankle movements during long periods of sitting Light leg exercises Avoiding prolonged immobility when possible Even small amounts of regular movement can make a noticeable difference in managing swelling. Protecting the Skin: A Crucial Step in Preventing Infection People with chronic leg swelling are more vulnerable to skin breakdown and infection, and this is due to a series of reasons, such as: Increased venous pressure damages small blood vessels Reduced oxygen and nutrient delivery to the skin Chronic swelling stretches and weakens the skin Inflammation causes skin changes Keeping the skin […]

It Is Never Too Late To Join A 1:1 Fitness Class

Giovanni doing a mobility/stability test on The Mat for ACL Rehab during a 1:1 Fitness Class

At Melbourne Massage and Treatment in Fitzroy North, as a clinical Myotherapist, I am enthusiastic to offer 1:1 fitness class that aim to improve your wellbeing and body strength. And one thing that I will never stop surprising my clients with is that it is never too late to start working on their strengths, no matter their age, gender, and capacity. Whether you’re recovering from injury, managing persistent pain, navigating age-related changes, or simply want more energy and confidence, personalised fitness is transformative. Why Starting Now A 1:1 Fitness Class Matters? Strength Training Improves Physical Health at Any Age Have you ever heard an older person wishing to be weaker? No, don’t you? That’s why strength and resistance training aren’t just for elite athletes or bodybuilders; they’re essential for everyone. As we age, our body’s natural capacity to regenerate, including regenerating muscle mass and strength, bone density, and other body tissues, naturally declines, which can affect balance, mobility, fall risk, and independence. Resistance training reverses this decline and improves functional outcomes. A systematic review by Kashi K. S. et al. (2023) found that resistance training significantly improved muscle strength, physical function, and reduced symptoms of depression in older adults. Exercise Matters for Mental Health Too Exercises are not only the best way to maintain physical health but also have an immense impact on our mental health. And that is a 1:1 fitness class or a group class, regular exercises can really change how you feel within your head. Infact, we have plenty of evidence from Recent Research that looks into this: A review by Ayaz A. et al. (2026) highlights how aerobic, resistance, and mind-body exercise modalities have psychological benefits, from improved mood to reduced stress and anxiety. Study by Ma Y. and Mumtaz S. (2025) finds that structured exercise programs improve mental well-being by activating neurobiological and psychosocial pathways. Meta-analysis by Rossi E. (2024) showed that strength training has moderate and significant antidepressant effects in adults with depressive symptoms. So yes, your workouts aren’t just changing your body, but they’re changing your brain. Why 1:1 Fitness Classes Are Especially Effective While training is beneficial for everyone, for physical and mental health, personalised training, like a 1:1 fitness class, makes a huge difference, and here’s why: Training Tailored to You Everyone has different goals when starting a fitness journey, or while they are training, and everyone has different needs and capacities, on which the goal is shaped. Therefore, a 1:1 fitness class session allows for customised programming that matches your goals, health history, injury status, and movement patterns, which generic videos or crowded group classes rarely provide. Expert Guidance Prevents Injury At Melbourne Massage and Treatment, I am proud of the studies I done (a Bachelor in health science clinical myotherapy, and following courses like the KLT training) and the effort I put in place to improve my fitness and communication skills, which led me to offer a tailored program for any of my clients. For people with pain, past injuries, or chronic conditions, this is crucial. Motivation and Accountability I often come across clients who don’t feel confident enough in themselves, who don’t like the gym and think that strength training for them is not a thing. And that’s when I can’t stop thinking about how powerful it is to change their mind by showing them how a few minutes of well-done movement, either with or without load, can change everything. That’s when I get them in for Fitness Class here in Fitzroy North, and I help them achieve their goals. Personalised Follow-up On top of a tailored 1:1 fitness class in person, what makes the difference in terms of service here at Melbourne Massage and Treatment, when I show some exercises, I will send you a PDF file with the picture and the description of the exercises, to ensure you will be bale to replicate those exercises anywhere you are ay your own time and comfort. Fitness Class Comes With An Added Bonus — Better Bone and Cardiovascular Health The action of lifting weights and lifting heavy is seen from your body as a positive stress, which creates a concatenation of benefits. Along those we find: Bone regeneration – increase of bone density Maintaining metabolic health Improving markers related to heart disease and diabetes Improve or maintain optimal equilibrium – poor equilibrium is the major cause of falls. And more… All the benefits a fitness class can deliver are crucial as we age. No one, as they age, wishes that their health gets more and more compromised, isn’t it? Start Where You Are — It’s Not About Perfection Whether you’ve never stepped foot in a gym before, you’re returning after an injury, or you’re trying to break a cycle of inactivity, the best time to start was yesterday. The next best time is now. It is never too late to start working on your strength, and this is the most important message I find myself passing on to my clients. The body can always adapt to load. And no matter if you have just started or you are a pro, you will always have to face some challenges. Therefore, start working on your mobility, improve the way your body can move, let’s than load it a little at the time, and build your own journey into wellbeing day by day, fitness class after fitness class. Final Thoughts You don’t need to be “fit enough” to start a 1:1 fitness class, and it’s absolutely never too late. Here’s the truth I’ve seen in across many clients: People in their 40s, 50s, 60s, and beyond see meaningful gains, both physically and mentally. Individualised guidance accelerates progress safely. Strength and structured exercise improve both quality of life and mental well-being. If you’ve been thinking about starting a fitness journey, come and talk to us at Melbourne Massage and Treatment, Fitzroy North. For those who decide to commit to a change, a positive change, for their well-being, there are 5 or […]

MLD vs Lymphatic Massage: A Clinician’s Guide to What Works and Why

What's the difference between MLD and Lymphatic Massage?

If you’re searching for lymphatic therapy in Fitzroy North, it’s common to see terms like Manual Lymphatic Drainage (MLD) and Lymphatic Massage used interchangeably. As a clinical myotherapist with specialised training in lymphoedema management (MLD since Nov 2021; lymphoedema therapy since Oct 2024, trained with the Vodder Academy), I am here to clarify exactly what these treatments are and why one is clinically recommended over the other — especially for conditions like lymphoedema or post-surgical swelling. In fact, the importance of understanding the difference between MLD and Lymphatic Massage is vital when you want results that matter, and not just temporary relaxation. What Is Manual Lymphatic Drainage (Vodder Method)? Manual Lymphatic Drainage (MLD) is a specialised technique developed by Emil and Estrid Vodder in the early 20th century, and it is characterised by gentle, rhythmic hand movements to stimulate the lymphatic system. The reason behind the gentle and light movement is to ensure that during the treatment, we can stretch the skin and let it recoil naturally; therefore, we stimulate the lymphatic system at its full potential. Therefore, MLD is not a “massage” in the spa sense, it’s intentionally structured to follow physiological lymphatic pathways to support lymph flow. Key points about MLD: Trained practitioners follow evidence-based protocols. Movements are light, rhythmic, and intentional, not vigorous. The “Vodder method” is internationally recognised and taught with strict standards. It is often integrated into Complete Decongestive Therapy for lymphoedema. One recent article explains the theoretical physiology and clinical context of MLD in lymphoedema management. Manual lymphatic drainage: the evidence behind the efficacy (PubMed) What Is Lymphatic Massage? “Lymphatic Massage”, on the other hand, is more of a broad term used in wellness settings, like a SPA or massage parlour. The wordling is really similar to Manual Lymphatic Drainage, and is often followed by promises of  “encourage fluid movement” or “before and after photos” but: Technique quality varies widely by practitioner. Some methods use deeper pressure and general strokes. It’s largely relaxation-focused, not always aligned with lymphatic anatomy. It isn’t generally part of evidence-based protocols for clinical conditions. In short, MLD is a clinically structured intervention; lymphatic massage is not. Indeed, who promotes Lymphatic massage as a service, often don’t know the pathway of the lymphatic system, and can’t tell you the difference between a Lymphoedema or a Lipoedema, and it may try to sell the fact that Lymphatic massage would detox your body (I will write a blog soon about this detox topic, as it is one of the biggest scam in the health and beauty industry). Side-by-Side: MLD vs Lymphatic Massage In the table below is a summary and a comparison between MLD and Lymphatic Massage features. Feature Manual Lymphatic Drainage (Vodder) MLD Lymphatic Massage Based on lymphatic anatomy ✔ ✖ Evidence-aligned technique ✔ ✖ Suitable for lymphoedema management ✔ ✖ Commonly used post-surgery ✔ ✖/varies Practised by trained therapists ✔ ✖ (wide variation) Relaxation / general wellness ✔ ✔ Clinical Evidence: What Research Shows About MLD and Lymphatic Massage As with any form of therapy, even in the case of MLD, the clinical research on MLD isn’t perfect, but the PubMed literature supports its role when used correctly within clinical programs. Lymphoedema Management A randomised controlled trial (RCT) reported that women with breast cancer–related lymphoedema experienced significant limb volume reduction and improved symptoms with MLD as part of therapy. A comprehensive systematic review found mixed outcomes but noted MLD’s accepted role in conservative lymphoedema treatment and generally positive effects on swelling and quality of life when integrated with other therapies. Inflammation & Post-Surgery Support MLD is also used, and clinical studies provide evidence in the setting of postoperative swelling and pain with orthopedic and cosmetic surgery. Indeed, post-surgery, the body responds with inflammation and swelling, which passes the acute phase, and the clearance of infections is better when moved to ensure the best recovery. Why MLD Is Clinically Preferred for Lymphoedema When lymphatic transport is impaired, as in lymphoedema or after surgery, the goal is not just temporary fluid “movement,” but supporting lymphatic drainage physiology. Here’s what clinical practice guidelines emphasise: Targeted Stimulation MLD uses gentle but precise hand movements that align with superficial lymphatic pathways and node groups. These are designed to: reduce interstitial fluid accumulation, activate lymphangiomotoricity, and facilitate fluid transport without trauma. This principle comes directly from the Vodder methodology as taught by the Vodder Academy. Part of a Larger Management Strategy Especially in lymphoedema, MLD is one component of a broader therapeutic approach that includes: ✔ compression therapy✔ movement and exercise✔ skin care and infection prevention This integrated strategy has been shown to improve outcomes more than any single therapy on its own. Post-Surgical Considerations As discussed in more depth in another blog, when heading for cosmetic and orthopaedic surgery, the recovery process is caractherised by an acute phase of swelling. That’s just teh body dping its thing. But, as we move away from the acute phase, it is essential to ensure that the oedema is reduced. That’s where MLD and compression therapy are essential. In fact, unlike a typical deep massage: MLD supports lymphatic flow without stressing fragile tissues. Studies show gentler lymphatic stimulation improves swelling and trismus after surgery. That’s why many rehabilitation specialists recommend structured MLD over general “lymphatic massage” in this context. So, What Should You Choose? As per everything, I reckon that your choice has to be aligned with your goal. Therefore: If you need clinical-grade lymphatic support for lymphoedema, post-surgical swelling, or ongoing fluid dysfunction, choose Manual Lymphatic Drainage (Vodder method) delivered by a trained clinician. If you want general relaxation and mild fluid support, a lymphatic massage in a wellness setting might feel nice — but it’s not a clinical substitute for MLD in these conditions. Conclusion From A Clinical Practitioner At Melbourne Massage and Treatment, Fitzroy North, I integrate MLD with evidence-based clinical reasoning, and not just as a “feel-good massage.” My approach is rooted in training with the Vodder Academy and ongoing lymphoedema therapy practice. If you’re concerned […]

Shoulder Pain Isn’t Just a Shoulder Problem

A man holding is shoulder do to shoulder pain

Shoulder pain is one of those presentations that can stop you from enjoying your day. Rolling in bed becomes difficult; carrying shopping or even sitting there and doing nothing can be frustrating. At Melbourne Massage and Treatment, I got to see many clients who complained of shoulder pain for a variety of reasons. Although one thing that is common with those different types of pain is the imbalance in the mobility stability joint chain, especially in people who do physical labour, repetitive overhead work, or intense gym training. Therefore, while many people expect me to focus only on the sore spot in the shoulder, my myotherapy approach is always broader and more thorough. Yes, I treat the shoulder as the primary concern, but effective, long-term relief comes from understanding why your shoulder is overloaded in the first place. That means looking beyond the glenohumeral joint and assessing thoracic mobility, scapular control, and thoraco-scapular stability, which are key components that are often overlooked but critical for shoulder health and to help you fix the shoulder pain. Why Shoulder Pain Often Persists The Shoulder is a joint characterised by a great amount of mobility and not much stability, which puts it at high risk of injury and so pain. When your shoulder hurts, it’s rarely because the shoulder itself is “weak” or “damaged” in isolation. Indeed, to arrive to the pain response, either you had a severe trauma, like a fall on the shoulder or more commonly, the shoulder is compensating for: Poor thoracic spine mobility Weak or poorly coordinated scapular stabilisers Faulty movement patterns under load Repetitive strain from work or training And let’s be clear, we are all different, so two individuals who do the exact same job or sport may end up having different pain and presentation due to basic anatomical differences in the shoulder. That said, here are some common presentations that can lead to shoulder pain: If the thoracic spine doesn’t move well, the shoulder is forced to work harder. If the scapula doesn’t stabilise properly, the ac joint gets overloaded Genetically, the space between bonds (Humerus and Acromioclavicle joint) is narrower than the norm My Clinical Assessment Process For Shoulder Pain When you come to my Myotherapy Clinic in Fitzroy North for shoulder pain, I don’t just ask where it hurts, but I would assess: Thoracic spine mobility (especially rotation and extension) Cervical movement in active and passive motion Scapular positioning and control Shoulder range of motion under load Training or work-related movement demands Previous injuries or recurring pain patterns This is particularly important if you: Work in trades or manual labour Train heavily in the gym or sport Perform repetitive overhead movements Have had recurring or long-term shoulder pain A tailored assessment, such as the above one, allows me to not only pinpoint why the shoulder is in pain and what further investigation may be needed to confirm the findings but also address these factors, allowing us to understand the underlying drivers of your pain. The Role of Thoracic Mobility in Shoulder Pain The thoracic spine (mid-back) plays a massive role in how your shoulder functions. This is because the thoracic section of the spine is the mobile portion that anticipates the stable scapula-thoracic joint in the mobility, stability chain. Limited thoracic mobility can lead to: Reduced the overhead range Increased strain on the rotator cuff Poor scapular mechanics Neck and shoulder tension As part of the myotherapy treatment protocol for shoulder pain, I often combine manual therapy, joint mobilisation, and movement-based rehab to restore thoracic movement.When the thoracic spine moves better, the shoulder doesn’t have to overwork, pain reduces, and then we can increase the strength by increasing the load. A classic example of the thoracic shoulder relation is a cricket player. The thoracic rotation along the throwing action is essential to optimise the force imprinted during the throwing action. In fact, imagine the thrower in a cricket game, using only the shoulder, and not rotating that thoracic joint chain. The shoulder load would be excessive, and in a short time, it would cause overload injury and so shoulder pain. Scapular Stability: The Missing Link Your scapula (shoulder blade) is the foundation for shoulder movement. Indeed, the scapula-thoracic joint is the stable joint between the thoracic and the glenohumeral mobile joints. But not only that, indeed, the scapula is the origin point of the rotator cuff muscles, a group of muscles that control the positioning of your humeral head in the glenoid fossa. If it lacks stability or control: The shoulder joint becomes vulnerable Tendons are placed under excessive stress Pain persists despite “strengthening” exercises As a Clinical Myotherapist, I focus on improving thoraco-scapular stability, ensuring the shoulder blade moves smoothly and supports the arm during load, lifting, and rotation. This is especially crucial for people involved in: Weightlifting Cross-training Construction or trade work Sports requiring throwing or overhead movement To strengthen the stability of the scapula, we then have to work on the rhomboid muscles and the trapezius (upper, mid, and lower), but even the levator scapulae. So yes, it is not a quick fix to restore shoulder functionality and remove shoulder pain, but there is a step-by-step journey that can be taken, and it is your choice to start walking along this path. I am here only to help you understand what the right path is for your presentation and ensure we take the right route. Hypermobility and Shoulder Pain One often overlooked factor in shoulder pain is hypermobility. Hypermobility means your joints move more than the norms which isn’t always a bad thing, but it significantly increases injury risk when stability is lacking, particularly in the shoulder. For hypermobile individuals: Ligaments provide less passive support Muscles must work harder to stabilise joints Poor scapular stability leads to shoulder overload When hypermobility exists alongside poor thoraco-scapular stability, shoulder pain becomes far more likely. In these cases, treatment isn’t about increasing flexibility; instead would be the opposite: Improving neuromuscular control Enhancing scapular […]

Glutes strengthening – Time To Exercises

Giovanni performing GLutes Strengheting exercises with KLT

Here in Fitzroy North, at my Myotherapy Clinic and 1:1 fitness class studio, I get to work with a wide range of clients, and what I notice is that there is a lack of knowledge and awareness on how to deliver a Glutes Strengthening. And why I believe that a squat is important is simply because squatting is an action that we do so often throughout the day that we all should be good at it, and it is the best functional movement that allows you to reinforce the full body structure. Therefore, when I come across those presentations, I ensure to educate my patients about the basic mechanics of a squat, including mobility, stability, and glutes strengthing. Are You Looking Into Glutes Strengthening? Let’s Check Your Joint Mobility and Stability First In order to deliver effective training for your glutes, including delivering an efficient squat, you will look at: Adequate ankle mobility A well-coordinated hip hinge Stability in fee tarsals and knee joints Those are regular things I would look at during a myotherapy treatment and 1:1 fitness class in Fitzroy North, to improve glute activation, movement efficiency, and injury resilience. Ankle Mobility Exercise to Improve Squat Depth and Lower Limb Mechanics As discussed in greater depth in the mobility and stability blog, before we start looking at strength and start working on functional movement, like the squat, we want to ensure that the mobile joints are mobile enough to deliver the right mechanics. In fact, limited ankle mobility often results in compensatory strategies such as: Excessive forward trunk lean during squats Early heel lift Increased stress on the knees or lumbar spine Clinical Importance of Ankle Mobility Adequate ankle dorsiflexion allows improved tibial progression during squatting movements, enabling more effective hip and glute loading. Exercise: Knee-to-Wall Ankle Dorsiflexion Drill Position the foot flat on the ground, facing a wall Aim for a 10 cm distance between the big toes and the wall Maintain heel contact with the floor Drive the knee forward toward the wall under control Perform slow, controlled repetitions Your aim is to teach the wall with the kneem, with a big toe-wall distance of min. 10 to 12 cm Clinical application:This exercise is commonly prescribed in myotherapy sessions to improve squat mechanics, reduce compensatory loading, and support long-term joint health. Hip Hinge Drill for Posterior Chain Activation and Spinal Control The hip hinge is a fundamental movement pattern required for safe and effective loading of the gluteal muscles, but not only that, indeed, poor hip hinge mechanics often present as excessive lumbar flexion or extension during deadlift-based movements. Why Hip Hinge Mechanics Matter Efficient hip hinging can help with: Increases glute and hamstring activation Reduces lumbar spine strain Improves RDL and deadlift performance Exercise: Wall-Assisted Hip Hinge Drill Stand approximately 20–30 cm from a wall Push the hips posteriorly to make contact with the wall Maintain a neutral spine and rib position Return to standing using glute contraction (squeeze those glutes) Clinical focus:This drill is a key component of both rehabilitation and performance-based programming at Melbourne Massage and Treatment. It is also a fundamental movement pattern taught in my glute-focused fitness classes, ensuring clients build strength safely and efficiently. Stability Starts From Your Feet Foot stability is a crucial part of delivering a good squat, especially during a low-bar squat, when feet are flat on the ground. Imagine your feet unable to give a stable direction to whatever is above, like the ankle, knee and hip. This would lead to knee shaking during squatting, and once the squat load increases, the risk of injury rises. So for foot stability, we look at: Even weight distribution of your load along the plantar of the feet, not only on your toes or on the heel. All toes, grabbing the floor, throughout the squat performance Lower-bar squat, feet flat on the floor (be barefoot or use gambaletto type of shoes) and feet wider than hip, stand in slight external rotation High-bar squat, feet open wide as hip stand (so a narrow stand) and heel well elevated. In both my clinical work and my strength-based fitness classes, foot stability is always assessed first. On the other hand, more about the high and low bar squat is available from this blog. Squats for Functional Glutes Strengthening In my glute-strengthening fitness class sessions, the squat is one of the primary movements we refine. Keep in mind that when we talk about squat for glut strength, we always refer to the lower-bar squat. Therefore, when performed with appropriate technique, this exercise is the most effective exercise for developing functional glutes strenghtening and improving lower-limb coordination. Below, you will find the most common Clinical Faults in Squatting Limited ankle mobility restricting depth Poor hip control resulting in lumbar compensation Reduced gluteus contribution due to motor control deficits So this is what you need to focus on to for a Optimal Glute Engagement while squatting: Maintain even foot pressure throughout the movement Maintain spinal alignment and controlled descent Drive upward through the heels and mid-foot Clinical note:Squat depth should be dictated by movement quality rather than arbitrary range targets. Romanian Deadlifts (RDLs) Another Glutes strengthening Exercise The Romanian deadlift, in comparison to the conventional deadlift, is a partial movement, where the load never touch the ground throughout the exercise (once it gets picked off the ground). This type of lift is ideal for exercising the posterior chain, particularly in the gluteal and hamstring musculature. Benefits of RDLs in Myotherapy and Strength Training Enhances glute and hamstring load tolerance Improves hip-dominant movement capacity Reduces injury risk through controlled eccentric loading RDL Execution Guidelines Maintain close bar or weight proximity to the body Initiate movement via hip hinge, not knee flexion Maintain spinal neutrality throughout the range Terminate the movement when pelvic control is lost Clinical relevance:RDLs are regularly integrated into rehabilitation and strength programs for clients with lower back pain or who are returning to lifting after injury. But are also ideal to build […]

Calf Injury Melbourne – How Can Myotherapy Help With Rehab?

A picture of the calf injury

Calf injuries, such as a muscle tear, can be annoying to deal with because they can affect how we move and walk. This type of injury is common in runners, but can affect any person who may take part in a hit-class or go off for an occasional run, without proper athletic preparation. As a Myotherapist in Fitzroy North, my approach to calf injury rehab combines: Hands-on myotherapy Load management strategies Progressive exercise rehab Fitness-based rehabilitation classes What is a calf muscle tear? To start with, we need to understand which muscles make up the calf and which are most likely to tear. Calf muscles include: Gastrocnemius (medial head) Gastrocnemius (lateral head) Soleus Plantaris Tibialis posterior Flexor hallucis longus Flexor digitorum longus Fibularis (peroneus) longus Fibularis (peroneus) brevis Fibularis (peroneus) tertius The gastrocnemius (medial and lateral head) and soleus muscles are indeed the muscles that are most likely to tear, given the high load of work they do for ankle plantarflexion. These injuries commonly happen during: Sprinting or sudden acceleration Jumping or rapid change of direction Fatigue, poor load management, or inadequate warm-up Common symptoms include: Sudden sharp pain in the calf Tightness or cramping sensation Swelling or bruising Reduced push-off strength when walking or running When we look into the recovery approach, regardless of the injury severity, calf tears respond best to active rehabilitation rather than prolonged rest. How Myotherapy Can Help With Calf Muscle Tear? Myotherapy is a hands-on approach to musculoskeletal injury, and we not only look at massage as a form of treatment but also actively show you how to load your injured calf to rebuild the resiliency and strength needed to recover and prevent further injury. In summary, myotherapy can help by: Reducing excessive muscle tone via massage and or dry needling Improving circulation Supporting movement efficiency Addressing compensations in the ankle, knee, and hip Create a step-by-step exercise guide for your rehab protocol In fact, rehab isn’t just about pain relief; it’s about building capacity for better performance in everyday life. Calf Injury Rehab: A Step-by-Step Approach Calf injury, as mentioned earlier, is really common in active and not active patients, and therefore it is important to look at the clinical history of the patient, including the load those muscles go through in everyday life, the mechanism of injury, the mobility capacity and what the patient expects from the recovery process too. Indeed, at Melbourne Massage and treatment, I focus on: Individual assessment Pain-guided progression Gradual return to sport, work, or training If you’re searching for calf injury treatment in Melbourne, structured rehab with a myotherapist makes a real difference. Acute Calf Injury Management: PEACE & LOVE Acute or early-stage calf injury rehab follows the PEACE & LOVE framework rather than outdated RICE protocols. PEACE – First 1–3 Days After Injury Protect – Avoid excessive loading that may worsen the tear. Elevate – Elevation assists in swelling reduction. Avoid Anti-Inflammatories – Inflammation plays a key role in tissue healing. Compress – Light compression may help manage swelling. Educate – Understanding recovery timelines improves outcomes. LOVE – Subacute Phase and Beyond Load – Gradual loading improves tissue strength and tolerance. Optimism – Positive expectations support recovery. Vascularisation – Gentle pain-free movement improves circulation. Exercise – Progressive rehab restores function and confidence. In the acute phase, which lasts about 72 hours, we call it the inflammatory phase, and pain, redness, and swelling are expected Rest is recommended to let the body kick in its own healing capacity. Phase 1 Rehab: Isometric Calf Exercises As in most musculoskeletal injuries, once pain settles, even in the case of a calf injury, the first step to take in the rehab process is isometric exercises. Isometrics involve muscle contraction without repetitive movement, making them ideal for early healing. Benefits of isometric calf loading: Maintains strength Reduces pain Minimises stress on healing fibres Common examples: Standing calf press into the floor – works well for both the gastrocnemius and soleus muscles Seated calf holds – focus onthe  soleus muscles Wall-supported calf contractions – if equilibrium is an issue Pain should remain low and settle quickly after exercise. A formula that I use with my patient is: pain post exercises = worst pain from injury / 2 So if your worst pain given by the calf injury was 8/10, post-isometric exercises, we are happy if you get a 4/10, but no more. And as long as it takes few minutes to 24 to settle, it’s fine. We will touch base on “why?” at the end of this blog. Phase 2 Rehab: Concentric and Eccentric Strengthening Week 1 to week 2 have passed since the injury, and it’s time to start loading the calf muscles with dynamic strengthening. The second phase is the longest one, and it may last somewhere between 4 and 5 weeks. Concentric loading The muscle shortens while producing force – Rising up during a calf raise Eccentric loading The muscle lengthens under load – Slow controlled lowering from a calf raise This phase restores: Calf strength Tendon resilience Capacity for walking, running, and work demands Isometric training allows the muscle fibres start the healing process, start closing the gap post calf tear, and therefore, now, with the strength training, we aim at improving the calf muscle function and injury resilience. This phase focuses as a priority on calf muscles, via calf raises, with a series of progressions: From double leg to single leg From feet flat on the ground to standing on a platform with a heel, with free fall From body weight only to increase the load From low reps to higher reps On top of those progressions for specific calf exercises, we will include other types of exercises, which focus on: Ankle mobility Quads and hamstring exercises to improve knee stability Glute exercises per equilibrium and power That said, at my Fitzroy North clinic, I ensure to pass on this information to my clients, teaching them the importance of tailored load, tempo, and volume to their […]

SWEP Program for Lymphoedema: What My Patients Need to Know

SWEP Logo

In Victoria, Lymphoedema patients are entitled to access the SWEP program (State Wide Equipment Program), a government-funded program that provides funding for garment wear on an annual basis. As a Myotherapist and Lymphoedema therapist working in Fitzroy North, I can help you overcome the bureaucracy and understand how to access the SWEP incentives and where to go and purchase the garments. What Is the SWEP Program? The SWEP or State-Wide Equipment Program is a Victorian government-funded scheme that provides subsidised or fully funded medical equipment to eligible individuals living with permanent or long-term conditions, and Lymphoedema is one of these conditions. For those who live with a chronic condition like lymphoedema, the SWEP can significantly reduce the financial burden of compression garments, which are an essential, not optional, part of lymphoedema management. So yes, SWEP is not a treatment program but an equipment funding pathway. Why Compression Garments Are Essential for Lymphoedema Lymphoedema is a lifelong condition, and unfortunately, in most cases, it is not curable. For managing this presentation, therapies like Manual Lymphatic Drainage (MLD) and Complete Decongestive Therapy (CDT) can help reduce the swelling, and then compression is what maintains results. Without appropriate compression: Swelling returns Tissue becomes heavier and more fibrotic Skin integrity is compromised Infection risk (cellulitis) increases This is why access to properly fitted garments through programs like SWEP is so important. What Lymphoedema Items Can Be Funded Through SWEP? The SWEP may assist with funding for: Compression garments (flat knit or circular knit, based on clinical need) Wrap systems Custom-made garments when off-the-shelf options are unsuitable The funding is based on: Medical necessity Functional impact Long-term condition status Financial eligibility The SWEP does not automatically cover all the costs, as approval depends on correct documentation and assessment, and that’s where I can assist you. Below you will find a section dedicated to the cost covered by SWEP via the Lymphoedema Compression Gargments Program (LCGP). SWEP and Lymphoedema Compression Garment Program (LCGP) In Victoria, patients with lymphoedema can access the Lymphoedema Compression Garment Program (LCGP) via SWEP. Indeed, SWEP and LCGP are 2 separate programs, but it is SWEP that took control of the LCGP in 2017, and this is how it works. LCGP is funded by the Department of Health and provides subsidised compression garments and wrap systems for eligible individuals diagnosed with primary, secondary, or sub-clinical lymphoedema affecting the limbs. What Is Funded Under the LCGP? From the day of submission to the SWEP for the garment wear, you have 12 months to get funding for: Adults 4 sets of compression garments per affected limb, or 3 sets of compression garments and 1 kit of Adjustable Wrap Systems (AWS) per affected limb, or 2 kits of Adjustable Wrap Systems (AWS) per affected limb 1 donner (once off) Children under 18 years of age 6 sets of compression garments per affected limb, or 5 sets of compression garments and 1 kit of Adjustable Wrap Systems (AWS) per affected limb, or 2 kits of Adjustable Wrap Systems (AWS) per affected limb 1 donner (once off) Available Subsidies Those above are the number of garments you get funding for, and each garment is subsidised as follows: Ready to Wear (RTW):$150 per set of garments per affected limb Made to Measure (M2M):$300 per set of garments per affected limb where RTW is not compatible with limb size, shape, or required compression class Adjustable Wrap Systems (AWS) kit:$150 per kit Donner (once off):$60 Who Is Eligible for State Wide Equipment Program? To be eligible for SWEP in Victoria, you must: Are a permanent Victorian resident, hold a temporary or permanent protection visa, or are an asylum seeker Have a long-term condition or disability, and/or are frail aged Do not receive other government funding for compression garments Are not an inpatient of a public or private hospital, or a permanent resident of a residential care facility Cannot claim garments through private health insurance Have not been discharged from a public hospital or extended care centre within the last 30 days, where garments relate to the hospital admission Further assistance with determining your eligibility can be obtained via this link, which directs you to the SWEP website’s Check Eligibility page. My Role in Supporting SWEP Applications At my Lymphoedema clinic in Fitzroy North, I regularly support patients by: Performing comprehensive lymphoedema assessments Identifying the correct compression type and class Providing clinical justification for garments Working alongside GPs and specialists for referrals (my clinic is situated in a GP clinic) Ensuring garments align with the patient’s stage of lymphoedema and lifestyle needs As a lymphedema practitioner, I trained with the Vodder Academy for Lymphoedema Management, so I do understand the importance of precise garment selection, not just eligibility. On the other hand, I am also a member of the Australasian Lymphology Association (ALA), and I stay aligned with current best-practice standards when recommending compression solutions. SWEP Is Not a Substitute for Treatment Another important point that I want to mark again is that SWEP does not replace therapy. What this means is that for the best outcomes, compression garments should be used alongside: Manual Lymphatic Drainage (MLD) Complete Decongestive Therapy (CDT) Skin care Movement and load management Ongoing review and garment reassessment In fact, compression works best after swelling has been optimally reduced, not as a standalone solution. This is because compression, applied to a non-managed Lymphoedema, may result in hard to apply, can crack the skin (which would lead to infections), and it may also be painful. SWEP in Fitzroy North At Melbourne Massage and Treatment, Myotherapy & Lymphoedema clinic in Fitzroy North, I support patients with evidence-based care, practical guidance, and individualised planning, so you can manage lymphoedema with confidence. If you’d like support with SWEP-related compression, assessment, or ongoing lymphoedema management, use the button below to book a FREE 15-minute online consultation (Option 9).  

Lymphoedema Compression Levels: Understanding mmHg in Compression Therapy

lymphoedema compression

Compression therapy is essential for lymphoedema management, and therefore, is worth it write a blog where we are going to talk about what compression is ideal for what lymphoedema presentations, including the mmHg levels. I’m Giovanni, and I run Melbourne Massage and Treatment, a Myotherapy and Lymphoedema clinic in Fitzroy North. I trained with the Vodder Academy in lymphoedema management, and I provide Complete Decongestive Therapy (CDT), which forms the foundation of effective lymphoedema treatment. What Does mmHg Mean in Lymphoedema Compression? As when measuring blood pressure, even when working with Lymphoedema, we use the measuring unit mmHg (millimetres of mercury) when talking about compression. Based on the type of presentation, as lymphoedema therapists, we would recommend different types of compression garments, including flat knit or circular knit. So, here is a short list of the purposes of compression garments: Support the lymphatic system Encourage lymphatic flow Prevent fluid from re-accumulating Maintain the results achieved through CDT Therefore, choosing the correct mmHg compression level is about balancing effectiveness, safety, and comfort, and not only apply some form of pressure on the affected limb. Compression Classes and Lymphoedema Management To simplify how compression garments work, companies like Sigvaris or Juzo grouped the compression into classes or levels, each corresponding to a specific mmHg range. Common Compression Levels Used in Lymphoedema Compression Lower compression levels – 15–20 mmHgOften considered in: Mild lymphoedema Early-stage swelling Fragile or sensitive skin Situations where tolerance is limited Moderate compression levels – 20–30 mmHgCommonly used for: Established lymphoedema Post-intensive CDT Long-term volume maintenance Daily functional support Higher compression levels – 30–40 mmHgUsually required for: Moderate to severe lymphoedema Fibrotic or hardened tissue Significant limb shape changes Swelling that rebounds quickly My personal suggestion is that the correct Compression Level should always be determined following a thorough clinical assessment, in order to avoid fluid retention and waste of money. Why Higher Compression Is Not Always Better Compression level in lymphoedema treatment, as mentioned above, has to be a balance of effectiveness and comfort, and different presentation, with or without fibrosis, mobile or immobile limb, comes with different compression needs. Indeed, applying the wrong type of compression can: Reduce comfort and compliance Increase skin irritation or skin breakdown Compromised lymph circulation Make garments difficult to don and doff In fact, effective Lymphoedema Compression works with the body, not against it, and that’s why for lymphedema presentation compression garments are recommended to be worn after taking specific measurements, that ensure a gradient pressure is applied on the limb, so that the lymph fluid is pushed in the right direction and not towards the extremity of the limb. Compression Levels and Complete Decongestive Therapy (CDT) At Melbourne Massage and Treatment, as part of lymphedema management, I offer MLD as a manual therapy to stimulate the lymphatic system, and CDT (Complete Decongestive Therapy), to reduce the swelling and limb size. More specifically, CDT, can help with: Reduce swelling after the delivery of Manual Lymphatic Drainage (MLD) Improve tissue quality Shape the limb appropriately Prepare the limb for long-term Lymphoedema Compression Help in the breakdown of fibrosis Once the limb has stabilised, compression garments help maintain volume reduction and prevent progression of lymphedema. Professional Assessment Is Essential Certain pharmacies or retail shops (including online one) may sell compression garments, but those are probably not specific enough for a Lymphoedema presentation. Indeed, the appropriate Compression Level depends on: Lymphoedema stage Limb shape and size Tissue texture and fibrosis Skin condition Functional needs and daily activity For compression garments, post MLD and CDT therapies, I refer patients to Sigvaris in West Melbourne, which specialises in medical compression for lymphoedema and ensures accurate fitting and garment selection. Lymphoedema Compression in Fitzroy North Living with lymphoedema can be challenging, and you may find yourself in need of ongoing care and help in navigating information regarding the right compression strategy. At Melbourne Massage and Treatment in Fitzroy North, I provide: Evidence-based CDT Personalised lymphoedema management Clear guidance on Lymphoedema Compressions Collaborative care with trusted compression garment providers So if you’re seeking professional lymphoedema treatment in Melbourne, or want clarity around compression levels and mmHg, I’m here to help. Accessing Compression Garments Through the SWEP Program For some people living with lymphoedema, the cost of Lymphoedema Compression garments can be a barrier to effective long-term management. In Victoria, eligible patients may access support through the State-Wide Equipment Program (SWEP), which provides funding for medically necessary aids, including compression garments for lymphoedema. As a Clinical Myotherapist, I can help you go through the SWEP program in collaboration with your GP. The role of the GP is to write a diagnosis and a referral to the SWEP program, and that’s where I can assist them. After that, you can refer to an approved compression provider, such as Sigvaris in West Melbourne, who can advise on garment selection and fitting. The Swep program for Lymphoedema patients can help with: Reduces the cost of Lymphoedema Compression garments for eligible patients Supports long-term lymphoedema management after Complete Decongestive Therapy (CDT) Ensures clinically appropriate compression through professional assessment FAQ – Lymphoedema Compression Levels

Lymphoedema Compressions: Circular Knit vs Flat Knit

Lymphoedema compression stocking samples

Once you have been diagnosed with lymphoedema (also known as lymphedema), you will soon learn that compression therapy plays a vital role in long-term management of this chronic condition, and one of the most common questions I hear in my clinic is: “What’s the difference between circular knit and flat knit lymphoedema compression garments?” In this blog, I will explain the difference between these two types of lymphoedema compression knit, so that it may help you understand better how your lymphoedema can be managed in the long term. Why Is Lymphoedema Compression Essential? As discussed in many more blogs, lymphoedema is a chronic condition caused by an impaired lymphatic system, which leads to the accumulation of lymph fluid and persistent swelling in one or more body parts. If not correctly managed, lymphoedema can progress and cause: Increased limb size – elephant leg Tissue fibrosis (hardening) Skin changes – including numbness Higher risk of infections – cellulitis is a common one Compression therapy is a cornerstone of CDT (Complete Decongestive Therapy), alongside: Manual Lymphatic Drainage (MLD) – ideal to boost your lymphatic system drainage capacity Skin care is essential to avoid skin cracks and infections Exercise and movement – especially if wearing circular knit compression Long-term compression – So in short, lymphedema compression supports lymphatic flow, helps maintain limb volume reduction, and prevents the worsening of lymphoedema. What Is Circular Knit Lymphoedema Compression? Circular knit compression refers to the method by which garments or bandages are made. In this case, the knit is made using a continuous circular weaving method, creating a seamless and highly elastic fabric. Benefits of circular knit compression: Lightweight and smooth texture Greater elasticity and stretch Often available off-the-shelf More discreet under clothing Circular knits are ideal for those lymphoedema patients who can and should move with the limb affected by lymphoedema. Indeed, the circular knits are designed to allow the lymphedema patient to move; therefore, while the limb is compressed, the lymphatic system is simultaneously boosted by compression and movement. When circular knitting may be suitable: Mild lymphoedema Early-stage lymphedema Limbs with minimal shape distortion Well-controlled swelling However, due to their elasticity, circular knit garments often lack the containment needed for more advanced lymphoedema, especially when fibrosis or limb shape changes are present. What Is Flat Knit Lymphoedema Compression? So, even in the case of Flat-knit compression, the name refers to the way the fabric is produced, like flat fabric and stitched together with a seam. This allows for higher stiffness and customised shaping. Benefits of flat knit compression: Firmer, more supportive structure Superior containment of swelling Custom-made to individual limb measurements Better control of irregular limb shapes Flat knit is usually recommended for: Moderate to severe lymphoedema Long-standing or progressive lymphedema Skin folds or lobes Fibrotic tissue Swelling that rebounds quickly A lymphoedema patient is unable to move much Therefore, based on the severity and lymphoedema stage, we would suggest using flat knit compression for more severe presentations or for someone who is unable to move the limb(s) affected. Compression Garments and Complete Decongestive Therapy (CDT) At Melbourne Massage and Treatment, in Fitzroy North, I offer Complete Decongestive Therapy (CDT) as part of lymphoedema management, which is internationally recognised as the most effective approach to lymphoedema treatment. Here is a list of things that I would offer during a lymphoedema management appointment: Comprehensive lymphedema assessment Manual Lymphatic Drainage Swelling reduction during the intensive phase of CDT Preparing limbs for compression garments Education on long-term self-management To simplify the process of lymphoedema management, at Melbourne Massage and Treatment, I do offer a free 15-minute online consultation, where I can answer your questions and go through an initial assessment about your clinical history. Compression After CDT After we manage to reduce the swelling in the limb(s) affected by lymphoedema, via MLD and CDT, which can take 3 to 5 appointments, or more, depending on your presentation, we can then look into getting garment wear that can fit your limb(s), so that the swelling can be managed for a longer time. While I do not supply compression garments directly, I refer patients to Sigvaris in West Melbourne, specialists in medical compression for lymphoedema, ensuring accurate fitting and high-quality garments. Circular Knit vs Flat Knit: Which Is Right for You? The correct compression garment depends on several factors, including: Stage and severity of lymphoedema Limb shape and tissue texture Presence of fibrosis Skin health Lifestyle and daily activity This is why coming for an appointment and getting your lymphoedema assessed and treated, where needed, is essential before selecting compression. Lymphoedema Treatment in Fitzroy North Living with lymphoedema can be challenging, but with the proper care, education, and treatment plan, it can be effectively managed. At Melbourne Massage and Treatment in Fitzroy North, I focus on: Evidence-based CDT Individualised lymphedema management Clear guidance around compression therapy Collaborative care with trusted garment providers Therefore, if you are in need of professional lymphoedema treatment in Melbourne or need clarity around compression options, I’m here to support you. About myself: a Myotherapist specialised in Lymphoedema Management My name is Giovanni, and I run Melbourne Massage and Treatment, a Myotherapy and Lymphoedema clinic in Fitzroy North. I trained with the Vodder Academy in lymphoedema management, and I provide Complete Decongestive Therapy (CDT), the gold standard for lymphedema treatment. My approach is tailored to each individual patient, to achieve objective results, and to help you enjoy more your life while dealing with Lymphoedema management.  

Face Swelling After Rhinoplasty: What You Should Know

Before and after Swelling After Rhinoplasty surgery

Along with many types of post-cosmetic surgery presentations I get to work with, Rhinoplasty can also present with facial swelling, which is one of the most common (and often most frustrating) parts of post-surgery recovery. While you may find many therapists claiming to work with lymphatic massage, as a therapist trained in Manual Lymphatic Drainage (MLD) through the Vodder Academy, I can help you achieve great results post surgery and help your body deal with excessive swelling, bruising, and, where it happens, even fibrosis. I So in this article, I want to explain why swelling can last longer than expected after rhinoplasty, what the science tells us, and how MLD may help reduce swelling and limit the development of fibrosis during the healing process. Why Does Swelling Persist After Rhinoplasty? Rhinoplasty is a surgery that can be done for cosmetic or functional reasons, like improving nasal breathing, and is a surgical procedure that involves deliberate trauma to bone, cartilage, and soft tissue. This trauma triggers inflammation and a temporary disruption of the lymphatic system, the network responsible for clearing excess fluid from tissues.   Scientific research published in the Plastic and Reconstructive Surgery Journal shows that: Approximately two-thirds of post-rhinoplasty swelling resolves within the first month Up to 95% resolves by 6 months Residual swelling can still be present 12 months or longer, particularly in the nasal tip. Now, two things about those data: Those numbers are the results of a study done on 40 patients, so still, even if they are quite promising, more evidence is welcome for further comparison. On the other hand, this prolonged swelling is a normal physiological response, but it can be uncomfortable and visually concerning. The Role of the Lymphatic System in Facial Swelling The swelling that you may present with post-rhynoplasty surgery is due to a temporary impairment of the lymphatic system, which acts as the body’s drainage mechanism. After surgery, lymphatic vessels can become overloaded or temporarily impaired, leading to fluid stagnation in facial tissues. In another paper by Meade R et al. (2012), published in the Oxford Academic Journal, it is shown that postoperative facial surgery disrupts lymphatic flow, leading to prolonged edema in the head and neck region. In more chronic cases, where lymphatic fluid stagnates for prolonged periods, patients may also experience tissue hardening and early fibrosis.  What Is Manual Lymphatic Drainage (MLD)? Manual Lymphatic Drainage is a gentle, non-invasive manual therapy designed to stimulate lymphatic vessels and redirect fluid toward functioning lymph nodes. Unlike remedial massage or deep tissue techniques, MLD is a post-surgical lymphatic massage characterised by: Light Pressure Slow and rhythmic Movements MLD aims to stimulate superficial and deep lymph vessels, not muscle tissue MLD is internationally recognised as part of Complete Decongestive Therapy (CDT), the gold-standard conservative treatment for lymphatic swelling. Lasinski B.B. et al. (2012). How MLD May Help Reduce Swelling After Rhinoplasty As mentioned above, the number of patients who undergone clinical trials for post-rhinoplasty swelling treatment is limited, but along with other studies available on PubMed, the physiological principles of MLD are well supported, and here is a breakdown of what you can come across while doing some research: Supporting Fluid Reabsorption By stimulating lymphatic flow, MLD helps the body clear excess interstitial fluid more efficiently, which may assist in reducing facial puffiness and pressure. Marxen T. et al. (2023). Improving Tissue Mobility Reduced fluid stagnation helps tissues remain softer and more pliable during healing, an essential factor for aesthetic outcomes. Masson I. et al. (2014). Encouraging Symmetrical Healing MLD techniques can be adapted to address asymmetrical swelling, which is very common after rhinoplasty. Ulu M. et al. (2025) MLD and the Prevention of Fibrosis When the body goes through severe trauma, like a surgery, as part of its natural reaction, it may build tissue under the skin. This tissue is called: Fibrosis. Fibrosis may feel firm to the touch and leave you with a feeling of tightness under the skin. When swelling is unattended, can leads to fibrotic formation and changes. In this clinical study by Masson I. et al. (2014), they looked into post-liposuction and body contouring surgery, and how Manual Lymphatic Drainage, particularly when combined with other conservative therapies, can reduce both swelling and tissue fibrosis. While facial tissues differ, the underlying biological mechanism is shared: improved lymph flow supports healthier tissue remodelling. When Can MLD Begin After Rhinoplasty? Timing is crucial, but MLD post- rhinoplasty should only begin: With surgeon approval Once acute inflammation has stabilised Using facial lymphatic drainage massage protocols appropriate for post-surgical tissue Once the antibiotic cycle is finished, and the risk of infections is no longer there anymore At Melbourne Massage and Treatment in Fitzroy North, I tailor each session based on: Surgical date Healing stage Tissue sensitivity Presence of swelling or firmness MLD is not a painful treatment, and it doesn’t matter how sensitive your skin is, or how good you are at tolerating pain, still, throughout the treatment, pain should not be experienced, as this would lead to increased inflammation, which is not what we need, when clearing off exceed lymph liquid to reduce oedema post-surgery. My Approach With MLD at Melbourne Massage and Treatment – Fitzroy North As a Vodder-trained MLD therapist, my focus is on precision, safety, and evidence-informed care. Each session is: Gentle and non-invasive Individualised to your healing phase Focused on supporting natural lymphatic recovery Most clients benefit from a short series of treatments over several weeks or months, depending on swelling persistence. Nothing can boost your healing, whether you went through a cosmetic surgery or just had a severe incident, but there are certain practices, like MLD or exercises, and even good food and plenty of rest, that can help in assisting your healing process and not make it worse or longer. <div class=”faq-accordion”> FAQs: </div>


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