Tennis elbow or even known as Lateral Epicondylitis, is a condition that occurs on the lateral side of the forearm, at the elbow’s high. A common cause is repetitive motions of the wrist and arm. Tennis Elbow refers to how common this condition can be in tennis players. Said so, Lateral Epicondylitis is a condition that can affect anyone. As per Golfer’s Elbow, the pain starts from the elbow area, in this case from the lateral side, and can irradiate down the arm to the wrist. Rest and counter medication can help relieve symptoms. In some cases, surgery is required. Tennis Elbow Symptoms The pain generated by the tennis elbow may radiate down the forearm along the lateral side (thumb side). In addition to the pain, you may experience weakness too. Here is a list of actions that may be difficult to do Shake hands or grip an object Turn a door handle Hold a cup of water Book now your next appointment to restore the mobility of your Tennis Elbow Causes Tennis Elbow As Lateral Epicondolytis is overuse and strain of muscle, it is caused by repeated contraction of the forearm muscles extensor. These repetitive stretches and movements can lead to tiny tears in the tendon tissue, creating inflammation and pain within the elbow area. Playing tennis with the pour technique often replicates this condition, especially using repeated backhand strokes. Many other common motions can cause tennis elbow. Here is an extended list: Using plumbing tools, which require strong grips Painting Using screwdrivers Food preparation, especially when the knife is not sharp Working in the office using a mouse for long hours Treatment Options At Melbourne Massage and Treatment, Giovanni offers a variety of options for treating Lateral Epicondylitis. MLD may be the most recommended per inflammation of tendons and muscles. Thanks to the light touch and repetitive movement, MLD stimulates the Lymphatic System directly, which takes care of the inflamed area. Combining Myotherapy, Remedial Massage or Thai Massage technique with MLD can help even release more tension along the arm and elbow. Tennis Elbow Exercises In addition to the massage technique offered at Melbourne Massage and Treatment, exercises placed as per usual a crucial role in recovery. Specifically, we can look in too eccentric exercises, which slow, lengthening muscle contractions. Here is a link to eccentric exercises for the Tennis Elbow. As you may notice in this video, the extension motion of the wrist is supported by the other hand. By doing so, the extensor muscle of the forearm that needs training is not working hard. So the actual strengthening happens in the wrist’s flexion when the extensor muscles are stretching under the extra pressure of the weight.
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Sep
Golfer’s Elbow also known as “medial epicondylitis” is an inflammation of the tendons that originates from the medial elbow side. The pain sensation can be local or spread along the forearm till down the wrist. Indeed, Golfer’s Elbow is similar to a tennis elbow, which occurs on the lateral side of the elbow. Both these conditions are not limited to those who play golf or tennis but can affect anyone who does repetitive movement their for usually builds pain usually builds up with time and can get quite intense if the condition is not looked after. Therefore, rest, massage and specific exercises are well recommended. Golfer’s Elbow Symptoms Pain: The area of pain as described above is around the medial side of the elbow and can spread down the forearm to the wrist Stiffness: The area of inflammation controls the forearm flexors, indeed, making a fist or flexing the fingers/wrist can be difficult or painful. Even the elbow can feel stiff in movement. Weakness: Due to the pain, you may experience weakness in the affected arm/forearm Numbness or tingling: Along the medial side of the elbow, pass the Ulnar nerve, which can refer to the ring finger and pinky finger with numbness or tingling sensation. Risk factors for Golfer’s Elbow Here below is the risk factors list for Golfer’s Elbow: Age 40 or older Doing repetitive movement of wrist/elbow daily Obese If this post talks to you, book your next massage session now. Golfer’s Elbow Treatment Option The treatment options for Golfer’s Elbow are many. Along Melbourne Massage and Treatment Services, MLD can be the least invasive and recommended. The gentle touch and repetitive mechanical stimulation of the cutaneous nervous system can help reduce inflammation, stimulate relaxation, and reduce swellings in the area. Said so, as MLD can have several absolute and partial contraindications. This treatment can not be applied to all. So other services such as Myotherapy, Remedial Massage or Thai Massage are more recommended. The treatment would aim to work on the surrounding area of the inflamed tendon to improve the tone of the forearm flexors. Medications such as anti-inflammatories can also be considered for this condition, especially when rest is impossible due to work commitments. Therefore, you better talk to your GP about the medication option.
Jul
In a previous blog, we did talk about heat packs, now it is time to talk about the Ice Pack. Ice pack application, in the last few years, is a practice that got reviewed. What Ice Pack is about? An Ice pack, as the name says, is a cold (icy) bag. As better explained in this study an ice pack is something that can be applied to an acute injury, to prevent swelling and reduce pain, but it can’t be used for too long. As per the heat pack, an Ice Pack burn the skin, and that’s one reason why its usage has to be short (10 to 15mins at a time). In addition, extended exposure to icy temperatures, would reduce the blood flow around the injured tissue and can also damage nerves. Ice Pack usage recommendation: You have a new injury or aggravation of an existing condition, and the pain is above 7 out of 10. Where you want to minimize swelling to keep you mobile later. There are different types of Ice packs: Home-made one, ice from the freezer wrapped in a towel. Gel pack Ice Bag (as per the photo) Instant one – most of the time found in the first aid kit. Snap it and a chemical reaction would occur in the bag and freeze the bag. Those last ones are efficient as you can store them anywhere safely and use them as you need them. The cold lasts for about 20 minutes. Not to be used if they are broken. On the other hand, if you running out of ideas of what to use as a Cold pack, you can even use a bag of frozen food. Still would do the work. We have the ice bath and the cold show related to this topic. I did experience cold showers myself, most of the time not of my choice, but because of a limited supply of hot water, and I have to say that even on this topic, there are a series of debates on how that works and if it’s beneficial. So far, a cold shower, compared to a hot shower, is better for dry skin. This is because the heat of the water combined with soap can wash away the good oils of the skin. Then the benefit of an Ice bath can be more of a placebo effect. But again, I haven’t done much digging about myself, so I would stay out of any comment regarding it. Ice pack after a Massage? Well, as mentioned above, the usage of Ice Pack is suggested after an acute injury. So, either after a Remedial Massage or a Thai Massage, firstly there should be no acute injury, secondly, you want the blood flow along the worked area to stay active and not restricted. That’s why a heat pack would be more recommended. If you find this helpful information and need a massage, book your next session here.
Jul
A muscle tear is an acute injury caused by a laceration of the muscle cells/fibres and or tendon to which the muscle is attached to. How can happen a muscle tear? A muscle tear happens when a muscle is weak and don’t activate at the right time. Weak muscles are common in repetitive movement or when a muscle overcompensates due to a fragile pattern. For example, tearing a hamstring is expected when the Gluteal Firing pattern is incorrect. This type of injury is common in sports activities. Still, it can also happen within a home environment by lifting a box incorrectly or during garden activities. The three grades of muscle tear. Grade 1 muscle tear is the mildest one. As per this case, only a few muscle cells have been torn. Symptoms are like: mild pain, moderate swelling, none or light bruising. In grade 2, a moderate amount of muscle cells have been damaged. Symptoms are like: Bruising is now more evident as per the swelling You must luckily hear a sound as the tear happens More severe pain, especially when trying to use that muscle. Grade 3 is the worst-case scenario. In grade 3 muscle tear, the muscle has fully torn. Still, a pop or a sound would happen as the tear happens. On the opposite side of where the muscle did lacerate, you will notice a bulge as the muscle coiled up after tearing. Weakness in using the limb where the muscle got torn. In case of a Grade 3 muscle tear, surgery is needed to reattach the muscle. How to treat a muscle tear? The immediate appliance of heat or cold packs is highly debated. A cold pack would numb the area and help with the pain symptoms. As mentioned in the “Ice Pack” blog post, that is actually recommended. On the other hand, a heat pack would help stimulate blood circulation in the affected area, reduce swelling, and boost recovery. It’s important to note that applying a heat pack too soon after an injury can actually make things worse. It’s best to wait until the acute phase has passed, which typically takes around 48 hours. At that point, heat therapy can be a helpful way to alleviate pain and promote healing. Regarding massage treatments, MLD can be the only technique used as soon as the tear happens. Indeed MLD would be highly recommended for boosting the recovery, especially in case of a tear in 3rd grade, where operation is needed. In case of a 3rd-grade muscle tear, the first thing to do is see a doctor. Other massage techniques, such as Myotherapy, Remedial Massage and Thai Massage, are still valuable for muscle tears. On the other hand, either Myotherapy, Remedial or Thai Massage can only be practised after 48 hours of rest are passed after the incidents. Indeed that 48 h is considered the acute phase of the muscle tear. How to prevent a muscle tear? More the body moves, the less the chance of injury. Making sure to do simple exercises involving basic body movement can help in muscle tear prevention. but not only. Keeping the joint moving is another essential aspect of injury prevention. How can massage help? Along with a massage treatment, the area of focus will be the torn muscle and surrounding area. Initially, the technique used with a massage treatment, especially for the injured area, would be MFTT and passive movement/mobilisation. That would help muscle recovery and facilitate joint mobility, reducing the muscle’s load. Going ahead with the treatments, techniques such as MET, a resisted muscle force technique, can be used. This would allow the muscle to gain elasticity. Book your next session by clicking here if you are suspicious of a muscle tear and need treatment.
Jun
Calf muscles make up the lower posterior portion of the leg. Calf Muscles are: 2 are the calf muscles, the Gastrocnemius and Soleus. Below is a table with Gastrocnemius and Soleus’s Origin, Insertion and Action. Gastrocnemius Origin The posterior surface of the lateral and medial condyle of the femurs Insertion Calcaneus via calcaneus tendon Action Flex the knee Plantar flex the ankle Soleus Origin Soleal line; the proximal posterior surface of the tibia and posterior aspect of the head of the fibula Insertion Action Plantar flex the ankle So, due to their origins and insertions, we can clearly understand how the Gastrocnemius is involved in knee flexion and how the Soleus is not. The Gastrocnemius does across the knee, as it originates from the femur itself. On the other hand, the Soleus doesn’t cross the knee, so it doesn’t play any role at the knee level. This aspect is so important to differentiate what of these 2 muscles are involved in the restrictive movement at the ankle, and or in calf pain. Calf Muscles testing Firstly the patient is lying down in a supine position (face up) doing active dorsiflexion. Secondly, we will ask the patient to lie in a prone position (face down), and we knee bend (passively), they would go in ankle dorsiflexion again. What happens there is when the knee is flexed passively, the Gastrocnemius is deactivated, and so the ankle dorsiflexion is happening by pulling the soleus only. Now, 2 are the case scenarios that could happen: Still a limited range of motion at ankle dorsiflexion with or without pain A better quality of ROM with a greater angle in dorsiflexion. In the first case, the tension muscles could still be both. In the second case, the Gastrocnemius is clearly the muscle limiting the ROM. For ankle ROM in dorsiflexion, we are looking for a minimum of 20° to up to 30°. It is not all about Muscle Pain. But can calf pain be related to something else and not just to muscle pain? The answer is YES. Calf muscle pain can be a RED FLEG for Deep Veins Thrombosis (DVT), especially after a flight. DVT Symptoms: Sharp pain; Heat at the touch; Soreness at the touch; Redness on the skin. In this case, you want to contact your GP immediately. Massages are absolute contraindications. In conclusion, for a full calf or muscle recovery, we want to look in too some exercises. Remedial Massage, Myotherapy, and Thai Massage are great ways to reduce pain and manage symptoms, but exercises are essential actually to heal a muscle. Indeed, when we talked about plantar fasciitis, those exercises are something that we can look at for calf strengthening.
May
When experiencing pain around the head, we talk about Headaches. Headache is a common condition, and for most cases, is not considered a serious illness. Migraine and headache. 4.9 million Australians experience migraine. Migraine is a specific type of headache, so consider that the number stated above is still a small figure. Headache and muscle. If you ever experience a headache, you may notice that the pain sensation does start from your cervical area. Or, by confronting yourself with who is around you, your headache pain pattern, is consistent, but it is different from the one of someone else. On the other hand, you may associate headaches to the result of a heavy drinking night, or of lack of water (which is why you get headaches after a heavy drinking night, by the way), but often headaches are there because of cervical muscle tightness. Wait, what? Yes, you did read right. How can we define then if the headaches come from muscle tension? So in order for this to happen, the muscle responsible for referring its pain up to the head must be tight or stretched out, and loaded with trigger points. As massage therapists, especially in the first consultation session, we would ask about headaches and if there are any, “where about do you feel the headache”? Indeed, the answer to this question is most luckily the giveaway to know which muscle is may responsible for your headaches. To confirm the suspicions, we would then assess your posture, looking for any muscular-skeletal unbalance, and then we would assess the Range of Motion (ROM). If the ROM show up to be limited on the muscle that we believe is responsible for the pain in the head, then most luckily we are halfway through the solution. I do say halfway through, a single massage session either Myotherapy, Remedial Massage, Thai Massage, or MLD is maybe not enough to release all the tension that is in needs to be alleviated to eradicate the headache. Said so, no journey starts, without doing the first step, isn’t it? When a headache is a Red Flag? For red flags, we refer to symptoms that may be present due to serious illness or condition. Some example includes clients who had a clinical history of stroke and or brain cancer, a recent car accident or recent head trauma, or blurred vision. If that’s the case, the next step is referring the client to a GP immediately for further investigation. What about the cervical muscle tension headaches type of presentation? As already mentioned in another blog post, the Occipital muscle can have headache type of pain in the lower section of the posterior side of the skull. If we then look into the area of the skull that seat above the ear, could be more tension from the Upper trap or Levator Scapulae. By keep moving more medially and above the head, Splenius cervis can refer to the medial superior side of the head and Splenius capitis to the middle top side of the head. Sternocleidomastoid, indeed, can refer to the frontal lobe of the skull. Now, all these muscles are sitting on the neck and throat and from above the shoulder. So, ensuring that those areas are free or not overloaded with tension can help in staying headache-free. Now, in this blog post, we are keeping the headache presentation type of pain to its simple aspects. On the other hand, the topic can be further discussed in person with Giovanni during your next massage appointment. Book now your next massage session, if you are trying to get to sort out your headache presentation. Other approaches to a headache-free life, out of massage therapy. There is a series of things that complimentary massage can help with to relieve headache pain. Exercises Keep yourself hydrated Good posture when seating and standing Good variety of food as diet intake Wearing glasses if needed. Meditation for stress management In conclusion, headache is a really common problem for all Australians, for both women and men. Don’t wait for your symptoms to get worse; you may not need to take medicine all the time if you have a headache, as the medicine will just numb the symptom but will not sort out the problem. If you are keen to learn more about where your headache may be coming from, book your next Massage Session today.
Apr
Plantar Fasciitis is a foot condition that can cause severe pain when walking or standing. Pain may be more intense in the morning when you step out of bed. If you ever had plantar fasciitis you will well know, that is not a fun thing to deal with. How to fix plantar fasciitis? In most cases, corrective exercises are the best way to retrain the foot and heal it once and for all from this condition. In this blog post, I talk more in detail about exercises for plantar fasciitis. How does Plantar Fasciitis manifest itself? Plantar Fasciitis manifest itself when the load of the foot is predominately put on the outside of the foot or on the back of the foot. It is the case we talk about an over-inverted foot, indeed a foot that is overloaded on its lateral portion. By doing so, the big toes flexor, the muscles that connect the big toes to the heel, get inflamed. As per consequence, pain does manifest below the heel. “It feels like if I got glass under my feet” someone that offers this condition would say. Plantar fasciitis demographic. People who spend a long time standing up/walking (waiters) Runners (who run with a heel strike) Pregnant women (due to the abundance of weight) The foot is a complex body part. Indeed, the foot contains 29 muscles, 26 bones and 30 joints. Therefore if not loaded correctly, the consequence can lead to major body musculoskeletal dysfunctions and unbalance. As already mentioned during the blog about the Fascia line, unbalanced feet can reproduce tension up to the back and shoulders. Plantar fasciitis functional test. A simple test that we do as massage therapists is to passively extend the big toes. (Windlass Test) If pain is reproduced on the heel, the test is positive. Therefore, this test tells us that the big toes, which most luckily would not even extend to their full range (65°), are not used when standing and or walking. That’s why is weak and tight. How can massage help reduce plantar fasciitis pain? At Melbourne Massage and Treatment, Myotherapy, Remedial Massage or Thai Massage can help reduce the tension along with the foot’s supinator muscles, which are responsible for over-invert the foot. That’s one of the reasons why the body weight gets overloaded on the lateral side of the foot. Regarding MLD, it can be most beneficial to reduce the inflammation within the plantar of the foot and help manage the pain. But as previously mentioned, massage can help in reducing the symptoms, and improve mobility. Where for full recovery, corrective exercises are essential. Was this post helpful? If you are suffering from Plantar Fascitis and would like to find a way out of the pain, book now your next appointment with Melbourne Thai Treatment. Here on the right side, is an example of a pair of shoes, for someone who suffers from plantar fasciitis. As you may notice, the lateral portion of the show is completely worn out, where the medial portion, is nearly touched, especially at the big toes area. So back to the fact, that the big toes are what should drive the foot along the strike motion if that shoe area is untouched, it means that person is not loading any weight on there. Footwear examination can be also used to identify weight balance in the foot area.
Apr
A Scap-Off Load is a special test or functional test that we use to evaluate the implication of Lev Scapular and Up. Trap in Cercival Rotation. As previously mentioned, in cervical rotation, we got a fair bit of muscle working towards this action. As many clients come in with cervical pain, it’s time to explain in more detail what’s going on there. Cervical Rotation. How does it happen? So, when we rotate our head, either right or left, the muscle on the same side of the rotation movement is contracting. If a muscle along those is weak, we may reproduce pain in rotation along the same side. To thin down which muscle is responsible for the limited ROM, we have to safely deactivate some of them to see if the left behind one can deliver the expected movement. Here is an example of how scap offload works. If a client comes in with 30° Cervical rotation on the R and pain on top of the scapula, that could be an indication that its levator scapulae is the muscle to target. To confirm this hypothesis, I would ask the client to shrug their shoulders and flex their elbow (the client is sitting on a stool). After that, I will make my way behind the client, and I will support their shoulder weight with my forearm and hands. As the client relieves the shoulder tension, that lev scapulae and up. Traps. are now deactivated. The next thing would be to ask the client to perform the cervical rotation. Ideally, I would like to see the client have a full range of motion (80° to 90°). If this post talks to you, book your next massage session by clicking here. That would tell me that the only muscles that are limiting the cervical rotation are the lev scap. and up trap. On the other hand, what could happen, is that the cervical rotation is, yes improved, but still limited, compared to the ROM expected. In this case, the muscles involved in the stiff range of motions are not only lev scap. and or upper trap. In fact, what is causing the limitation is the cervical occipital muscles. And yes, spending long hours at the computer or looking at the phone doesn’t help. After this test, to narrow down even more which other muscles are involved in the stiffness of the cervical area, I do run another series of tests. Those tests would look into joint areas like C0-C1, which would refer to Obliquus Capitis Superior muscle, and the C1-C2 test, which would look at tension for Obliquus Capitis Inferior. Furthermore, for the other facet joints that make up the lower cervical region (C3 to C8), I would analyze each facet joint individually. These series of tests are indeed part of my Myotherapy training. Last would be then the usage of the joint mobilisation technique. In this case, we would look into what joint has lost mobility or which one has an excess of it. Strengthening the cervical. In order to improve the presentation, massage on its own is not enough. As per any condition so far, the strengthening of the muscle, in this case, the cervical and upper thoracic one, would allow to prevent further pain and discomfort. The work that the cervical muscle has to do daily is considerably high, giving the natural weight of the skull. So exercising a chin tag in a supine position can help. Ideally, we would do these exercises in the supine position (lying down face up) so that we have gravity to fight back as we train our deep flexors. To further improve the strengthening, once the chin tag is not enough, we can start using a soft rubber band to create resistance. Said so, be mindful that the cervical area is a delicate area to work on too, and those exercises are best practice under the supervision of an expert trainer or massage therapist.
Apr
First Massage Appointment. At Melbourne Thai Treatment, a first massage appointment session does last a bit longer than a regular appointment. Indeed, if you go on the booking page, you may notice that the first appointment lasted 75mins. Why so?! Well, within the first appointment, as a therapist my aim is to track down your Clinical History. For doing so there is initially a form to fill in and in a second stage few subjective questions that I am going to ask. Questions are like: “What do you do for work?” “What sports activity do you do or did?” “On what side do you sleep?” “Are you Right or Left Handed?” Ext… These and other questions, relevant always to the presentation that you come in with, are for me therapist essential to understand how you end up having the pain or discomfort that I have to remove or reduce. Obviously, those questions asked during the first massage appointment can take a bit of time to be answered Occasionally an answer gives space to a new question. Said so, the more specific are the answer more I can narrow down the clinical situation. If this post is talking to you, book your next massage session by clicking here. As per result, will be easier to find a path to alleviate pain and discomfort. On the other hand, as the session last longer than a regular visit, as a therapist I charge a bit more. For a Remedial Massage and a Thai Massage a first appointment session would last 75mins. About MLD a first Massage session would last 60 minutes. Indeed, with this post, I would like to share and explain to any clients that the first appointment is not more expensive because I am greedy. Is through, the time we spend doing the massage itself is per usual the same time that we would spend during a general consultation. But, that initial time that we spend working out your Clinical History, will save time after actually treating the condition. In conclusion, I would not see the first appointment as an extra expense, but as an investment in your health. Before we find out what’s the cause of your pain, and discomfort before I can create a proper treatment for it.
Mar
As already mentioned earlier MLD is a fantastic manual technique that can be used to improve the healing of many conditions. Along with the conditions that MLD is useful for there is bone fracture. Said so, in order to understand how MLD can help to speed up the recovery from a bone fracture we have to analyse what’s happening within the body when such trauma happens. A bone fracture is an injury that can happen at any age, due to an accident or trauma. The main type of bone fractures are: Displaced Angulated Shortened Rotate Symptoms of bone fracture Pain Swelling Bruising Deformity Inability to use the limb. The fracture so can be a crack side to side or in the middle of the bone. Eventually, the bone can crumble too, or break in multiple areas. At the worst, the bone can also cut the skin, and come out of the body. If this post is talking to you, book your next massage session by clicking here. Depending on where the fracture is, and what type of fracture it is, surgery could be required. Independently if surgery is required or not, still MLD can help to boost the recovery. Indeed, when a fracture happens the body recognises a trauma to its system. As long as the body won’t know exactly what the trauma is, and if the trauma does involve a skin crack or not, to prevent infections and external bacteria or pathogens to enter the body, the vein, capillaries and the lymphatic system around the trauma area get restricted. As per result, the body does swell. In fact, this explains why, when oedema happens the body does swell. It is an automatic body response to prevent further damage to happen. As the body then, realise what the issue is, slowly does reactivate the lymphatic system, and does fully reopen veins and capillaries, so that the blood can start circulating again freely. But the time that the body can reduce the swelling by itself, with a lymphatic system that works at regular speed (about 7 to 8 bits per minute) it would take a while to reduce the swelling. Furthermore, when I bone is broken that body part would have to stay still for a while, weeks or months. As per result, the blood and lymph flow would be slower than usual. And here is where MLD comes to be useful. If by reading this post, you feel like MLD is what you need now to recover from your injuries, click here to book now your next session. As MLD therapists indeed, we would check that there is no acute infection in the area where we want to apply MLD. If that’s the case, then, we can start our work. By boosting the lymphatic system, up to 3 to 4 times its normal ratio, we can quickly reduce the swelling. And what about if the area affected is covered with a plaster cast? Well, let’s not forget that the lymphatic system works as a vacuum and the area of loads is below the clavicle. So, stimulating the Lymphatic system at the top can actually already improve its suction ability till down the feet. For example, if the fracture is at the foot, initially MLD can be applied at the neck, to open the Lymphatic System duct that reverses in the veins, and secondly can be applied to the abdominal level and down the legs, just before the foot. Now, that swelling reduction, come’s with many benefits. For example, in the area treated, there is a transaction of extra oxygen, protein, vitamins, blood and other essential elements useful for the bone to heal. And occasionally, depending on the type of fracture is not only the bone the one that has to heal. In fact, along with a bone fracture, the body part fractured stays steel for weeks and months. That would create a weakness in the muscle that would then require rehabilitation. As a Remedial Massage therapist, I would have to refer the client to a Physiotherapist for rehabilitation. Even so, as a Remedial Massage therapist, I can still deliver massage services that can help in restoring muscle functionality. In conclusion, MLD can help with: reducing the swelling along a bone fracture; help in speeding up the recovery of the skin damaged by the fracture and or by the operation; Speeding up the healing of muscles and soft tissue around the fracture; Ultimately, by increasing relaxation, MLD is also useful to keep the humour of the person at ease, as often happens that after a trauma such as a bone fracture, the person can feel anxious and demoralised due to poor mobility and difficulties in moving.