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Preventing Lymphoedema

Posted on by Giovanni La Rocca
2 feet where one has lymphoedema
24
Dec

Lymphoedema is a condition that causes swelling in the arms, legs, or other parts of the body, often due to an impaired lymphatic system. For many, this condition can be a result of surgery, radiation therapy, or injury to the lymph nodes. Although preventing lymphoedema cannot always be entirely achievable, there are several proactive strategies that high-risk individuals can adopt to minimise their chances of developing this debilitating condition. At Melbourne Massage and Treatment Lymphoedema Clinic in Coburg, we specialise in offering personalised care to prevent lymphoedema from progressing, and our experienced therapist, Giovanni, is here to guide you through some of the most effective preventive measures. Understanding Lymphoedema: Who’s at Risk? Certain individuals are at higher risk of developing lymphoedema, especially those who have had cancer treatments that involved the removal of lymph nodes or radiation therapy. Other risk factors include: Surgical procedures involving lymph node removal Radiation therapy, which can damage the lymphatic system Infections that affect the lymphatic system Trauma or injury that affects the lymph nodes or vessels Genetics, as some people are born with a predisposition to lymphoedema Smoking people who are smokers are more at risk of Lymphoedema Obesity, elevates the risk of lymphoedema Even if you haven’t yet developed lymphoedema, but are at high risk, it’s crucial to implement lifestyle strategies that can help in its prevention. To better understand the level of your risk of developing Lymphoedema, check the following link: • Arm Lymphoedema Risk Table • Leg Lymphoedema Risk Table Top Tips for Preventing Lymphoedema Here are some effective strategies to help prevent lymphoedema from developing: Maintain a Healthy Weight Carrying excess weight can put added pressure on the lymphatic system and increase the risk of developing lymphoedema. It is essential to manage your weight through a balanced diet and regular exercise. Maintaining a healthy weight will help reduce the strain on the lymphatic vessels and promote optimal fluid circulation. Stay Active Exercise is one of the most effective ways to keep your lymphatic system functioning well. Movement helps to stimulate the flow of lymph fluid, which reduces the risk of fluid retention and swelling. Simple low-impact exercises, such as walking, swimming, and tai-chi can be great options for lymphatic health. But also strength training can boost circulation and prevent lymphoedema from developing. Each exercise program is something to look into along the different stages of Lymphoedema, and it is also based on your previous and current level of fitness and medical history. On the other hand, avoid prolonged periods of immobility or standing, as these can increase the likelihood of fluid build-up. If you have a sedentary job or lifestyle, take regular breaks and move. Little move are better then no move at all. Wear Compression Garments Compression garments help maintain fluid circulation and prevent swelling. For individuals at risk, wearing compression sleeves, stockings, or garments as made on measurement can help prevent lymph fluid from accumulating in affected areas. Giovanni can recommend clinics where to get the compression garments from, and he would highly recommend staying away from the pharmacy type of garments worn, as they are most likely not going to serve their presentation and can lead to more discomfort than benefit. Protect Your Skin and Limbs Skin protection is essential to reduce the risk of infections, which can trigger or worsen lymphoedema. Minor cuts, insect bites, or burns can cause infections that may lead to fluid retention. Ensure your skin is clean, moisturized, and free from scratches. If you are at high risk of lymphoedema, be mindful of potential skin injuries and take precautions to prevent cuts or wounds, especially on limbs that are at risk. After showering, make sure to dry your skin well and avoid, where possible, synthetic clothes, which may keep the level of humidity on the skin and not let it breathe. Practice Good Hydration Staying hydrated is crucial for maintaining overall health and supporting the function of your lymphatic system. Drinking enough water helps to keep your lymphatic system flowing smoothly and reduces the chances of fluid retention and swelling. Even though there is no general recommendation of how many glasses of water you should drink daily, make sure not to feel dehydrated, depending on your activity levels, environment, and overall health. Water also can be absorbed into the body by the intestine from the food that we eat. So ensure to eat plenty of veggies and fruit, that not only would come with diet benefits, but would ensure you are taking enough water per day. Monitor Your Health Regularly Regular monitoring of your body, especially areas that may be more prone to swelling, is key. If you notice any signs of swelling, tightness, or discomfort, it’s important to address these symptoms early before they progress. Giovanni at Melbourne Massage and Treatment, Lymphoedema Clinic offers personalised assessments and treatments to ensure that potential issues are identified and treated early. We specialize in lymphatic massage and other treatments that can help prevent the onset of lymphoedema. Limit Heat Exposure Heat can cause blood vessels to expand and may increase the risk of fluid build-up in the limbs. For individuals at risk of lymphoedema, it’s best to avoid excessive heat from hot showers, saunas, or prolonged sun exposure. If you need to be in hot environments, try to keep your limbs elevated to reduce swelling. Manage Stress Effectively Chronic stress can affect the functioning of your immune and lymphatic systems, making it harder for your body to fight infections and manage fluid balance. Engaging in relaxation techniques such as deep breathing, meditation, or mindfulness can reduce stress and support overall lymphatic health. Avoid Tight Clothing and Jewelry Tight clothing, especially around the arms or legs, can restrict the flow of lymph fluid and increase the risk of lymphoedema. Avoid wearing tight-fitting garments or jewellery that may impede circulation, and opt for loose, comfortable clothing instead. This includes bras and underwear. Indeed, in the case of bras, they can put pressure right on the […]

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Running and Hip Impingement

Posted on by Giovanni La Rocca
Giovanni using a belt to deliver a mobilisation on hip for hip impingement
20
Dec

Running is a fun activity and top of one of the most common sports activities among adults, it is a good sport for increasing insurance, cardio, and building strength in the lower limb joints and bond. Yes, you red that right, running can help in building bone mass and make your joint stronger. About the joint strength, it is possible, if you have been training for the right amount of time doing what your body can do, but by still following simple biomechanics rules. On the other hand, there is a common pain presentation for male runners in their 30’s to 40’s that is Hip Impingement. Is there a right way to run? The shortest answer to this question is no. No, there is no right way to run; everyone is different, and we are all going to act differently when asked to do something, and that’s okay. On the other hand, there are certain things we should all look into before commencing run training. One of these is the mobility of our lower joints, like the big toe and the ankle. It is all connected As per already explained in the mobility stability blog, we know that the body has joint which are mobile, and joints which are stable. Those joints are sitting one after the other one in a sequence like: mobile, stable, mobile, stable etc… The toes are mobile joints, the metatarsals are stable joints, the ankle is mobile, the knee is stable, and the hip is mobile. For the purpose of this blog, we stop at the hip. Now, when we run or even walk, we grip the ground with the toes. The big toe specifically has to take the major part of the load, as it is in line with the centre of mass, and therefore, to allow most of the movement, it needs to be able to extend to a certain degree. For walking 45°, for running 65°, for sprinting 85°. If this extension is limited or missing, the stable joint above will try to compensate for this missing mobility, and this thing would get funny. Hip joint The hip joint is a ball-socket joint type, where the socket is part of the pelvis, and the ball is the top part of the femur. Now, those two bonds are interconnected via a series of ligaments and can already present different person per person. So there is one who may have a retroverted hip, or an antroverted hip, which means, retroverted the back side of the femur head is bigger than the anterior one, and antroverted the opposite, the anterior side is bigger than the posterior one. That presentation can manifest issues when someone is trying to do a squat or a hip hinge. Restricted ankle dorsiflexion can lead to hip impingement Going back to the mobility stability chain, when the dorsiflexion of the ankle is compromised, which would happen when a big toe is not acting as a mobile joint, this disbalance of movement would create repercussions on the hip socket. Now, we have the knee between the ankle and the hip, which is a stable joint. If the ankle is not dorsiflexing correctly, the knee will start banding to the side to try to accommodate the shock absorption and the lack of ankle mobility. When this happens, the femur leans to one side more than the other, starts pushing into the pelvis’s socket, and grinds the ligaments. Yes, because if the knee goes laterally during the running motion, on its opposite side, the femur will go medially. This mechanism is called hip impingement, and we know that male runner in their 30s to 40s are really prone to this presentation. In more technical terms, we refer to hip impingement as FAI or Femoroacetabular Impingement, where acetabulum is the name given to the socket of the pelvis. More about FAI There are two main types of Hip impingements: CAM impingement and Pincer impingement. CAM impingement occurs when the femoral head loses its spherical shape at the head-neck junction, resulting in an altered head-neck ratio and impingement. On the other hand, Pincer impingement involves excessive prominence of the acetabular rim, causing the femoral head to pinch against it. Diagnostic tests like the FADDIR maneuver, commonly used to detect FAI, show variable accuracy. Studies on different age groups and sport-specific populations have reported sensitivity and specificity rates ranging from 41% to 80%, highlighting the complexity of diagnosing FAI, especially when distinguishing between CAM, Pincer, or mixed types. Prevention of hip impingement In order to minimise the chance to suffer from this presentation, is good to analyse the dorsiflexion of the ankle. For this there is a really simple test, called knee to wall, which anyone can do in their home. What you would need is a wall, and an mesuring tape or ruller. The idea is to stand 10 cm away from the wall, and that’s the distance between the big toe and the wall. The second foot is sitting behind at a comfortable distance to maintain equilibrium. The side that we are testing has to start bending at the knee, aiming to touch the wall with the knee itself. The heel of the foot tested can’t lift off from the ground, whereas the other heel can. Ideally, we can reach the wall with our knees. If not, step 1 cm forward, and try again, till the time you find the distance that you can cover. Ideally, the average distance that should be able to cover is 10 to 12 cm. Recovery from a hip impingement If you are already experiencing a hip impingement, it would be advised to seek help. Book now a Myotherapy session to start your journey of recovery. During the initial consultation, we would evaluate your clinical history and sports activities and perform some testing, including the knee-to-wall. After that, if we confirm that your presentation is a hip impingement, we will start working on mobilising the ankle and the hip […]

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Treatment Options for Lymphoedema

Posted on by Giovanni La Rocca
A-therapist-applying-combine-decongestive-therapy-via-bandages-to-a-lymphoedema-arm
14
Dec

Hello, and welcome! I’m Giovanni, and today I want to share some insight into the available treatment options for lymphoedema. If you or someone you know is dealing with this condition, I understand how overwhelming it can feel to navigate the many different approaches to treatment. As someone specialising in lymphoedema management through Manual Lymphatic Drainage (MLD) and Complex Decongestive Therapy (CDT), I aim to provide a holistic approach to managing and reducing the symptoms of lymphoedema. I’ve studied with the Vodder Academy and am a Clinical Myotherapist, so my work is built on solid, evidence-based practices. But I also believe that looking at all available treatment options for lymphoedema —medical, surgical, and holistic—is key to finding a management strategy that works for you. What is Lymphoedema? Before we dive into treatment options, let me quickly touch on what lymphoedema is. Lymphoedema is a condition that causes fluid retention and swelling, usually in the arms or legs, as a result of damage or blockage to the lymphatic system. This can occur after surgery, radiation treatment, or due to inherited conditions. While lymphoedema may be chronic, the good news is that with the proper treatment, symptoms can often be managed or reduced significantly. Medical Treatment Options for Lymphoedema Medical treatments for lymphoedema typically focus on managing the fluid buildup and improving lymphatic drainage. Here’s a quick overview of what you might expect in a clinical setting: Compression Therapy Compression garments are often a cornerstone of lymphoedema management. They help reduce swelling by applying controlled pressure, which encourages the flow of lymph fluid. These garments come in different forms, including- Stocking – Sleeves – Bandages They can be custom-fitted to provide maximum comfort and effectiveness. Compression stockings are recommended to be purchased from a clinic that takes measurements of your limb and makes the stockings based on the measurements. I often refer my patients to Sigvaris in West Melbourne for these types of services.’ The benefit of this approach is that you will have a compression that is ideal for your limb, with no greater risk of fluid congestion and other side effects. Pharmaceuticals and Diuretics In some cases, medications may be prescribed to address symptoms like inflammation or to reduce fluid retention. However, it’s important to note that diuretics are generally not a primary treatment for lymphoedema, as they don’t directly address the underlying lymphatic issue. Other medications that are prescribed for Lymphoedema are creams to maintain skin moisturised in order to reduce the chance of cracking and skin damage. Manual Lymphatic Drainage (MLD) I specialise in MLD, a gentle, hands-on technique that stimulates the anastomosis of the lymphatic system and encourages the movement of excess fluid from swollen areas. MLD can be incredibly effective in reducing swelling and relieving discomfort. It works by stretching and letting the skin recoil under some really gentle pressure. This way, the lymphatic system is stimulated to work harder, and takes up the fluid to healthier parts of the body where it can be processed more efficiently. Combine Decongestive Therapy (CDT) It is part of the treatment I offer for Lymphoedema patients here at Melbourne Massage and Treatment. It consists of bandages used to compress the affected area. The compression is applied after MLD has been delivered, and it is applied to maintain fluid movement throughout the anastomosis, which is the alternative connection of the lymphatic system through which the liquid moves after the MLD stimulation. The bandages are applied and are recommended to stay on for about 24 hours. After this time, once you remove them, you will wash them, roll them and come back for another treatment. A back-to-back treatment would ensure that the swelling of the lymphoedema can be managed and reduced as quickly as possible. Laser therapy Laser therapy is a non-invasive treatment that can be used in a clinical setting to treat specific lymphoedema presentations. Indeed, Laser therapy is used when the patient already presents with fibrosis, the hardening of the skin. Low-frequency lasers are the ones used most often, and we know there are also portable pen lasers that are efficient enough for this therapy. Pneumatic compression therapy: This therapy consists of using a sleeve pump machine that gets placed over the affected area and inflates sequentially to apply pressure. The rhythmic compression helps stimulate lymphatic flow, reduces swelling, and improves circulation by encouraging the movement of excess fluid toward lymphatic drainage sites. All those therapies are recommended in combination. To start with, for the best results and quick reduction, MLD and CDT would be more effective. Surgical Treatment Options for Lymphoedema While surgery is generally considered a last resort for lymphoedema, there are certain cases where it may be necessary or beneficial: Liposuction for Lymphoedema This technique is sometimes used to remove excess fat tissue that has accumulated as a result of chronic lymphoedema. It’s not a cure, but it can help reduce the volume of swelling and improve the appearance of the affected area. Lymphovenous Anastomosis (LVA)/Bypass It involves connecting the lymphatic vessels and nearby veins, allowing excess lymph fluid to drain into the bloodstream instead of accumulating in tissues. Vascularized lymph node transfer (VLNT) a surgical technique used to treat lymphoedema by transplanting healthy lymph nodes along with their blood supply to the affected area. The transplanted lymph nodes, typically harvested from the patient’s groin or other regions, are reconnected to the recipient’s blood vessels. Lymph Node Transplantation In some specialised cases, surgeons may transplant healthy lymph nodes from one part of the body to another to help restore lymphatic drainage. This option is more complex and is usually reserved for severe, treatment-resistant lymphoedema. Surgery, of course, comes with risks and recovery time, so it is typically considered only after all other treatments have been explored. Lymphoedema Holistic Treatments: Taking a Whole-Body Approach While medical and surgical treatment options for lymphoedema can certainly help with this presentation, I firmly believe that a holistic approach is crucial for long-term success. Here are some natural and complementary therapies […]

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Frequently Asked Questions about Remedial Massage

Posted on by Giovanni La Rocca
09
Dec

Remedial massage is a popular therapeutic technique designed to alleviate pain, reduce muscle tension, and restore function in individuals suffering from muscular conditions, injuries, or chronic pain. It is more than just a way to relax, it’s a targeted therapy designed to address specific muscular issues and improve overall well-being. At Melbourne Massage and Treatment, we understand whether you’re new to massage or considering it as a treatment option, it’s natural to have questions about this specialised therapy. Key Takeaways Remedial massage targets specific issues like pain, tension, and mobility restrictions. It offers benefits such as pain relief, stress reduction, and improved circulation. Ideal for those recovering from injuries, dealing with chronic pain, or experiencing postural issues. Sessions include assessment, targeted therapy, and follow-up guidance. Common Frequently Asked Questions About Remedial Massage Here, we answer the most commonly asked questions to help you make informed decisions to get remedial massage service for your health and wellness. What is remedial massage? Remedial massage is a therapeutic technique aimed at treating musculoskeletal pain, injuries, and chronic conditions. It targets specific areas of discomfort to relieve pain, improve mobility, reduce muscle tension, and aid rehabilitation. How does a remedial massage differ from a regular massage? Unlike regular massages that focus on relaxation therapy, remedial massage is targeted and therapeutic. It addresses specific muscle issues like tension, pain, or injury using techniques like deep tissue, trigger point therapy, and myofascial release. What conditions can be treated with remedial massage? Remedial massage can treat muscle tension, chronic pain, sports injuries, headaches, sciatica, postural imbalances, whiplash, and carpal tunnel syndrome. What should I do before a remedial massage session? Arrive early, wear comfortable clothing, stay hydrated, and communicate any specific areas of discomfort to your therapist. What should I expect during a remedial massage session? You’ll lie on a massage table while the therapist uses techniques like deep tissue massage, trigger point therapy, myofascial release, and stretching to relieve muscle tension and improve flexibility. Can remedial massage help with stress and anxiety? Yes, remedial massage can help reduce stress condition by promoting relaxation and lowering cortisol levels, offering relief from both physical and mental tension. How do I find a qualified remedial massage therapist? Look for certified therapists with accredited training, experience in treating specific conditions, and good reviews or recommendations from others. Can remedial massage be combined with other treatments? Yes, it can complement treatments like physiotherapy, chiropractic care, or acupuncture. Just ensure all therapies are coordinated to avoid interference. What should I do after a remedial massage session? Drink plenty of water, avoid intense exercise for 24 hours, rest, and follow any mobility or rehabilitation exercises suggested by your therapist. Can I book a remedial massage if I am pregnant? Yes, many therapists specialise in pregnancy massage to relieve discomfort like back pain, swelling, and muscle tension. Be sure to inform the therapist about your pregnancy. Is remedial massage effective for long-term pain management? Yes, regular remedial massage can be effective in managing chronic pain by reducing stiffness, improving mobility, and complementing other treatments like exercise and physical therapy. Can remedial massage improve my flexibility? Yes, remedial massage can help improve flexibility by releasing muscle tension and stretching tight areas. Techniques such as myofascial release and deep tissue work can enhance the range of motion, making it easier to move and stretch. Can remedial massage help with sports performance? Yes, remedial massage can enhance sports performance by improving muscle function, reducing tension, and increasing flexibility. It can also help in recovery, preventing injuries, and maintaining optimal muscle condition, especially for athletes who engage in strenuous physical activity. Is it safe to get a remedial massage while recovering from an injury? Remedial massage can be beneficial during recovery, but it’s important to consult with a healthcare provider to determine when it’s appropriate. Once the acute phase of the injury has passed, massage can help reduce scar tissue, improve circulation, and enhance the healing process. Can remedial massage help relieve migraine pain? Remedial massage can be effective in reducing migraine frequency and intensity by relieving muscle tension in the neck, shoulders, and scalp. Regular massage may also help with stress management, a common migraine trigger. Is remedial massage suitable for older adults? Yes, remedial massage can be very beneficial for older adults, particularly in managing conditions like arthritis, joint pain, and muscle stiffness. It helps improve mobility, reduce pain, and enhance overall comfort, but therapists may adjust the pressure for sensitivity and fragility. Can I receive a remedial massage if I have a medical condition? In many cases, yes, but you should inform your therapist of any medical conditions, such as heart disease, diabetes, or autoimmune disorders. They will tailor the treatment to ensure safety and effectiveness. Always consult with your doctor before starting therapy if you’re unsure. How do I know if remedial massage is right for me? If you’re dealing with musculoskeletal pain, stiffness, injury recovery, or muscle tension, remedial massage may be an excellent option. If you’re unsure, consult a therapist who can assess your condition and recommend a treatment plan tailored to your needs. Can remedial massage help with post-surgery recovery? Yes, once cleared by a healthcare provider, remedial massage can aid post-surgery recovery by reducing muscle stiffness, promoting circulation, and improving the range of motion. It can also help manage scar tissue and promote overall healing. Can remedial massage help with chronic fatigue? Remedial massage can help manage symptoms of chronic fatigue by improving circulation, reducing muscle tension, and promoting relaxation. Remedial massage is better for sleep improvement, which is essential for people suffering from fatigue. How can remedial massage support injury prevention? Remedial massage helps identify and address areas of muscle imbalance or tension, which can contribute to injuries. Regular sessions improve muscle flexibility, strength, and posture, all of which help reduce the risk of injury during physical activity. Is remedial massage beneficial for desk workers? Yes, remedial massage is especially beneficial for desk workers who may experience neck, […]

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Symptoms of Lymphoedema

Posted on by Giovanni La Rocca
A-therapist-applying-combine-decongestive-therapy-via-bandages-to-a-lymphoedema-arm
06
Dec

When the lymphatic system stop working, either because for a congential malfunctioning, or because of a an external intervention, which did lead to lymphatic system damage, the individual may start experiencing symptoms of Lymphoedema. At Melbourne Massage and Treatment in Coburg, Giovanni understand how challenging lymphoedema can be, which is why he provide expert care through Manual Lymphatic Drainage (MLD) and Combined Decongestive Therapy (CDT). These non-invasive treatments help manage the symptoms and improve your quality of life. What is Lymphoedema? Lymphoedema occurs when the lymphatic system is blocked or malfunctioning, leading to a buildup of lymphatic fluid. This fluid results in swelling in the affected areas, often in the arms, legs, or other extremities. Lymphoedema can be primary (a hereditary condition) or secondary (often caused by injury, surgery, or infection). The fluid that builds up in the body is a fluid that is naturally produced by the body and is released under the skin and between tissues by the bloodstream. It is reached in protein, bacteria, viruses, dust, and other minor substances that the body is unsure how to handle. Stages of Lymphoedema Lymphoedema progresses in stages, with each stage representing the severity of the condition. Recognizing the symptoms early on can help prevent the condition from advancing, so it’s important to be aware of the subtle changes in your body. Stage 0: Latent or Subclinical Stage In this early stage, there are no visible signs or symptoms of lymphoedema, but the lymphatic system may already be compromised. People in Stage 0 may experience a feeling of heaviness, discomfort, or mild swelling, int the limbs affected by this presentation, but these symptoms typically disappear after resting or with limb elevation. The fluid retention is still minimal and may not be noticed by the individual, but it can be detected through careful assessment. Stage 1: Reversible Stage At this stage, swelling is more noticeable, but the skin is still soft, and the swelling can still decrease with limb elevation and movement. When the swelling is present, the skin will feel puffy or tight, and there may be a sensation of heaviness in the affected area. In this relevant early stage, it i still easy to intervene for prevent further degeneration, and if you are unsure of what you are experiencing, reach out Giovanni for a 15 minutes free consultation, in which, at least thanks to the analysis of your clinical history, we can already evaluate if what you are experiencing is a Stage 1 Lymphoedema. Stage 2: Spontaneously Irreversible Stage In Stage 2, the swelling becomes more persistent and is not fully responsive to movement and limb elevation. The asking of the affected area may begin to feel firmer, and there can be noticeable thickening of the skin. This is the stage where fibrosis (scarring of the tissue) starts to develop, and it’s crucial to stop this from going any worse. While the swelling might fluctuate, it becomes more difficult to manage without intervention. At this point, manual treatments like Manual Lymphatic Drainage (MLD) can significantly help reduce swelling and improve the overall function of the lymphatic system. Stage 3: Lymphostatic Elephantiasis The final stage of lymphoedema is characterized by extreme swelling and thickened, hardened skin. The affected area may look large, disfigured, and become painful to the touch. Tissue fibrosis is advanced, and the skin may develop ulcerations or infections due to poor circulation and immune system function. Indeed, along with the swelling and the fibrosis buildup, the outer layer of the skin is placed further away from the blood capillary, which is responsible for releasing oxygen and other substances essential for skin regeneration.Therefore, as the skin breaks open, due to its poor condition, it is more subject to infections and contamination of pathogens. Stage 3 lymphoedema is debilitating and requires ongoing care and treatment to prevent complications and manage symptoms. At this stage, a combination of therapies such as Combined Decongestive Therapy (CDT) and MLD becomes vital for managing the swelling and restoring lymphatic flow. Common Symptoms of Lymphoedema Lymphoedema symptoms can vary from person to person and depend on the stage of the condition. The common symptoms include: Swelling: The most obvious sign of lymphoedema is swelling in the affected area, typically starting in the arms or legs. The swelling is often gradual and may worsen over the course of the day, especially after prolonged standing or sitting. Tightness or Heaviness: Affected limbs may feel heavy or tight, particularly after physical activity or at the end of the day. This sensation is often worse in the early stages and may become more pronounced as the condition progresses. Pain or Discomfort: Pain, tenderness, or discomfort in the swollen area is common, especially when there is fibrosis (hardening) of the tissues. The pain can range from mild to severe, depending on the stage. Reduced Range of Motion: As the swelling and fibrosis increase, it can lead to a limited range of motion, particularly in the arms and legs. This can impact daily activities and mobility. Skin Changes: In later stages of lymphoedema, the skin may appear thickened or leathery, with a shiny, tight appearance. There may also be visible folds in the skin, particularly around the knees, elbows, or ankles. Frequent Infections: Swollen tissues have a reduced ability to fight off infections, so people with lymphoedema are more susceptible to bacterial and fungal infections, which can further complicate the condition. Numbness or Tingling: As the swelling progresses, the nerves in the affected area may be compressed, leading to sensations of tingling, numbness, or even burning. Increased Skin Sensitivity: The skin in the affected area may become more sensitive, prone to rashes, or develop sores due to the increased swelling and poor circulation. Commonly Affected Areas of the Body Lymphoedema can affect different parts of the body, but the most common areas are: Arms: After surgery, particularly mastectomy (breast cancer surgery) that involves the removal of lymph nodes, the arms are a common site for lymphoedema. The swelling can […]

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Diagnosis of Lymphoedema

Posted on by Giovanni La Rocca

Lymphoedema is a condition often associated with cancer survivors, particularly those who have undergone surgery or radiation therapy, but it can also occur due to other chronic conditions or injuries. Characterized by the swelling of limbs due to the accumulation of lymphatic fluid, lymphoedema can significantly impact a person’s mobility, emotional well-being, and overall quality of life. Early diagnosis of lymphedema and management are key to preventing long-term complications, and at Melbourne Massage and Treatment in Coburg, Giovanni, a skilled Myotherapist and Lymphoedema therapist, specializes in identifying and managing this condition using a combination of manual techniques and physical assessments. In this blog, we’ll explore how lymphoedema is diagnosed, the challenges of identifying it early, and Giovanni’s approaches to detecting and managing the condition. What is Lymphoedema? Lymphoedema occurs when there is a disruption in the lymphatic system, leading to the accumulation of lymph fluid, a protein-rich fluid that sits beneath the skin and between the body’s tissue, which often causes swelling in the limbs or other areas of the body. This condition can develop due to a variety of factors, such as lymph node removal during surgery, radiation treatments, injury, or genetic predisposition. Early detection of lymphoedema is crucial to prevent the condition from worsening and causing complications like tissue fibrosis, infections, or reduced mobility. Challenges in the Diagnosis of Lymphoedema Lymphoedema can be difficult to diagnose, especially in its early stages. In its initial phase, symptoms such as heaviness, tightness, or mild swelling may seem subtle and easy to overlook. Patients might attribute these sensations to muscle strain or arthritis, delaying the diagnosis. Furthermore, swelling can fluctuate, making it even harder to identify at the outset. By the time noticeable swelling occurs, the condition may have already advanced, complicating treatment and requiring more intensive management. This is why early detection is so important, as it allows for less invasive treatments and better long-term outcomes. Giovanni’s Approach to Diagnosis of Lymphoedema As a Myotherapist and Lymphoedema therapist at Melbourne Massage and Treatment Lymphoedema Clinic, Giovanni uses manual techniques and physical assessments to diagnose lymphoedema. Although he does not use imaging technology or machines to detect the condition, Giovanni’s training and experience enable him to identify the signs and symptoms through careful observation, palpation, and physical examination. That said, if it is needed, Giovanni can write a referral doctor for your GP to indicate why he believes it is important for you to undertake a specific scan or some medical test. 1. History taking The earlier approach to Lymphoedema diagnosis is an extended look at the medical history, where any past surgery, injury, accident or medications need to be outlined and taken into consideration. 2. Clinical Assessment Following the history taken to diagnose lymphoedema is the clinical assessment. Giovanni conducts a thorough physical examination of the affected limb or area, paying close attention to key signs of lymphoedema, such as: Persistent swelling that doesn’t subside with rest Feeling of heaviness or tightness in the limb Changes in skin texture, such as hardening or thickening Reduced range of motion in the affected area Along with your booking confirmation, you would also receive a form to fill in online, which would start paving the road to your diagnosis. 3. Tape Measurement Method One of the simplest, yet effective, ways Giovanni diagnoses lymphoedema is by using tape measurements. This involves measuring the circumference of the affected limb at various points (e.g., wrist, forearm, upper arm) and comparing these measurements to the unaffected side. Over time, consistent and progressive changes in limb circumference can indicate the development of lymphoedema. While this method is cost-effective and easy to perform, it may not detect early, subtle changes in limb volume. However, when paired with other assessments, it offers valuable information about the progression of the condition. 4. The Pitting Test Giovanni often performs the pitting test, a hands-on method to assess fluid accumulation in the affected area. This simple test involves pressing down on the swollen area with his fingers. If an indentation (or “pit”) remains for several seconds after the pressure is released, it indicates the presence of excess fluid in the tissue, which is a hallmark of lymphoedema. The pitting test helps Giovanni evaluate the severity of fluid retention, but it is more subjective than advanced diagnostic tools. 5. Stemmer’s Sign – Tissue assessment Giovanni also uses palpation (manual examination through touch) to assess the affected area’s tissue texture and consistency. In the early stages of lymphoedema, the tissue may feel soft and puffy, but as the condition progresses, it can become firmer, and in some cases, the skin may develop a thicker, fibrous texture. These changes are essential indicators of lymphoedema and are crucial for determining the stage of the condition. In addition to this, the Stemmer’s Sign is a test that consists of picking what we would expect to be wrinkled skin, like the one just before the toe/tarsal joint. A positive test would result in the impossibility of pinching any skin due to the swelling in the area. 6. Lymphoscintigraphy A lymphoscintigraphy is a scan that is part of nuclear medicine tests, and it is specifically used to detect any interruption within the lymphatic system. The test is done in the specific clinic, and no recovery is needed for it. The procedure consists of injecting a radioactive liquid either in the feet or hands and with a specific camera, detecting the movement of the liquid within the body. We would expect the liquid to move within a certain timing and pathway along the lymphatic system. If that doesn’t happen, this test can give a good understanding if anything is not functioning with the lymphatic system. Why is Early Detection Crucial? The earlier lymphoedema is detected, the easier it is to manage. Early-stage lymphoedema is often easier to treat with less invasive interventions, such as manual lymphatic drainage (MLD), compression therapy (CDT), specific exercises, and skin care. These treatments can help reduce swelling, prevent the condition from worsening, and improve the […]

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Remedial Massage and Mental Health

Posted on by Giovanni La Rocca
30
Nov

At Melbourne Massage and Treatment, we understand that mental health is just as vital as physical health, which is why we offer tailored remedial massage therapies designed to not only alleviate physical discomfort but also enhance mental well-being. This holistic approach helps harmonise body and mind, creating a pathway to a more balanced lifestyle. Key Takeaways: Stress Alleviation: Remedial massage significantly lowers stress levels, promoting a calmer state of mind. Improved Sleep: Regular sessions can enhance sleep quality, directly impacting mental alertness and mood. Emotional Balance: The therapeutic touch of massage can help release emotional blockages, leading to improved mental health. Impact of Remedial Massage on Mental Health and Well-being The relationship between remedial massage and mental health is profound. By focusing on the body’s muscular and nervous systems, remedial massage can trigger positive changes in mood, stress levels, and emotional health. It achieves this through various mechanisms: Stress Reduction: Massage therapy is renowned for its ability to lower cortisol levels (the stress hormone) and increase serotonin and dopamine levels, which are associated with happiness and well-being. Enhanced Sleep Quality: By promoting relaxation and easing muscle tension, remedial massage can improve sleep patterns, which is crucial for mental health. Boost in Circulation: Improved blood flow ensures that more oxygen and nutrients are delivered to various parts of the body, including the brain, which can enhance cognitive function and mood. Understanding Stress and Muscle Connection One of the primary ways stress impacts the body is by causing muscle tension. This tension can become chronic, leading to pain, reduced mobility, and even a cycle of increased stress. Remedial massage breaks this cycle by targeting areas of tension, improving blood flow, and encouraging the muscles to relax. This release not only benefits physical health but also signals to the brain that it’s safe to unwind, creating a mental domino effect of calm and relief. Who Can Benefit the Most from Remedial Massage? While remedial massage is beneficial for nearly everyone, certain groups may find it particularly helpful for mental health: Professionals with High-Stress Jobs: Those in demanding careers often carry stress in their shoulders, neck, and back. Regular massage can alleviate this tension and prevent burnout. Students and Academics: Intense focus and long study hours can lead to physical and mental fatigue, which massage therapy can help combat. Parents and Caregivers: The responsibilities of caregiving can be both physically and emotionally taxing. Massage offers a restorative break and self-care opportunity. Athletes: Beyond physical recovery, athletes can benefit from the mental clarity and focus that massage provides. The Role of Professional Expertise The effectiveness of remedial massage relies heavily on the expertise of the therapist. A well-trained practitioner can tailor techniques to address both physical and emotional needs, ensuring a holistic experience. For example: Trigger Point Therapy: Targets specific areas of tension to release deep-seated stress. Myofascial Release: Focuses on the connective tissue surrounding muscles, helping to alleviate both physical and emotional restrictions. Relaxation Techniques: Combines gentle strokes with rhythmic movements to promote overall well-being. Creating a Sense of Safety and Comfort One often overlooked aspect of remedial massage is its ability to foster a sense of safety and comfort. The nurturing environment provided by skilled therapists allows clients to let go of their mental guards, fostering a state of deep relaxation. The physical touch involved in massage, when done professionally and respectfully, can also stimulate oxytocin, often referred to as the “bonding hormone.” This hormone promotes feelings of trust, connection, and emotional stability, all of which are crucial for mental well-being. Regulating the Body’s Nervous System The human body operates on a delicate balance between the sympathetic and parasympathetic nervous systems. When stress levels rise, the sympathetic system takes over, preparing the body for fight or flight. This prolonged activation can lead to mental health issues such as anxiety and burnout. Remedial massage counteracts this by activating the parasympathetic system, which promotes rest, digestion, and recovery. This physiological shift can calm the mind, lower heart rate, and encourage a sense of inner peace. Supporting Trauma Recovery For individuals recovering from trauma, remedial massage offers a unique and non-invasive method of care. Trauma often manifests physically, with tension and discomfort being common symptoms. Massage helps release these physical manifestations, providing relief while also creating an opportunity for emotional healing. Working with a trauma-informed therapist ensures that the massage is adapted to the client’s needs, offering a safe and empowering experience. Enhancing Emotional Awareness Many clients find that remedial massage helps them become more attuned to their emotions. As physical tension melts away, it’s not uncommon for individuals to gain clarity about their feelings or life situations. This enhanced emotional awareness can help in identifying stressors or triggers, paving the way for more effective mental health management strategies. The process of connecting with one’s body through massage can also encourage mindfulness, a practice known to improve mental health outcomes. Creating a Holistic Approach to Health Remedial massage is often most effective when combined with other health and wellness strategies. Clients can integrate massage therapy with: Regular exercise for physical and mental fitness. Mindfulness practices such as yoga or meditation. Professional counselling or therapy sessions for deeper emotional healing. Reducing the Impact of Chronic Stress Chronic stress is a silent yet significant contributor to mental health challenges. Left unmanaged, it can lead to a range of physical and emotional issues, including insomnia, anxiety, and even depression. Remedial massage addresses the physical manifestations of stress—tight muscles, lack of mobility, and tension headaches—while simultaneously calming the nervous system. This dual-action approach makes it an effective tool for managing long-term stress. By releasing tension stored in the muscles, remedial massage provides immediate relief and fosters a sense of mental clarity. Over time, regular sessions can help reset the body’s stress response, making it easier to cope with everyday pressures. Enhancing Connection Between Mind and Body Modern lifestyles often create a disconnect between the mind and body. Many people find themselves operating on autopilot, unaware of the tension or […]

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Causes of Lymphoedema

Posted on by Giovanni La Rocca
2 feet where one has lymphoedema
30
Nov

Lymphoedema is a chronic condition that occurs when there is a blockage or damage to the lymphatic system, causing the build-up of lymph fluid in the tissues, leading to swelling, discomfort, and other complications. At Melbourne Massage and Treatment in Coburg, Giovanni’s Lymphoedema clinic specializes in managing lymphoedema with a tailored approach, offering relief and improving the quality of life for those with this condition. Understanding the causes of lymphoedema is vital for effective prevention and management. Let’s explore the main causes of lymphoedema and how they impact your health. Primary Lymphoedema: Genetic and Congenital Factors Primary lymphoedema occurs when the lymphatic system does not develop properly from birth. This type of lymphoedema is often inherited and can develop during childhood, adolescence, or even adulthood. In some cases, the lymphatic vessels may be too few or poorly formed, while in others, they may become dysfunctional over time. There are several types of primary lymphoedema, with the most common being congenital lymphoedema, which presents at birth or in early childhood. Another type is known as lymphedema praecox, which usually develops during puberty, and lymphedema tarda, which can appear in adulthood. A major characteristic of primary lymphoedema is that the swelling start distally in the body, which means it start in the furthest point away, like feet or hands, and it move proximal to the centre of the body. Secondary Lymphoedema: Damage to the Lymphatic System Secondary lymphoedema is the most common form of the condition and is a result of a damaged lymphatic system. This can happen for a series of incidents. Here below is a list of mechanism of action that can result in a damage or disruption to the lymphatic system. Trauma and tissue damage burns varicose vein surgery large wounds scarring Venous disease chronic venous insufficiency venous ulceration post-thrombotic syndrome intravenous drug use Infection cellulitis/ erysipelas lymphadenitis tuberculosis filariasis Inflammation rheumatoid arthritis dermatitis psoriasis sarcoidosis dermatosis with epidermal involvement Endocrine disease pretibial myxoedema Immobility and dependency dependency oedema paralysis   Factitious self-harm   Other obesity medication Source: Lymphoedema Framework 2006 And more specifically and often: Cancer Treatment (Surgery, Radiation, and Chemotherapy) One of the leading causes of secondary lymphoedema is cancer treatment. Lymph nodes may be surgically removed or damaged during radiation therapy, impairing the body’s ability to drain lymph fluid properly. This is especially common in breast cancer, prostate cancer, and melanoma patients. Unfortunately, cancer and lymph node removal don’t work the same for everyone, and in order to prevent the lymphoedema from degenerating, it is better to keep an eye on the development of any swelling or other symptoms. Managing Lymphoedema at Melbourne Massage and Treatment At Melbourne Massage and Treatment in Coburg, we understand that the causes of lymphoedema can vary greatly from patient to patient. Whether your condition is primary or secondary, managing lymphoedema requires a comprehensive, personalized approach. Our skilled therapist, Giovanni, offers targeted manual lymphatic drainage massage and combined decongestive therapy as effective treatments to reduce swelling, alleviate discomfort, and improve overall function. By tailoring each treatment plan to address the unique causes of your lymphoedema, Giovanni ensures you receive the most appropriate care for your situation. If you’re experiencing swelling or discomfort due to lymphoedema, don’t hesitate to schedule a free 15-minute consultation with Giovanni to learn how our treatments can help you manage this condition effectively. FAQs About Lymphoedema Q: What are the common symptoms of lymphoedema? A: The most common symptoms of lymphoedema include swelling, a feeling of heaviness or tightness in the affected limb, limited range of motion, and discomfort or pain. Skin changes, such as thickening or hardening, may also occur over time. Q: Can lymphoedema be cured? A: Unfortunately, there is no cure for lymphoedema. However, it can be effectively managed with the right treatments, such as lymphatic drainage massage, compression garments, and lifestyle changes. These treatments help reduce swelling and improve the quality of life for those affected. Q: How can I prevent lymphoedema? A: While primary lymphoedema may not be preventable, secondary lymphoedema can be reduced by maintaining a healthy weight, avoiding infections, and following the advice of your healthcare team after cancer treatment or surgery. Early detection and management are key to preventing progression. Q: Can lymphoedema develop after surgery? A: Yes, lymphoedema can develop after surgery, especially if lymph nodes are removed or damaged during the procedure. It is essential to follow post-operative care instructions and monitor for any signs of swelling to address potential lymphoedema early. Q: Is lymphoedema painful? A: Lymphoedema can be painful, particularly when the swelling becomes severe or if the condition leads to infections. The discomfort can vary from mild to more intense, depending on the degree of swelling and any associated complications. Q: How is lymphoedema diagnosed? A: Lymphoedema is typically diagnosed based on physical examination, medical history, and symptoms. In some cases, imaging tests such as ultrasound, MRI, or lymphoscintigraphy may be used to assess the lymphatic system and determine the extent of the condition. Q: What treatments are available for lymphoedema? A: Treatments for lymphoedema include manual lymphatic drainage massage, compression therapy, exercise, skin care, and, in some cases, surgical interventions. A personalized treatment plan tailored to your specific condition can help manage swelling and improve lymphatic function. Q: Can I still lead an active life with lymphoedema? A: Yes, with proper management, people with lymphoedema can lead an active life. Regular exercise, such as walking or swimming, combined with treatments like lymphatic drainage, can help reduce swelling and improve mobility. Be sure to follow your therapist’s advice to maintain a balanced approach to physical activity. If you are experiencing lymphoedema symptoms or want to learn more about how we can help, book an appointment with Giovanni at Melbourne Massage and Treatment in Coburg. We are dedicated to providing effective care to help you live your best life.

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Understanding Lymphoedema

Posted on by Giovanni La Rocca
a finger pressing on a lymphoedema fit
27
Nov

At Melbourne Massage and Treatment, located in Coburg, I do understand that living with lymphoedema can be challenging, both physically and emotionally. As part of my commitment to providing exceptional care and treatment for my patient, I have created this comprehensive guide to help you better understand what lymphoedema is, its causes, symptoms, and how the lymphatic system works. Whether you’re newly diagnosed or managing the condition long-term, this guide will help empower you with the knowledge to make informed decisions about your treatment. What is Lymphoedema? Lymphoedema is a condition that causes swelling due to the improper function of the lymphatic system. The lymphatic system is responsible for draining excess fluid, proteins, and waste products from tissues back into the bloodstream. When this system is compromised, fluid can accumulate in the affected areas, causing swelling, discomfort, and other health issues. At Melbourne Massage and Treatment, I specialize in lymphoedema care and offer a range of services, like Manual Lymphatic Drainage and Combined Decongestive Therapy, to help manage the condition and reduce its symptoms, allowing you to live a more comfortable and active life. The Biology of the Lymphatic System To better understand lymphoedema, it’s important to first explore the lymphatic system’s function in the body. The lymphatic system consists of a network of vessels, lymph nodes, and other organs that help maintain fluid balance and support the immune system. Lymph Vessels: These small tubes transport lymph fluid, which contains immune cells, proteins, waste, and other substances. Lymph Nodes: These small, bean-shaped structures filter lymph liquid and trap harmful substances, such as bacteria and viruses, to protect the body, thanks to the action of the immune system. Lymph liquid: The fluid circulating throughout the lymphatic vessels, which is dug in the body by the bloodstream and collected by the lymphatic system. Lymphatic Organs: The spleen and tonsils also contribute to the lymphatic system, filtering blood and defending against infections. But along the list of organs that are part of the lymphatic system we also find bone marrow, spleen, thymus, tonsils and adenoids. The lymphatic system works by collecting excess fluid below the skin and between tissues and returning it to the bloodstream. The fluid is collected from anywhere in the body and is then delivered to the clavicle, cervical area, and is there where it gets discharged into the bloodstream. However, when the lymphatic system becomes damaged or obstructed, it can lead to lymphedema because the liquid can not be brought to the discharging destination. This may occur due to interruption of the lymphatic vessels or the removal of lymph nodes. Causes of Lymphoedema We classified Lymphoedema into two types: primary and secondary. Both types have different causes, and understanding the underlying factors can help guide appropriate treatment options. Primary Lymphoedema Primary lymphoedema is rare and is based on genetic predisposition. This condition arises due to an abnormal development of the lymphatic system. This form of lymphoedema can manifest at any stage of life, and when it does so, the swelling would start distally and move proximally: Congenital Lymphoedema: Present from birth, this occurs when the lymphatic vessels fail to form properly. Lymphedema Praecox: This type typically develops during adolescence, often affecting one or both legs. Lymphedema Tarda: This type occurs after the age of 35 and may be linked to genetic factors or environmental triggers. Secondary Lymphoedema Secondary lymphoedema is far more common due to external factors that damage the lymphatic system. In this case, the swelling would start proximal to the damaged area and move distally down the limb/s. These include: Cancer Treatment: This is particularly common after surgeries that remove lymph nodes or radiation therapy, which can interfere with the normal flow of lymph fluid. Infection: Conditions like cellulitis (skin infection) or parasitic infections can damage the lymphatic vessels and lead to fluid buildup. Surgery or Physical Trauma: Any injury or surgical procedure that affects the lymphatic system can result in lymphoedema. Lipedema: A presentation like lipedema that is characterised by excess fat accumulation can, in a late stage, increase pressure on the lymphatic vessels, impairing their ability to drain fluid effectively. Venous Insufficiency: Chronic venous insufficiency causes poor circulation and increases pressure on the lymphatic system. At Melbourne Massage and Treatment in Coburg, I work to support clients with lymphoedema, particularly those who have developed the condition due to cancer treatments or other medical interventions. Symptoms of Lymphoedema The main symptom of lymphoedema is swelling, often affecting one or both limbs. However, other signs and symptoms can also develop, especially if the condition is left untreated. Common symptoms include: Swelling: The affected area will swell, most commonly in the arms or legs, but can also occur in other parts of the body. The swelling may start gradually and worsen over time. Heaviness or Tightness: The swollen area may feel heavy, tight, or full, making it difficult to move the affected limb Reduced Mobility: As the condition progresses, the swelling can limit your ability to move the affected limb freely. Skin Changes: The skin may become thickened, dry, or prone to infection as the condition worsens. Frequent Infections: Due to the severe swelling, the skin is prone to cuts and cracks. Underneath, a high protein liquid is now present, which, when in contact with pathogens present in the air, can easily develop infections. If you experience any of these symptoms, it’s important to seek treatment promptly to manage the condition and prevent complications. At Melbourne Massage and Treatment, we offer a range of therapies designed to help reduce swelling and improve mobility. Treatment and Management of Lymphoedema While lymphoedema is a chronic condition, it is highly manageable with the right care. At Melbourne Massage and Treatment, we specialize in lymphoedema management and offer a holistic approach that combines various therapies to reduce swelling, improve circulation, and maintain quality of life. Treatment Options Include: Manual Lymphatic Drainage (MLD): A gentle, specialized massage technique that encourages the movement of lymph fluid and reduces swelling. Combined Decongestive Therapy (CDT): Application of bandages, applied post Lymphatic Drainage treatment, which are […]

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Meniscus tear

Posted on by Giovanni La Rocca
26
Nov

A meniscus is a cushion type of structure that sits between the femur head and the tibia, on the medial side of the knee and the femur and the fibula on the lateral side of the knee. Its role is to protect any friction between the femur head and the other bonds. In sports activities where there is a lot of stop-and-go or stop-and-twist type of motion, such as basketball or netball, the meniscus is put under intense stress, and the chance of injuries can increase. Meniscus tear classification? A meniscus tear is a type of injury that can be classified based on its severity and size. There are different types of classifications, but the most used and accepted is Laprade’s classification (LaPrade et al., 2014). Laprade classification of Meniscus root tears (MRTs) is based on the morphology during arthroscopic assessment. The classification includes five distinct lesions: Type 1 tears represent partial root tears that are stable (7% of all meniscus root tears). Type 2 tears represent complete radial tears within 9 mm of the root attachment centre (67.6%). This type of tear is then subdivided in three other sub-group based on the distance of the tear from the center of the root attachment (2A 0–3 mm, 2B 3–6 mm and 2C 6–9 mm). Type 3 tear was defined as bucket-handle tear with complete root detachment (5.6%). Type 4 tears are complex oblique tears with complete root detachment (10%) and bony avulsion of the root attachment (9.9%).   Meniscus tear symptoms In order to diagnose a meniscus tear, the gold standard method is an MRI scan. That said, nowadays, the only time you would get an MRI scan to your knee for a meniscus injury, is for surgery purposes, as we now know, that live with a meniscus tear is possible, as long as the muscle that across the knee joint are well looked after. That said, in the early stage, the symptoms of meniscus tear can include: Joint swelling Tenderness in the knee on the medial or lateral portion of the knee A feeling of catch in the knee as is moving Limited range of motion A feeling of the knee not able to hold the weight. Localised pain To alleviate the discomfort, the aid of a crutch, especially in the early stage, is recommended, and as per all acute phase injuries, the first few days, rest and movement with pain-free range of motion are extremely important. In addition to this, heat can be applied for intervals of 15 minutes once or twice a day. How do we rehabilitate a meniscus tear? As with all injuries, there is not one rehabilitation process that works for everyone, but there are guidelines that can be used to lead a recovery process. Let’s start with the acute phase (first phase), which is the first 72 hours. In this time frame, we would avoid putting direct weight on the affected side and, where possible, do simple knee flex/ext pain-free movements. Placing a pillow under the knee could help avoid locking the knee, which may not feel comfortable. Second phase: In this phase, which would be somewhere after the initial 72 hours, if it feels comfortable, we can start placing some gentle weight on the knee, even though using a crutch can still be acceptable, especially in the early stage of this phase. The second phase can last up to 5 or 6 weeks. An active range of motion, where the knee flexion is always greater, and the knee extension is getting closer to full extension, would keep increasing daily. In this phase, we can introduce Isometric exercises for knee flexion and extension. Those types of exercises can be done with a bench curl machine or an elastic band or ankle weight. What is most important is to start with lightweight or resistance, hold the weight for 40 seconds, and release for 40 seconds. The time frame can be adapted to the patient’s comfort. Halfway through this phase, we can start to introduce eccentric and concentric loads with weights and potential assisted sit and stands type of movement, with a chair that is higher than average and something in front of the patient where they can hold on to (like the back of another chair). As the patients’ confidence and muscles start responding more and more to these exercises, we can move to the third phase, and here we are in week 7 or 8. The chair for sitting and standing is now at average height; we may not need anterior assistance anymore. It is now essential to ensure the patient is walking and confident about placing weight on the affected side. Single-leg squats can be initiated, maybe even with the aid of a stick initially, and day by day without. The load on the anterior and posterior chain muscles of the thigh is increased, and as we move forward from week 10 to week 12, plyometric exercises can be introduced. Along those exercises, we look into explosive lunge, squatting, skipping the rope and running. A great test would be the hopping test, which consists of single-leg hopping, side to side. One minute of oping should not reproduce any pain. All these progressions are approximations of a natural healing process, and based on the individual presentation, this protocol can be modified and enriched as needed. Meniscus tear and surgery. In their meta-analysis of 6 randomised control trials, Meng et al., 2024, concluded that data favor exercise therapy over surgery as a first intervention for meniscus tears. These conclusions come from the fact that the pain reduction, estimated with the knee Knee Injury and Osteoarthritis Outcome Score (KOOS), does not show any difference between the arthroscopic partial meniscectomy (APM) and exercise therapy. That said, it doesn’t mean that surgery is never an option. What Meng et al., 2024 prove is that before heading for an invasive procedure, it is worth it to look into exercise therapy on its own. If the conservative method does […]

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Melbourne Massage and Treatment - - - Close for Holiday till the 25th/9/2023 - - -
To all the new and returning clients, thanks for being here . I am currently in holiday, and I will be back to give treatment on the week of the 25th/Sept/2023. If you are in severe pain, and feel unwell, please reach out for your GP. If you have any inquire, contact me by clicking here. Booking are open for the month of September and onward. Click here to book your next appointment.