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Pregnancy Lymphatic Drainage Massage in Melbourne | Fitzroy North

Lympahtic Drainage for pregnancy

Manual Lymphatic Drainage (MLD) is an ideal treatment to reduce swelling and oedema, and if so, at Melbourne Massage and Treatment, I offer manual lymphatic drainage during pregnancy. Swelling, heaviness in the legs, water retention, and aching joints are all common during a pregnancy. One treatment that is safe, gentle, and highly effective in reducing these symptoms is Manual Lymphatic Drainage (MLD). In this blog, we’ll explore the benefits, safety considerations, positioning, and when lymphatic drainage may or may not be recommended. What Is Manual Lymphatic Drainage for Pregnancy? Lymphatic drainage is a gentle, rhythmic technique designed to stimulate the lymphatic system. This improves the movement of lymph fluid, helping the body eliminate unwanted substances, reduce fluid retention, and improve overall well-being. Manual lymphatic drainage is beneficial for pregnant individuals (Cataldo Oportus et al., 2013), particularly for managing swelling, improving circulation, and supporting relaxation. Benefits of Lymphatic Drainage During Pregnancy In a city like Melbourne, where the weather can get really hot, those temperatures can be an extra challenge during pregnancy. Here is a list of MLD benefits for your gestation time: 1. Reduction of Swelling (Oedema) Swelling in the legs, ankles, and feet is extremely common in pregnancy due to increased pressure on the lymphatic and circulatory systems. Lymphatic drainage helps move fluid away from congested areas, relieving discomfort and heaviness. 2. Relief from Pregnancy-Related Back Pain During pregnancy, the increasing weight can affect posture and strain the back. Lymphatic drainage, performed in a comfortable side-lying position, helps reduce tension through its profound relaxation effect. 3. Improved Circulation Changes in blood volume and circulation during pregnancy can cause fluid retention and fatigue. Lymphatic drainage promotes healthy blood and lymph flow, improving oxygen and nutrient delivery to both mother and baby. 4. Mental and Emotional Well-being One of the most underestimated benefits of lymphatic drainage is how deeply relaxing it is. Better sleep, reduced stress, and a sense of lightness are very common outcomes. At Melbourne Massage and Treatment in Fitzroy North,you would receive pregnancy lymphatic drainage massage in a seated or semi-reclined position on a hydraulic table, which allows maximum comfort and safety throughout the treatment. FAQ – Pregnancy Lymphatic Drainage Massage in Melbourne   Reference Cataldo Oportus, S., de Paiva Rodrigues, L., Pereira de Godoy, J. M., & Guerreiro Godoy, M. de F. (2013). Lymph Drainage in Pregnant Women. Nursing Research and Practice, 2013, 1–3.

The Star Excursions Balance Test

The Star Excursions Balance Test (SEBT) is a fabulous functional test that can tell us a lot about the mobility and stability of the ankle, knee, and hip joints. On top of being a functional test, the star excursion can also be used as an exercise, and via a series of progressions, which we will discuss in more detail later, can help you train for better running performance and injury prevention. Why is the Star Excursion Balance Test Important? The importance of the Star Excursions Balance Test lies in its ability to assess, with one motion, the capacity of your ankle to remain stable on the surface of support (the floor) and how this stability is transmitted to the knee first and, consequently, to the hip. This is possible because the transfer of vertical pressure is applied to each joint while you are aiming to get the movement done. The movement required is to keep the feet of the anchor down to the floor, from the toes to the heel, while with the other foot, you aim to reach the furthest point away within the eight cardinal directions (like a star *). Along those movements, then, we also get observational data about your: Proprioception: The ability to sense the position of the body and its parts in space. Balance: The ability to control the body’s centre of mass over a stable base of support. Functional Movement: How well the body can perform multi-directional movements, such as stepping, reaching, and stabilising. The Role of the Star Excursion Balance Test in Lower Limb Injury Recovery So, if you are someone who has sustained lower limb injuries, particularly around the ankle, knee, or hip, these capabilities are often compromised. By using the Star Excursion Balance Test, we can: Assess any deficits in these areas, which might increase the risk of re-injury or limit recovery progress. But not only that. Indeed, that information will shape the recovery program, allowing us to understand better which muscle group or joint we need to focus more on with the exercises. Help runners, as running is a dynamic activity that places high demand on the lower extremities. Even minor imbalances or weaknesses can lead to conditions such as IT band syndrome, shin splints, and knee pain. The Star Excursion Balance Test helps in identifying these early warning signs before they evolve into more serious conditions. What Does the Star Excursion Test Measure? The primary purpose of the SEBT is to evaluate a person’s capacity to control body movement while standing on one leg. In rehabilitation, the Star Excursion Balance Test trains and improves: Ankle Stability and Control: It challenges the ankle to support the body’s weight while shifting through various planes of motion. Knee and Hip Joint Function: By demanding strength and flexibility in the lower limb, it helps retrain the kinetic chain, especially after joint injury. Balance and Proprioception: The test improves your ability to sense where your body is in space, which is essential for both preventing and recovering from injuries. Postural Awareness: Training balance also trains your ability to maintain proper posture, which can reduce stress on your joints and muscles during exercise. In fact, the test consists of reaching with one leg in multiple directions (anterior, posterior, medial, and lateral and a mix of those directions) while maintaining balance on the other leg. This shows their neuromuscular control and postural stability. It mimics the demands placed on the body during dynamic activities like running, cutting, and jumping. The Progression of the Star Excursion Test The beauty of the Star Excursion Test is its flexibility. It can be adapted based on the individual’s injury level, fitness, and goals. The test itself involves several variations, which I implement depending on the stage of recovery or the individual’s needs: Softer Ground: For those in the early stages of rehabilitation, we may perform the test on a softer surface, such as a foam pad or balance disc. This reduces the stability of the base and forces the individual to engage more stabilising muscles, which aids in proprioceptive training and can be beneficial for rebuilding ankle and knee control. Weight on the Ankle: For those who have had ankle injuries, I often modify the test to place more weight on the injured ankle. This helps rebuild strength and functional control, as it forces the injured area to bear load and engage in movement patterns that may have been avoided during the healing phase. Eyes Closed: To increase the challenge, I sometimes ask my clients to perform the test with their eyes closed. This removes visual input, forcing the body to rely more on internal feedback (proprioception). This is especially important in the latter stages of rehabilitation, as it helps to refine neuromuscular control and reduce reliance on external cues. Using the Star Excursion Test with Lower Limb Injury Recovery and Runners The SEBT is a functional test that I like to use, with all its variations, to assess the progress of patient recovery. Whether you present with an injury, or you want to improve your form and body functionality throughout exercises, the SEBT allows us to look in depth at what we need to work on, too. For example, after a sprained ankle, I’ll often use the SEBT to check whether an individual is able to move without compensation, ensuring that their body has regained sufficient control and strength before returning to activities like running or sports. And this, don’t be surprised, is something that I do and has to be done whenever someone presents with complaints about knee or hip pain, too. Again, an unstable ankle would transmit that instability up the chain. On the other hand, for runners, the test helps evaluate areas of weakness that might predispose them to injuries such as Achilles tendinopathy, patellofemoral pain, or iliotibial band syndrome. Since running places repetitive stress on the lower limbs, identifying and addressing weaknesses early can prevent long-term problems and improve overall performance. Myotherapy and SEBT […]

Knee Replacement Surgery

Diagram of Knee Replacement

Knee replacement surgery, or knee arthroplasty, is a transformative procedure designed to alleviate pain and restore function in patients suffering from severe knee damage. While the surgery is a crucial step toward improved mobility, the journey doesn’t end in the operating room. The rehabilitation process is vital for ensuring a successful recovery and regaining your pre-surgery quality of life. A key component of this recovery is Manual Lymphatic Drainage (MLD) and a tailored exercise program. Understanding Knee Replacement Surgery Knee replacement surgery as the name says, is basically the replacement of a damaged knee joint with an artificial one. There are two type of knee replacement surgery: a total knee replacement (TKR), which replaces the entire knee joint, or a partial knee replacement, which targets only the damaged part of the joint. Nowadays, the decision to undergo knee replacement surgery is often made when conservative treatments, such as medications and physical therapy, have failed to provide relief. This is because, we are more aware now than ever, of how surgery are complex intervention that can yes, give pain relief and benefit, and save life, but occasionally can come with complications and leave the person with other permanent damage. The Rehabilitation Process As in any surgery, the rehabilitation process is extremely important to ensure that the patient returns to the best of their functions. What the rehabilitation involves are physical therapy, exercises, and, where needed, even mental support. Immediate Post-Surgery Care: Pain Management: Right after your surgery, you will be given pain relief medications and antibiotics, which will help in managing the pain response and keep you free from infection risks. Initial Movement: As a few days are pass, is super important to start moving. Initially would be a matter of few mm or cm, passive and active movement, but as days goes by these movement has to be increased, in order to avoid further muscle atrophization and to increase the blood flow to the area. Exercise: Isometric Exercises: As per discussed in many other blogs, those exercises are the first step in the recovery process. An isometric exercise consists of muscle contraction and barely any limb movement. This allows for maintaining a connection between the muscle and the Central Nervous System (CNS), which is essential to ensure muscle engagement for more complex tasks. Initially, those exercises can be achieved with only 25% of your strength, and within 10 days post-surgery, you may start pushing at 50% of your strength or more. Strengthening Exercises: This second step in the exercise journey can start in week three or four after surgery. The process focuses on strengthening the muscles surrounding the knee joint. These exercises are essential for supporting the new joint and improving overall stability. Strengthening exercises may look different from person to person, in terms of load, but they all aim to increase the load to which the knee joint is placed, to stimulate muscle growth, blood flow, and restore all tissue damaged along the surgery. Plyometric Exercises: Lastly, along the rehabilitation process, there are the plyometric exercises, which consist of loading the tendon like a spring (that’s what their function is) and releasing that loading in a fast motion. For a knee joint, think of explosive squat-type exercises. These type of exercises would start around week 8 to 10 post surgery. This is a step-by-step guide of what a rehabilitation process may look like. Each individual then may have a different journey to follow, given their clinical history, and other factors, including genetics and return to daily activities. In addition to the exercises, physical therapy Consistency: Adhering to a home exercise program is crucial for maintaining progress during therapy sessions. Monitoring Progress: Regularly perform your home exercises and track your progress. If you encounter any issues or experience increased pain,get in touch with your physical therapist to discuss what you are presenting with and what can be done about it. Monitoring and Follow-Up: Your surgeon and physical therapist will evaluate you on an ongoing basis to ensure that your recovery is progressing as expected. Any complications or concerns will be addressed promptly. The Importance of Manual Lymphatic Drainage (MLD) Manual Lymphatic Drainage (MLD) is a gentle, hands-on therapy designed to stimulate the lymphatic system and reduce swelling, which can be particularly beneficial following knee replacement surgery. Here’s how MLD supports recovery: Benefits of MLD in Knee Replacement Recovery: Reducing Swelling: Fluid Management: Swelling or edema is a common issue after knee replacement surgery. MLD helps move excess fluid away from the surgical site and reduces overall swelling, which can enhance comfort and mobility. Enhancing Circulation: Improved Blood Flow: By promoting lymphatic flow, MLD also improves blood circulation, delivering essential nutrients and oxygen to the healing tissues, which supports a faster recovery. Reducing Pain and Discomfort: Pain Relief: The gentle massage techniques used in MLD can help alleviate pain and discomfort associated with swelling and inflammation, contributing to a more comfortable recovery experience. Facilitating Faster Recovery Helping the Healing: By reducing swelling and improving circulation, MLD can lead to a more efficient recovery process, enabling more effective physical therapy and exercise. Incorporating MLD into Your Rehab Routine Timing: MLD can be introduced a few days to a week after surgery, depending on your surgeon’s recommendations and your individual healing progress. How can I help? At Melbourne Massage and Treatment, as a Clinical Myotherapist I am trained in helping people recovering from knee surgery or other major surgeries, either with Fitness Class, which can be part of a Myotherapy treatment plan, but even via treatment like Manual Lymphatic Drainage. So if you are about to get a surgery, that is a knee replacement or any other surgery, and you are looking for someone that can assist you with your recovery, get in touch now to discussed your needs and I can give you a rund down on how I will be able to help you. Knee replacement surgery and lymphoedema. As mentioned earlier, we can all have different outcomes from the […]

Key Differences Between Muscle Tension Headaches & Migraines

Giovanni working on a patient neck to relief symptoms of muscular tension headache

Muscle tension headache and migraine are two different types of presentation that have in common a pain, which can also be debilitating, in the head area. Back in 2019, in Australia, 3 million people were estimated to suffer from migraine (Wijeratne et al., 2023), where, define how many people are suffering from muscular tension head-ache is a bit more tricky, as is not a presentation that can be easily tracked, due to self managed protocols, and other miss data counting. That said, they have different origins, symptoms, and treatment options. In this blog post, we will explore the key differences between muscle tension headaches and migraines, helping you understand how to identify and manage them. What Are Muscle Tension Headaches? Muscle tension headaches, or tension-type headaches, are the most common. This type of headache originates from cervical or facial muscle tensions, which recreates a pattern of pain on the head of facial area. As with all muscles, but even joints, the pain that we can experience can be local or in an area around the tense spot. These headaches are often linked to stress, lack of good posture, anxiety, and even sleep disturbances. They can be chronic or occasional, but compared to migraine, they lack neurological symptoms. Symptoms of Muscle Tension Headaches: Dull, aching pain or pressure around the head, especially in the forehead, temples, and back of the head. A sensation of tightness or “band-like” pressure around the head. Mild to moderate intensity (usually not as severe as a migraine). Pain can last from 30 minutes to several hours, sometimes even days. Tenderness or tightness in the neck, shoulders, and scalp. Causes of Muscle Tension Headaches: Stress: Emotional and mental stress is one of the primary causes of muscle tension in the neck and scalp muscles. Lack of good posture: Sitting or standing with poor posture and lack of strength in the musculoskeletal system, especially for long work, can strain muscles and trigger headaches. Sleep issues: Sleep deprivation or poor-quality sleep can exacerbate muscle tension and lead to headaches. The body recovers from the fatigue of the day before during sleep, especially in the early morning hours. Sleep deprivation would increase the chance of a headache. Dehydration: Not drinking enough water can lead to tension and headache symptoms. The body withdraws water from the brain to keep the organ functioning, causing physical brain shrinkage, which leads to headaches. Recent studies have indicated that chronic tension-type headaches (CTTH) are often exacerbated by environmental stressors, and poor posture in daily activities can cause muscle imbalance and contribute to the frequency of these headaches (Bendtsen et al., 2018; Grazzi et al., 2016). Treatment Options: Pain relief: Over-the-counter pain relievers, like ibuprofen or acetaminophen, can help ease the discomfort. Heat pack: Applying a warm compress to the neck and shoulders can help relax tense muscles. Keep always in mind that heat application should be limited to 10-15 minutes, once or twice a day. Massage: Gentle massage of the neck and shoulder muscles can reduce tightness and alleviate headache symptoms. Stress management: Practising relaxation techniques such as deep breathing, thai yoga, and meditation can reduce stress and prevent muscle tension headaches. Strengthen muscles: Strengthening the muscles around your cervical and shoulder area can help reduce the chance of suffering a headache by reducing the inflammatory response that the muscle would activate due to a lack of strength. What Are Migraines? As I mentioned above, the significant difference between headaches and migraines is due to neurological symptoms, a unique characteristic of migraines. Migraines are neurological events that involve complex brain activity. They are characterised by intense, throbbing pain, usually on one side of the head. They are often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. Migraines are more debilitating than muscle tension headaches and can last a few hours to several days. The intensity of the headache doesn’t have to be severe. Symptoms of Migraines: Although many people experience nausea, vomiting, and light sensitivity, migraine symptoms can vary, with some individuals experiencing dizziness or visual disturbances without significant head pain. Throbbing or pulsing pain, usually on one side of the head. Nausea and vomiting. Sensitivity to light, sound, and sometimes smells (aura). Visual disturbances such as flashing lights or blind spots (this is known as an aura, which can occur before or during the headache). Dizziness or feeling lightheaded. Migraines are understood to be primarily driven by neurovascular changes and neuronal hyperexcitability (Feng et al., 2021). A review by Wagner et al. (2021) found that the pathophysiology of migraines involves alterations in neurotransmitter systems, notably serotonin and CGRP (calcitonin gene-related peptide), which contribute to the vasodilation and pain signaling pathways. Causes of Migraines: Genetics: Migraines tend to run in families, suggesting a genetic component. Hormonal changes: For many women, changes in estrogen levels, such as during menstruation, pregnancy, or menopause, can trigger migraines. Environmental triggers: Bright lights, strong smells, certain foods (like chocolate, cheese, or caffeine), weather changes, lack of sleep, and allergies that cause sinus issues are common migraine triggers. Neurological factors: Migraines may involve changes in the brain’s nerve pathways, chemicals, and blood vessels, which cause inflammation and pain. Treatment Options for Migraines: Prescription medications: Triptans and anti-nausea medications are commonly prescribed to treat the acute pain of migraines. Preventive medications: For frequent migraine sufferers, medications such as beta-blockers, antidepressants, or anti-seizure drugs may be prescribed to reduce the frequency and severity of attacks. Lifestyle changes: Regular sleep, a healthy diet, and consistent exercise can help reduce the frequency of migraines. Cognitive-behavioural therapy (CBT): Managing stress through therapy can help alleviate migraine triggers. Alternative therapies: Acupuncture, biofeedback, and massage therapy are sometimes used as complementary treatments for migraine management. Recent studies support preventive treatments for chronic migraines, such as CGRP antagonists (Kundera et al., 2020) and neuromodulation techniques like transcranial magnetic stimulation (Lefaucheur et al., 2017). Key Differences Between Muscle Tension Headaches and Migraines Although muscle tension headaches and migraines involve head pain, they differ […]

Ankle Sprain: Why you should care about it.

image that rapresents an ankle sprain, with the three ligaments that can get involved

Ankle sprains are among the most common injuries, especially for athletes, active individuals, and even those who simply trip or misstep during daily activities. Despite being a frequent injury, the importance of properly recovering from an ankle sprain is often underestimated. Proper rehabilitation is crucial not only for returning to normal activities but also for preventing long-term complications like chronic instability, arthritis, or re-injury. In this blog, we’ll take a closer look at ankle sprains, their impact on the ligaments involved, and why recovery is so vital for the health of your ankle and the joints above it. What is an Ankle Sprain? An ankle sprain is an injury that occurs to the ankle ligament, which may stretch or be torn. Most commonly, this happens on the lateral portion of the ankle, as the plantar of the feet turn internally. The role of ligaments is to connect bones to each other and provide stability to the joint. In the acute phase of injury, you may experience swelling, pain, bruising, and sometimes instability in the joint. Mechanism of action includes sudden twisting, rolling, or turning motions, like sports or walking on uneven surfaces. Not all ankle sprains are the same, indeed, we have a classification system for it, which is based on their severity: Grade I (Mild): A slight stretching or microscopic tearing of the ligament fibres, typically causing minimal swelling and pain. Grade II (Moderate): Partial tearing of the ligament, with noticeable swelling, bruising, and limited mobility. Grade III (Severe): Complete rupture of the ligament, leading to significant swelling, instability, and difficulty bearing weight. Which Ligaments Are Most Affected? The ankle joint consists of several ligaments, but sprains most commonly affect the lateral (outer) ligaments. These include: The anterior talofibular ligament (ATFL) is the most commonly sprained ligament on the front of the ankle. Calcaneofibular ligament (CFL): A ligament that connects the fibula to the heel bone. Posterior talofibular ligament (PTFL): Less frequently injured, but it can be involved in more severe sprains. Studies show that the ATFL is the most commonly injured ligament, with up to 85% of all lateral ankle sprains involving this ligament (Kerkhoffs et al., 2012). The CFL is also frequently injured, but less commonly than the ATFL. As mentioned above, most often an ankle sprain happens on the lateral portion of the ankle, but in rare cases, the deltoid ligament on the ankle’s medial (inner) side can be sprained, particularly during more forceful or traumatic incidents. Why more laterally than medially? Biomechanically, our ankle finds it easier to turn inwards than outwards. Therefore, it is easier to exceed in ankle inversion (the feet’ plantar face the medial line of the body) than the other way around. This is due to the disposition of the bond in the ankle and feet. The Risks of Not Fully Recovering from an Ankle Sprain Many people recover from an ankle sprain and return to normal activities, but this doesn’t always mean the ankle is fully healed. Incomplete recovery can lead to several risks, including: Chronic Instability: If the ligaments don’t heal properly, the ankle may feel unstable, making it prone to future sprains or injuries. This can create a cycle of repeated sprains, leading to longer-term joint instability. Re-injury: Insufficient rehabilitation increases the risk of re-injury. Returning to physical activity too soon or without proper strength can cause the ligaments to overstretch or tear again. Arthritis: Studies have shown that improper healing of the ankle joint can lead to post-traumatic osteoarthritis (PTOA). This occurs when the joint surfaces are not properly aligned during healing, leading to cartilage degradation over time. Research suggests that 5-20% of individuals who suffer from ankle sprains may develop PTOA later in life (Delco et al., 2017). Muscle Weakness and Atrophy: After a sprain, the muscles around the ankle often weaken due to disuse and immobilisation. This weakness can extend to other areas of the body, increasing the risk of compensatory injuries (e.g., knee or hip strain) as you change how you move to protect the injured ankle. The Benefits of Proper Recovery As with any injury, the recovery process is dictated by your subjective presentation, which includes your clinical history, fitness level, and more. Here are some of the key steps for a full recovery: Achieve strength and joint stabilityThanks to the therapist’s guidance and a mix of treatment and exercises focused on the muscles that cross the ankle joint, like the peroneal and calf muscles, you can regain ankle stability and strength to return to your daily activities. This process can take up to 12 weeks, and its success is based on a mix of your clinical history and effort placed in the recovery process. Reduction in the Risk of Chronic PainPast the acute phase of injury, the risk of developing chronic pain is a common problem for individuals who don’t rehabilitate properly after an ankle sprain. In fact, studies suggest that proper rehab can reduce the risk of long-term pain by improving joint function and reducing stiffness with research indicating that patients who complete a rehabilitation program are 60-70% less likely to experience chronic ankle pain compared to those who don’t (Gribble et al., 2016; Zamperetti et al., 2019). Rehabilitate the Range of MotionA key goal of rehabilitation is to restore the full range of motion (ROM) to the injured joint. Restoring normal ROM is critical for preventing compensatory movements that can strain other joints along the joint chain, like the knee, hip, or lower back. The Recovery Process: What to Expect Proper recovery from an ankle sprain typically involves several stages: Acute Phase (0-72 hours) – P.E.A.C.E: Protect: Safeguard the injured area from further harm and avoid excessive strain. Elevate: Raise the injured area to reduce swelling and improve blood flow. Avoid Anti-inflammatories: Refrain from using anti-inflammatory medications unless advised by a healthcare professional, as they can hinder the natural healing process in some cases. Compress: Apply compression (e.g., with bandages or sleeves) to reduce swelling and provide support. Educate: […]

Strengthening Exercises: Building Resilience for Better Health

@ people doing exercises for cuff rotator muscle

Strengthening exercises are an important way to improve our overall health by improving muscular endurance and stability around the joints. Unlike isometric exercises, which are performed with static muscle contractions, strengthening exercises involve dynamic movements that are capable of creating contractions and lengthening of muscles. This type of training is relevant not only for sportsmen but also for everyone who wants to raise their physical condition. Why Strengthening Exercises? Recent studies have focused on the role that strengthening exercises play in the maintenance and enhancement of musculoskeletal health. Strength exercises play a key role in preventing injuries, rehabilitation, and the enhancement of daily functional activities. Why this is possible is because this type of training consists of applying resistance to your body that will challenge your muscles, bones, ligaments and tendons, helping build strength, endurance, and overall physical function. Strengthening exercises stimulate muscular hypertrophy, which is defined by an increase in muscle size and strength. This is very important for preventing and even delaying the onset of sarcopenia, a major factor in declining health with natural aging. Strengthening for Injury Prevention and Recovery Imagine having a shoulder injury and undertaking rehabilitation: It would start with light movement and isometric exercises. After the initial healing phase, strengthening integration is essential. Strengthening exercises rebuild the muscle’s strength, provide joint stability, and regain total function. For example, with a shoulder injury, performing resistance exercises such as rotations with a resistance band and or weights, along different planes and directions, can help regain the strength of the rotator cuff muscles. These exercises will enhance not only the muscles around the shoulder but also the overall stability of the joint and consequently reduce the chance of future injuries. Without going through the exercises phase, you may experience a decrease in pain over the weeks after the initial injury (it depends on the severity of the injury), but that doesn’t mean that you are out of danger or re-injury. Indeed, as soon as you place extra force in the joint or on the soft tissue of the shoulder, the risk of re-injury would skyrocket, as the shoulder complex it may not be ready or strong enough to permorm such actions. Body tissues and Exercise Strengthening. What’s the deal? Throughout our lifespan, our metabolism slows down. During this process, not only will we process energy intake differently, but how our body recovers and regenerates will also change. So, all the body’s soft and hard tissues will have difficulty recovering and staying strong. That’s where the strength exercises come through. Applying a resistance to those tissues, a positive stress resistance, would allow those tissues to regenerate and grow stronger. These are valid for both soft and hard body tissues. We define positive stress as something that does not put the body in danger but is a stress that the body can handle and take advantage of, like a few kg of a dumbbell or a resistance band. Then, the stronger we get, the more weight we can handle, and that’s how we progress in the exercises. How Do Strengthening Exercises Benefit Tendons? Probably the most essential rehabilitation of connective tissues besides bones would have to be the tendons, which connect muscles to bones. When you do resistance training, tendons encounter controlled stress that stimulates the building of collagen. Collagen is vital in repairing and strengthening tendons; thus, the substance is one of the priorities in any rehabilitation program for tendons. For instance, in the rehabilitation from Achilles tendinopathy, there are such eccentric calf raises- you gradually lower the heel below the level of the step, which are particularly effective. The exercise improves resilience and strength of the tendon through progressive loading and stimulating collagen synthesis. Examples of Effective Strengthening Exercises Squats: Excellent for overall strength of the lower body. First, try squats with your own weight, then add weights as you progress. Deadlifts: So good for exercising the posterior chain, such as hamstrings, glutes, and lower back. Go with lighter weights to perfect the form before adding any resistance. Push-Ups: A great exercise for your upper body since it targets the chest, shoulders, and triceps very well. Variants such as decline or incline push-ups can be done to increase/decrease the intensity level. Progressing the Strengthening Exercises Exercise progression is necessary if improvement is to be continually achieved; otherwise, this often leads to a level where no significant further improvements are made. Start with exercises that match your current fitness level and gradually increase the intensity by adding more weight, increasing repetitions, or incorporating more complex movements. For example, one can perfect squats with one’s own body weight and then subsequently move on to the next level by adding dumbbells or even a barbell. Or, for instance, when one masters regular push-ups, they can always try modifications, such as adding weights to the push-up or doing one-arm push-ups to make their muscles work harder. Incorporating Strengthening Exercises into Your Routine It is easy to incorporate a routine where another routine already exists. Indeed, strength exercises don’t have to be associated with hours and hours in the gym. You can have a dumbbell or a kettlebell or a resistance band, sitting in your kitchen, and while you wait for your morning coffee to come up, you can do a few squats. A few minutes of well-practised exercise here and there are better than nothing. Start with little, learn how to experience the pleasure of movement and the benefit of exercising and from there you can build a stronger and longer routine of self-care. And as you learn more and more, you can start looking into balancing a comprehensive program that blends strengthening exercises with cardiovascular activities and flexibility training to promote overall health and functionality. How often should we exercise? I often get asked this question when I give exercises to my patients. We now know that the frequency of strength exercises is strictly related to our goals. So to increase your strength, you look for 3 to 5 […]

Managing Menopause Symptoms

image of a woman meditating as a practice for managing menopause syptoms

Menopause is a natural phase in every woman’s life, but it comes with a variety of physical, emotional, and mental challenges. As hormone levels shift, particularly estrogen, progesterone, and testosterone, many women experience symptoms like hot flashes, mood swings, sleep disturbances, and weight gain. Fortunately, for managing menopause symptoms, various lifestyle changes can be put in place, such as exercise, a balanced diet, improved sleep hygiene, and stress management techniques. In this blog, we will explore how adopting a healthier lifestyle can significantly improve your menopausal experience. Exercise and Physical Activity For Managing Menopause Symptoms Exercise is again the best recommendation for health improvement that can be offered here. Of course, implementing exercises alone without following any other changes or advice (where needed) is not going to do the trick. But let’s start from here. Exercises can improve overall health and have specific benefits that help ease common issues like weight gain, mood swings, and hot flashes. But not only that. Indeed, exercises, and in particular strength training, are positive stress, which allows the body to regenerate and ensure the slowing down of bone and muscle mass, which is one of the main issues that a woman going through menopause is going to face. Here is a list of exercise routines that you could focus on. But keep in mind that if you really want to choose, I would strongly suggest Strength Training. Aerobic Exercise:Walking, swimming, cycling, or jogging would help in improving circulation, promote heart health, and relieve stress (for the last one, especially if done in open-air environment). Regular aerobic exercise has also been shown to reduce the frequency and intensity of hot flashes. Plus, it aids in weight management, especially during menopause when metabolism slows. Strength Training:Engaging in strength training exercises, such as weightlifting or resistance band workouts, helps preserve muscle mass and improve bone density, which decreases as estrogen levels decline. This is essential for reducing the risk of osteoporosis and maintaining strong bone and muscle mass. Yoga or Pilates:Both yoga and Pilates are great for improving flexibility, balance, and muscle strength while reducing stress and anxiety. These low-impact exercises help maintain your physical health and mental well-being, both of which can be affected by hormonal fluctuations during menopause. Tai Chi or Qigong:These ancient practices involve slow, deliberate movements and deep breathing. They are excellent for enhancing balance, reducing stress, and promoting relaxation—especially helpful for managing mood swings and anxiety. Eating an Anti-Inflammatory Diet A nutrient-rich diet can significantly help in managing menopause symptoms. By incorporating specific foods and avoiding certain triggers, you can reduce inflammation, balance hormones, and support your body’s needs during this transition. Phytoestrogens:Phytoestrogens are plant-based compounds that mimic estrogen in the body and can help alleviate symptoms like hot flashes and night sweats. Foods rich in phytoestrogens include soy products (tofu, tempeh, edamame), flaxseeds, lentils, chickpeas, and whole grains. Calcium and Vitamin D:As estrogen levels decline, the risk of bone loss and osteoporosis increases. To support bone health, incorporate calcium-rich foods such as leafy greens (kale, broccoli, sesame seeds), fortified plant-based milks, and dairy products. Vitamin D is crucial for calcium absorption, so get it from sun exposure or foods like fatty fish (salmon, mackerel) and fortified foods. Vitamin D is cumulative, so during the longer days of the year, ensure to spend some extra time in the sun. But of course, do so during the safest hours and not at UV light pick time. Regarding Vitamin D and Calcium supplements, there is a strong debate about whether they are good or what potential side effects they have, so you’d better talk to your GP about the specifications. Healthy Fats:Omega-3 fatty acids found in fatty fish, flaxseeds, chia seeds, and walnuts have anti-inflammatory properties that can help reduce joint pain and inflammation during menopause. These healthy fats also support heart health, which is increasingly important as estrogen levels drop. Whole Grains and Fibre:Fibre helps stabilise blood sugar levels and improves digestion, which can be helpful as metabolism slows. Incorporate fiber-rich foods like whole grains (brown rice, oats, rye), fruits, vegetables, and legumes to support digestive health and reduce bloating. In the case of beans and grain, ensure that they are soaked when needed to reduce the bloat side effect. Limit Sugary and Processed Foods:Foods high in sugar and processed carbs can cause blood sugar spikes and crashes, leading to irritability and fatigue. This is where having a variety of fresh food is a key component. So yes, no one wants you to overstress about what you eat or not, but, generally speaking, if you have never looked into a balanced anti-inflammatory diet, it is time to do so. Reducing Alcohol and Inflammatory Foods Both alcohol and inflammatory foods can exacerbate menopause symptoms, so limiting or avoiding them can provide significant relief. Limit Alcohol:While alcohol might seem like a way to unwind, it can actually trigger hot flashes, disrupt sleep, and contribute to mood swings. Moderation is key—try limiting your alcohol intake to no more than one drink per day, and if possible, reduce it further to see if it improves your symptoms. Alcohol is a substance that the body does not recognise, and it has quite a hard time breaking it down. Avoid Inflammatory Foods:Highly processed foods, refined sugars, and trans fats can increase inflammation in the body and worsen menopause symptoms like joint pain, fatigue, and mood swings. Instead, focus on anti-inflammatory foods such as berries, leafy greens, fatty fish, and nuts to support your body during this phase. Inflammatory foods are all those that contain Omega-6 fatty acids, which are long-chain fatty acids, that would get collected in your Lymphatic System at first, and attacked by the macrophages (white cells), inciting an inflammatory response. Caffeine:Excessive caffeine can disrupt sleep and worsen hot flashes. If you find that caffeine aggravates your symptoms, consider reducing your intake or cutting back on coffee and other caffeinated beverages, especially in the afternoon or evening. Here is a great podcast from ZOE podcast about […]

Hormones and Menopause: What is happening?

Representation of Estrogen levels in woman at different age

Menopause is a crucial step in a woman’s life. Menopause marks the time when a woman’s fertility comes to an end, but it is also a time when the woman’s body goes through many meaningful changes that are all driven by hormone fluctuation. Indeed, this is the main reason menopause can be so challenging and, second, different for each individual. In this blog, I will summarise why hormone imbalance can cause so many changes, and what those changes are. The Women’s Hormones: which is which, and what’s their role Before we dive into what is happening during menopause, we have to take a look at the different types of hormones in a woman’s body and what they are responsible for. Here is a simplified list: Estrogen Produced by: Ovaries (mainly), adrenal glands, fat cells Functions: Regulates the menstrual cycle Stimulates the growth of the uterine lining (endometrium) Develops female secondary sexual characteristics (breasts, hips, etc.) Maintains bone health and cardiovascular function Influences mood and cognitive function Influences the dryness of skin and hair cells, even in the vagina walls Maintains muscle strength by helping different proteins to combine when the muscle needs to contract. Pain modulator and more…. Progesterone Produced by: Ovaries (corpus luteum), placenta (during pregnancy) Functions: Prepares the uterus for pregnancy after ovulation Maintains pregnancy and prevents early contractions Regulates the menstrual cycle Supports breast development for milk production Follicle-stimulating hormone (FSH) Produced by: Pituitary gland Functions: Stimulates follicle growth in the ovaries Helps mature eggs for ovulation Works with estrogen to regulate the menstrual cycle Luteinizing Hormone (LH) Produced by: Pituitary gland Functions: Triggers ovulation (egg release) Stimulates the formation of the corpus luteum (which produces progesterone) Helps maintain early pregnancy Prolactin Produced by: Pituitary gland Functions: Stimulates breast milk production after childbirth Inhibits ovulation while breastfeeding Oxytocin Produced by: Hypothalamus (released by the pituitary gland) Functions: Triggers uterine contractions during labor Stimulates milk ejection during breastfeeding Plays a role in bonding and emotional attachment Testosterone (in women) Produced by: Ovaries, adrenal glands Functions: Supports libido (sex drive) Helps with muscle strength and bone density Affects mood and energy levels The Role of Hormones during the Menstrual Cycle. Since puberty, women’s lives are impacted by hormonal changes on a monthly basis. Indeed, once a woman starts her menstrual cycle, hormones dictate how she feels, how her skin looks, and how her hair and other body parts feel. This is possible because the body’s cells, in many of the body’s parts, are covered in hormonal receptors, especially for estrogen. Here, you will find a graph that shows how the hormones fluctuate during a woman’s menstrual cycle. Notice how in period time (Red bubble) and by the end of the Secretory Phase (Violet bubble), all the hormones, especially Estrogen, reach and maintain a low pick. To simplify the blog, we would focus on estrogen and progestogen hormones because those are the two primary hormones that play a role in the menopause journey (which includes the perimenopause and postmenopause time). Running low on Hormones and Menopause symptoms? Now that we analyse the role of the hormone in the menstrual cycle, we have a clearer idea of what does what and which hormone fluctuates in which phase of the month. Moving forward, we have to introduce the knowledge that women are born with all the eggs that they will ever release during menstruation. This is important information because this is what would roughly determine the start of women’s perimenopause and so menopause. I say roughly because during the 3 to 4 decades of menstruation cycles, each time, there would be a release of approximately 10.000 eggs per month for the first 2 to 3 decades and then less and less once perimenopause starts. So, on average, a woman is born with about 100.000 thousand eggs in her body, and on average, by the age of 30, she is lost about 90% of her eggs, and in her early 40′ s, she loses another 7% of those eggs, which marks already the perimenopause time (ZOE Podcast – with Dr Claire Haver). Indeed, the symptoms of menopause do not happen one day to another, even if menopause marks the day of 12 months of no menstrual cycle, but they start during perimenopause, which is a phase that begins about 10 to 7 years earlier than menopause. Now, you may start to understand all this “between” and “as per average,” which explains why the menopause experience is different from person to person, at least from the aspect of timing. Other factors play a massive role in symptom development and intensity, such as genetics, diet, external factors and stimuli, lack of exercise and movement, other pre-existing conditions, and more. What Happens Once Fewer and Fewer Eggs Get Released in a Menstrual Cycle? As we have previously seen, the level of hormones changes based on the body’s necessity to release eggs cyclically. But as a woman starts to run low on the amount of eggs released, the body also changes the production of hormones, and this is where things start get complicated. So, from a more regular fluctuation of hormone levels, the body finds itself with a more randomised and unpredictable production of hormones, and all the glands and organs responsible for hormone production and for the body’s functionality would start to be heavily affected by this. Indeed, as we already expressed earlier, Estrogen reaches its peak during the proliferative phase (the orange bubble in the above graph), which now is going to slowly disappear, and so less and less Estrogen is going to be produced. Estrogen, as described in the previous table, has a huge list of implications, and all the body functions that depends from Estrogen presence are going to be affected. Here we go then, during the perimenopause, with symptoms like: Irregular periods (shorter, longer, heavier, or lighter) Missed periods or unpredictable cycles Sudden warmth, flushing, or sweating (mainly upper body Night sweats cause sleep disturbance Difficulty falling or staying asleep Waking […]

How Strength Exercises Can Help With Bone Density

An image showing different level of Bone Density

Bone density is a key factor in bond fracture prevention. Bone is made of cells that die and regenerate. When this process is compromised, the risk of fracture arises. During the early stages of life, we can ensure that we intake and store calcium through food to build up our bones, but after a certain age (about 30), the body stops absorbing calcium, and the storage that we created is now our reserve for the rest of life. Cell Regeneration in Bone and Other Body’s Tissues The body’s cells, like muscle cells, skin cells, tendon cells, ligament cells and even bond cells, are in constant change via a process called cell regeneration. Old cells die off and they get replaced with new cells. In the case of bone, the cells that allow this process to happen are called osteoblasts. While we age, this process slows down, meaning that cells would still die, but they don’t get replaced. A typical example is a woman going through menopause. Estrogen, which is the hormone responsible for bond metabolism, allows the activity of osteoblasts. During menopause, indeed, women have a drop in Estrogen production, and osteoblasts are not as operative as they used to be. Strength Exercises and Cell Regeneration As this meta-analysis shows, strength exercises are a positive stress stimulus for the body and can help the osteoblast work harder and maintain bone cell regeneration. When the body perceives stress as physical resistance, it does its best to establish a reparation mechanism. So whenever we pick a weight against gravity, the body would implement a regeneration of the tissue that are used to complete this action. Who Is at Risk of Losing Bone Mass? There are several factors that can contribute to decreased bone mass: Age: Bone density typically peaks in early adulthood and declines with age. Gender: Women, especially postmenopausal, are at higher risk due to hormonal changes that accelerate bone loss. Family History: A family history of osteoporosis can increase risk. Body Size: Individuals with smaller body frames may have less bone mass to draw from as they age. Hormonal Levels: Thyroid imbalances and reduced sex hormones can lead to bone loss. Dietary Factors: Low calcium and vitamin D intake contribute to diminished bone density. Lifestyle Choices: A sedentary lifestyle, excessive alcohol consumption, and smoking are linked to weaker bones. I have included factors like dietary and hormonal levels in the above list. Bear in mind that taking supplements such as calcium and vitamin D (which helps retain calcium) could have severe contraindications. So, always talk to your doctor or specialist about the intake of supplements. How to determine Bone Density? To determine bone density, there is a diagnostic test called Dual-energy X-ray Absorptiometry (DEXA or DXA). This non-invasive procedure measures the mineral content in bones, usually in areas like the spine, hip, or wrist, to assess bone density and identify potential risks of osteoporosis or fractures. The results are given as a T-score, which compares your bone density to the average peak bone mass of a healthy young adult. A T-score of -1.0 or above is considered normal, while a score between -1.0 and -2.5 indicates low bone mass (osteopenia), and a score of -2.5 or lower suggests osteoporosis. Other methods, like ultrasound or quantitative computed tomography (QCT), can also assess bone density, but DEXA remains the gold standard for bone health evaluations. Mobility before strengthening So far, we have discussed how strength exercises are a good way to maintain bond density. Still, I would not recommend that anyone who is not into strength exercise and has bone density issues go and start lifting heavily. Why (?), you may ask. Well, before we start lifting heavy, we want to ensure that the body mechanics are optimal for it, so we better start looking into your mobility and then pass on to the strength part of things. Please be aware that mobility has nothing to do with elasticity or stretching. Those are different practices. How Can We Achieve Great Mobility For people who decide to take a journey to ensure an optimal level of mobility and then strengthen the body, the first step is to assess their joint mobility with active and passive range of motion. After that, we could use a combo of Myotherapy treatment and mobility exercises to ensure they can quickly pick up the best of their mobility capacity, given their subjective presentation. And here is a list of mobility exercises which we may look into at first: Hip Openers to improve range of motion in the pelvis and lower back. Ankle Drills to support proper weight distribution in weight-bearing exercises. Thoracic Spine Mobility Exercises to prevent excessive strain on the lower back. AC Joint External rotation to ensure we can build strong rotator cuff muscles, essential for shoulder health It Is Time To Strength. How Can We Do This? Once the minimum mobility is achieved, which may take 1 to 2 weeks of training, depending on each individual and their subjective history and effort, we can start looking into more strengthening exercises. So, here is a list of different exercises that can help with strengthening, written with the progressions to follow: Calf raises with double leg, single leg and weight Hamstring and Quads Curl that gets weight added as weeks go by Standing Adduction and Abduction at cable machine or with resistance bend Glut Muscles training at cable machine or with resistance bend Deadlift for back and posterior chain muscle strength Squat with weights and explosion variations Cuff rotator-specific strength is Ideal before stepping into more complex arm weight-lifting Cervical muscle strength to prevent cervical headache and sore neck All of those exercises, except the cervical one, can then be modified to achieve plyometric drills and combined movement. But this is a process that would take months, and there is no rush to get to it, as I want you to be safe throughout the entire journey. Integrating Exercise into Myotherapy Treatment At Melbourne Massage and Treatment, I incorporate […]

How Lymphatic Drainage Massage Can Help with Menopause Symptoms?

Menopause abstract raffiguration

Menopause is a natural transition in every woman’s life, which marks the end of a woman’s menstrual cycles and fertility. Typically menopause occurs between the ages of 45 and 55, even if there are exceptions. Along this time frame, the woman’s body would go through a major change in hormonal balance that can trigger a variety of physical and emotional symptoms which may affect daily life. As a Lymphatic Drainage practitioner, I get to work with a lot of woman who seek relief from those symptoms with Lymphatic Drainage Massage (also known as Manual Lymphatic Drainage – MLD). This therapeutic technique focuses on stimulating the lymphatic system to improve circulation and can stimulate a deep relaxation feeling. When do Menopause Symptoms start? Menopause symptoms start earlier than menopause itself. Indeed, symptoms can begin 10 years or several months before actual menopause, and this is the phase called Perimenopause. Different women, based often on their genetic background and lifestyle, would experience completely different symptoms with various intensities. But let’s have a look at what those symptoms are like: Lack of estrogen (not only during the menstrual cycle days); Irregular periods and heavy bleeding; Hot flashes (less common than what you think); Heavy mood swings; Disturbance in sleeping; Brain fog, which means difficulty concentrating, feeling mentally foggy, and struggling with simple tasks; Memory problems with difficulties in recalling names or words and challenges with verbal memory; Anxiety and Depression; Fatigue and Low Energy; Lightheadedness or dizziness; Ringing in the ears (tinnitus) can also occur; Wright gain, even with no change in diet; Low libido; Change in skin and hair consistency; Exceed of body hair, especially facial; Joint and muscle pain. These are some of the most common symptoms, which are often related to a drop in estrogen or changes in other body’s hormones. What are the changes between perimenopause and Menopause? The shift between those two phases is characterised by the fact that the woman would stop ovulating, and menopause starts at the end of the 12 months with no ovulation. Symptoms can settle as time passes by, but this is a really personal journey, and from what I heard and read, everyone experienced their own journey differently. Per my understanding, thought, an equilibrated lifestyle, which includes regular time for sleep, movement (with resistance, so strengthening), and an anti-inflammatory diet, is a key component for balancing those symptoms and improving the menopause experience. At the end of this blog, I would leave some links to books and podcasts I found (as a man) interesting to undestand better what a woman may go through this time of life. What is Lymphatic Drainage Massage, and how it works? Lymphatic Drainage Massage is a specialized form of gentle, rhythmic massage that aims to stimulate the body’s lymphatic system, which is responsible for removing waste, toxins, and excess fluids from tissues. The lymphatic system plays a crucial role in immune function and maintaining fluid balance in the body. During the treatment, I would with my hands, perform light stretches and gentle pressure on your skin, starting at the cervical area and moving distally from there. The consequence of these light, repetitive skin stretch and pressure would boo the capillary of the Lymphatic System to work faster and harder, consequently collecting more lymph liquid, reducing potential swellings, and improving body fluid circulations. Only the area that I working on too would be exposed. The rest of the body is covered with a towel all the time. How Lymphatic Drainage Massage Can Help Alleviate Menopause Symptoms Many women have found Lymphatic Drainage Massage a beneficial complementary therapy during menopause. Here’s how it may help with specific symptoms: Reducing Fluid Retention and BloatingGiven the ability of the lymphatic system to collect exceed liquid, Lymphatic Drainage Massage can help reduce water retention and bloatiness, which are common complaints during menopause. Also, when working on the abdominal area, MLD can help in speeding the bell and bludder functions. Improving Sleep and Reducing FatigueThe constant repetitive mechanical stimulation of the skin, stimulates the parasympathetic response of the central nervous system, that promote relaxation. This results in contributing to sleep quality and reducing fatigue during the day. Relieving Joint and Muscle Pain Along with the stimulation of fluid circulation and the parasympathetic nervous system (rest and digest mode) lymphatic drainage massage promotes relief of stiffness and reduces discomfort in muscles and joints. Managing Stress and Mood SwingsThe calming effect can help balance mood swings and reduce stress by affecting the cortisol level in the body. Massage has been shown to stimulate the production of endorphins, the body’s natural “feel-good” hormones, which can help elevate mood and reduce symptoms of anxiety or depression. Enhancing Skin HealthAs menopause can cause dry skin, LDM may help by improving blood flow, promoting detoxification, and increasing the delivery of nutrients to the skin. This can lead to healthier, more radiant skin. Supporting Hormonal BalanceWhile lymphatic massage cannot directly balance hormones, it can help reduce the toxic load on the body by facilitating detoxification, which may support overall hormonal balance. Is Lymphatic Drainage Massage Safe During Menopause? Lymphatic Drainage Massage is generally considered safe for most women, including those going through menopause. However, as already stated on the MLD page of my website, there are a series of contraindications that went to make sure we tick off before commencing any treatment. For more details about those conditions click here. Melbourne Massage and Treatment Location, Charges and Giovanni’s Lymphatic Drainage Massage Training. Location: Currently, my clinic is situated in Fitzroy North at Level 1/175 Holden St. This is right at the corner between Holden St, and St George Rd. The clinic is wheelchair accessible and has wheelchair accessible toilet too. To get here, you can use Tram 11 Stop 24, Tram 96 Stop 19 (the 96 Tram is 8 minutes’ walk), or Train Stop Rushall (the Train stop is 10 minutes’ walk). If you are driving, you can find the car park on Barkly St or Pilkington St. Please […]


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