Pain is something that we all experience, and it can start after an injury, during an illness, following surgery, or even without an obvious cause. Indeed, pain is not always related to body damage, like a muscle tear or a broken bone. In support of this, to better understand pain, modern science shows us that pain is a complex experience produced by the nervous system. It is influenced by information coming from the body, but also by previous experiences, expectations, emotions, stress, sleep and the context in which the pain occurs. The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage. What we have to understand, to start with, is that pain can occur even when there is little or no ongoing tissue damage. That’s really important when we talk about chronic pain. What is chronic pain? By definition, chronic pain is described as pain that persists or recurs for more than three months. That said, this doesn’t mean that an injury has remained damaged for such a long time. In fact, in some people, pain initially begins because of an injury or another physical problem but continues after the original tissue has had enough time to heal. This is where chronic pain can develop, because the nervous system has become more sensitive to signals from the body. So yes, even after such a long time and with physical damage repaired, the nervous system is still in alert mode, creating a signal of pain, where actually nothing physical npothing is wrong. This is one reason why treating chronic pain is often more complicated than simply finding a damaged muscle, tendon or joint and treating that structure. Chronic pain can involve different mechanisms, including nociceptive, neuropathic and nociplastic pain, and more than one mechanism can be present at the same time. Pain does not always equal damage When I treat patients who suffer from chronic pain, including pain that recurs after years, I have to ensure I explain how pain actually works, and that pain and tissue damage are not always directly proportional. Indeed, we are all aware that we all have different pain tolerance, and that someone can have significant pain with relatively little tissue damage, while another person can have substantial structural changes with surprisingly little pain. This does not mean that the pain is imaginary, or that you have to feel crazy to be in constant pain. Unfortunately, the pain is real. But what this means is that we need to create a management program to change how your nervous system is dealing with pain management and response. Because at the base of it all is that when pain persists for a long time, the sensitivity of the pain system can change. This can contribute to increased sensitivity to pressure, movement or other normally tolerable stimuli. It is like an alarm that went on every day for weeks, and then months, and out of nowhere, any stimulus can trigger it. So yes, this is one of the reasons why chronic pain needs to be approached as more than a local problem in a muscle or joint. Why can pain continue after an injury has healed? After an initial injury, or a nociceptive stimulus, pain can hang around even when no stimulus of major level is left. A stimulus that could give you pain is getting spiked with a needle, for example, when doing a blood test. If that same experience is then associated with a major stressor, like a trauma- think of pain that started after a severe car accident- the pain can be more challenging, because your central nervous system is now associating the pain not only with a physical injury (a needle penetrating the skin) but to a severe car accident. That trauma, that intense experience, can now wire your nervous system to be in alert mode constantly and therefore constantly fire a pain response, even though the physical damage is repaired. Other factors can also influence pain processing, including: Higher level of stress Poor sleep Previous pain experiences Fear of movement Expectations about what a particular movement might do to the body. So yes, you now can also understand that avoiding movement completely is not always the best long-term solution, because that fear of movement can increase the pain expectation and experience. Can hands-on treatment help chronic pain? This is another topic I find myself sharing constantly with my clients. Hands-on treatment, yes, is extremely helpful with chronic pain, and here is why. Manual therapy, that is, Remedial Massage or MLD, can provide a strong sensory input to the nervous system. Any form of touch therapy, indeed, is simply a stimulation to the nervous system. The trust built with my clients and the nervous system touch stimulation create a positive cycle that can help modulate the pain response for the better. In more detail, touch, pressure and movement stimulate sensory receptors and provide the brain with new information about the area being treated. This can influence how pain is processed and may temporarily reduce pain sensitivity. A systematic review and meta-analysis of physical therapy interventions in people with chronic musculoskeletal pain found improvements in some measures associated with pain processing, including temporal summation and conditioned pain modulation. The authors concluded that physical therapy may have a modest effect on altered pain processing, although the results differed between treatment approaches. But even if science backed up the benefit of hands-on treatment for chronic pain, we have to remember that massage can only provide pain modulation, and no one, with their hands, can actually fix a problem or heal you. And I can stress this enough to my clients. In fact, I always explain to them that I see hands-on treatment as one part of a broader treatment plan, rather than the entire solution. The temporary reduction in pain can be useful because it may make it […]
Tag Archives: coburg
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Facet Joint Irritation and Muscle Weakness: What You Need To Know
In my experience as a Clinical Myotherapist at Melbourne Massage and Treatment Myotherapy and Lymphoedema [...]
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Chronic Pain: What it is, and what can you do about it?
Pain is something that we all experience, and it can start after an injury, during [...]
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Bunion and Morton’s Neuroma: Can a Bunion Affect Neuroma Recovery?
While a bunion and a Morton’s neuroma are two different foot conditions, if they are [...]
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Knee Pain in Coburg
Knee pain is a common form of injury and can affect people of all ages [...]
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Post-Surgery MLD Melbourne – Vodder MLD Therapist
Any form of surgery is an invasive procedure for the body to deal with, and [...]
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Sep
While a bunion and a Morton’s neuroma are two different foot conditions, if they are co-existing, they can sometimes influence the way the forefoot is loaded, causing delays or difficulties in the recovery process. Starting with the bunion, which medically is known as hallux valgus, changes the position and function of the big toe and first metatarsophalangeal joint. On the other hand, Morton’s neuroma is a painful condition involving one of the common plantar digital nerves, most commonly between the third and fourth toes. If you present with both conditions, treating the neuroma without considering how the rest of the foot is functioning may not always address the mechanical factors contributing to your symptoms. This is what this blog is going to analyse: Can a bunion make it harder for a Morton’s neuroma to settle? The answer is not as simple as saying that a bunion causes a neuroma, as there is not enough evidence for it. But what we know is that hallux valgus can alter how load is distributed through the forefoot, and this may be relevant when managing a sensitive or irritated interdigital nerve. What is the relationship between a bunion and a Morton’s neuroma? As mentioned above, a bunion does not automatically cause a Morton’s neuroma. That said, both conditions can be influenced by the way forces are distributed through the forefoot. Indeed, Hallux valgus can change the position of the big toe and first metatarsal, which are sitting more laterally than they should be, and alter normal walking mechanics. We know, in fact, that while walking, the big toes should be the primary driver and taker of the body weight at the toe level, and if pushed to a lateral position, it can’t take such load; therefore, the body weight is then redistributed along the phalangea box and other toes. But to be more specific, and by following what the data show, we better understand this 2025 systematic review and meta-analysis involving more than 6,000 feet found that hallux valgus was associated with reduced hallux loading when measured inside footwear. But evidence that hallux valgus consistently increases loading beneath the central metatarsals was inconclusive. And this is important because it gives a distinction between bunion and Morton’s neuroma formation, as neither is the consequence of the other. Basically, the correlation and causation effect. Indeed, foot mechanics are individual. Your symptoms can be influenced by the shape of your foot, footwear, activity, walking pattern, joint mobility, strength, and how you distribute your body weight while moving. How can a bunion affect Morton’s neuroma recovery? Now that we clarify the distinction between the correlation and causation of Morton’s neuroma from hallux valgus, we can dig more into how the bunion can affect Morton’s neuroma recovery. Morton’s neuroma is a condition that can not be recovered by only exercises or some other external interventions, but, to start with, it needs rest. By rest, we mean reducing stress on the structure involved, not no movement at all. This is why footwear modification and pressure redistribution are commonly used in Morton’s neuroma management. Therefore, the bunion may become relevant because hallux valgus can alter the way the forefoot loads during walking. For example, some people with hallux valgus develop a tendency to move the centre of pressure away from the first metatarsophalangeal joint during late stance. Research has demonstrated this lateral shift in people with bilateral hallux valgus. As a result, if the big toe can not contribute effectively to propulsion, the body may find another way to complete the movement. So again, this can overload the neuroma site, limiting rest and slowing recovery. Think about the whole foot, not just the painful spot When dealing with a painful presentation, I always invite my client to stop focusing only on the painful spot, and start to understand that nothing work in isolation. Therefore, if someone has a neuroma, it can be tempting to focus entirely on the area between the toes. But a better approach would be asking: Why is this area becoming irritated? The answer is often made up of a combination of factors, which may include: Footwear used Training load or walking volume Forefoot structure or movement Possible pre-existing injury So that’s why treating the neuroma alone may not be enough if the mechanical contributors are still present. Can bunion exercises help reduce stress on a Morton’s neuroma? The short answer is yes, but it is not always as simple. Evidence suggests exercise can improve pain and some measures of hallux valgus, particularly in mild-to-moderate cases. However, this is different from saying that bunion exercises have been proven to treat Morton’s neuroma. So what we can therefore assume is that by improving the foot mechanics and load, we may reduce stress on the neuroma site, assisting the body’s natural recovery. Exercises may include: controlled big-toe movement exercises to improve intrinsic foot muscle control toe spreading exercises strengthening exercises for the foot controlled calf and ankle exercises balance exercises progressive weight-bearing exercises exercises that improve the way the foot controls load during walking And there is no one-size-fits-all. What we should focus on too is the ability and capacity of the individual, and then work on what they are missing out on. As an example, forcing the big toe into a position with a toe separator simply because someone has a bunion is not necessarily appropriate, and it may not create the desired change anyway. The aim is not to “push the bunion back into place”. The aim here is to improve the available movement and control of the foot and help the person tolerate load more effectively, yes, starting from the big toe, if a bunion is present, but the focus has to be also on the other toes, as well as the ankle. Can big toe mobility affect pressure on a Morton’s neuroma? For what we know, the big toe plays an important role during walking, particularly during the later part of stance. For simplicity, we expect […]
Aug
Lymphatic Walking is another trend that you really don’t need to overthink. But let me introduce myself first. My name is Giovanni, and I am a clinical myotherapist specialised in Manual Lymphatic Drainage (MLD). I work with client who has an intact Lymphatic system but even with client who have Lymphatic System pathology, like Lymphoedema. In this blog, I am going to share the basic knowledge and explanation of why Lymphatic walking is a nonsense term, but you should still walk. Walking is good for you. It gets your muscles moving, supports cardiovascular health, improves fitness and can be an easy way to stay active. But recently, you may have heard of lymphatic walking. Your lymphatic system is already working, no matter what. So no, you don’t normally need a special walking technique to “switch it on.” The lymphatic system is a complex transport network that continuously moves fluid, proteins, fats and immune cells through the body. Lymphatic vessels have their own pumping mechanisms, while movement of surrounding tissues, breathing, and other mechanical forces can also influence lymph transport. Does walking increase lymph flow? Yes. And with this, we already gave enough credit to this trend. Any form of movement can help the lymphatic system work more and can help your body feel less bloated and tight. This is because any form of muscle contraction is going to directly stimulate your lymphatic system capillaries to collect more liquid and therefore move more fluid. Now, walking is a perfectly reasonable activity for supporting normal circulation and lymph transport, because the primary movers in the body for walking are your legs. Legs contain the biggest muscle group of the body, and are a body area where the fluid has to travel the most, in a proximal direction, to reach the clavicle, where the lymphatic fluid is then dumped into the bloodstream (at the subclavian veins). But again, there is nothing particularly magical about “lymphatic walking.” Again, your lymphatic system responds to many forms of movement. Walking, cycling, swimming, resistance training, climbing stairs and ordinary daily activities all involve muscular contractions and changes in pressure that can contribute to lymph movement. In other words: You don’t need to learn a special walking pattern to make your lymphatic system work. But what I really want to make sure we all understand is that there is nothing inherently wrong with doing them. Just don’t confuse a different walking technique with a medically necessary way of “activating” your lymphatic system. Do you need to boost your lymphatic system? Ok, this is another big topic that I often find myself talking to my clients about here at Melbourne Massage and Treatment in Coburg. If, overall, you are a healthy person, no, you don’t need to boost your lymphatic system. And the reason is quite simple. Your lymphatic system, like many body systems, works fine just by you doing the right thing. If you keep yourself in motion- yes, in this case, even just walking- your lymphatic system works even stronger than usual. This is why phrases such as: “Your lymph is stagnant” “You need to activate your lymph” “Your lymphatic system is blocked from sitting” “Do this walk to detox your lymph” “You need to flush your lymph” should be treated with some scepticism, as are a bunch of nonsense words. That said, there are, of course, genuine lymphatic disorders. People with conditions such as lymphoedema can experience impaired lymphatic transport and may require appropriate assessment and management. Exercise and movement can form part of lymphoedema management, but that is very different from saying that everybody needs to perform a special walking routine to prevent their lymphatic system from becoming “stagnant.” What if you have lymphoedema? This is where we need to sit and talk. Medically talk, no social media trend chat. If someone has lymphatic dysfunction, simply telling them to “walk more to boost their lymph” is not an adequate treatment plan. In fact, exercise can be beneficial for people with lymphoedema. But when someone presents with Lymphoedema, we need to take into consideration the bigger picture, which is their medical and clinical history. Therefore, management of lymphoedema may involve several components, depending on the individual, including exercise, compression, skin care, education, self-management and appropriate manual techniques. That is very different from following a social-media video promising to “flush out toxins.” Lymphatic massage is not the same as Manual Lymphatic Drainage Something that I already touched on is the topic of lymphatic massage and what’s the difference between Lymphatic Massage and MLD. A massage advertised as “lymphatic” is not automatically Manual Lymphatic Drainage (MLD). MLD is a specific manual technique with particular principles and techniques. It should not simply be used as a marketing label for any gentle massage that claims to “drain toxins.” Understanding this distinction is particularly important if you are looking for treatment for an actual lymphatic condition. But also, if you are looking to find a therapist who can tell you more about your lymphatic system needs, if any, and not just grab your money promising a healthy trend. So, what is MLD? Manual Lymphatic Drainage is a specialised, gentle manual technique that increases lymphatic fluid transport. Vodder Academy is the world academy that has a patent for MLD as a technique and treatment modality. That’s the academy I studied with for my Applied MLD, Lymphoedema Management and Cosmetic Surgery recovery specialisation. That said, there are other schools that offer training for other lymphatic treatment, but personally, with extended research, I found that the Vodder Academy was the best school to study with. Not only because they hold the gold standard for Lymphoedema treatment, but also because the training doesn’t stop at the course; there is a real network of teachers and students who spend time sharing resources and experiences from all over the world. Can healthy people have MLD? Yes, of course they can. If you are overall healthy and not suffering from any lymphatic condition, you can still receive […]
Aug
If you live in Coburg or the surrounding area, you’ve probably come across both Myotherapy and Remedial Massage. Have you ever wondered what the difference is? While those treatment modalities share some techniques, they have different goals. Therefore, choosing the right treatment depends on whether you’re dealing with pain, recovering from an injury, improving your movement, or simply looking to relax. At Melbourne Massage and Treatment in Coburg, I do offer both services and understanding the difference can help you get the most appropriate care for your needs. Quick Look at Remedial Massage and Myotherapy Differences Myotherapy Remedial Massage Pain & injuries Relaxation & recovery Assessment Massage Exercise prescription No rehabilitation program Long-term function Short-term muscle relief Acute & chronic conditions General muscle tightness Healthcare treatment Therapeutic massage What is Remedial Massage? Remedial Massage focuses on relieving muscle tension, improving circulation, and promoting relaxation. Although it can help reduce muscle soreness and stiffness, the primary aim is to help your body recover from everyday stress or physical activity rather than managing complex injuries. Remedial Massage is an excellent choice if you want to: Relax tight muscles Recover after exercise or sporting events Prepare muscles before competition Reduce general muscular tension Improve flexibility Support overall wellbeing Many active people also include regular Remedial Massage as part of their maintenance routine to help manage training loads. What is Myotherapy? Myotherapy is a treatment modality, evidence-based, offered by a healthcare professional who focuses on: Assessing, Treating, Managing musculoskeletal pain and movement dysfunction. As a Clinical Myotherapist in Melbourne, I also tend to specify that Myotherapy as per TAFE education and a Bachelor of Health Science is different. Goes without saying that someone who trained in a bachelor setting has better knowledge and clinical reasoning than someone who trained at TAFE level. Back to what Myotherapy is about, it is not only treating sore muscles, but it aims to identify why your pain or injury has developed. Then, treatment often includes a combination of hands-on techniques movement assessment exercise prescription education to help improve long-term outcomes. Myotherapy is suitable for people experiencing: Acute injuries Chronic pain Sporting injuries Neck and back pain Headaches related to muscle tension Tendinopathies Shoulder, hip, or knee pain Reduced mobility Muscle weakness following injury Indeed, the goal isn’t simply to reduce pain today, but the goals are: Short term: reduce the pain and possibly improve range of motion Long term: become stronger, and reduce the likelihood of the problem returning. The Main Difference The biggest difference between Remedial Massage and Myotherapy is the treatment goal. Remedial Massage essentially focuses on relieving muscle tightness and promoting recovery and relaxation through massage techniques. This is possible because while we massage a body part, we stimulate the nervous system and other body systems, which react with biological responses such as mild inflammation and relaxation. Myotherapy, on the other hand, focuses on understanding the cause of pain or movement limitations and creating a treatment plan that may include exercise, rehabilitation, and education alongside hands-on treatment. Therefore, if your goal is to overcome an injury, improve movement, or build strength, Myotherapy is generally the better option. If your goal is to unwind, recover after exercise, or enjoy a therapeutic massage, Remedial Massage may be exactly what you’re looking for. Now, Myotherapy May Be the Better Choice If You Have: Ongoing neck or back pain A recent sporting injury Tendon pain Joint stiffness Recurring muscle strains Pain affecting work or daily activities Weakness after an injury Goals of returning to sport or exercise safely Where treatment during a Myotherapy session may include: Soft tissue therapy Joint mobilisation Dry needling Trigger point therapy Exercise prescription Strength and rehabilitation programs Movement assessment Education about your condition So, to conclude about what Myotherapy is about, Myotherapy is to improve function, not just reduce symptoms. Remedial Massage May Be the Better Choice If You Want To: Relax after a busy week Reduce muscle soreness after training Prepare for a sporting event Recover following a marathon or competition Reduce general muscular tightness Enjoy regular maintenance treatments Therefore, when we look at Remedial Massage, we are looking at a treatment modality that helps your muscles feel looser and more comfortable while supporting recovery from physical activity. Can You Have Both? Of course you can. As mentioned earlier, while we do deliver a Myotherapy session, we will still use hands-on treatment, the same treatment option that we would use for Remedial Massage. And indeed, many of my clients here at Melbourne Massage and Treatment use both services throughout the year. For example: You may see a Myotherapist while recovering from a shoulder injury. Once you’re pain-free, you may continue with regular Remedial Massage to help maintain muscle health and recover from training. The two treatments complement each other well depending on your goals. Which Treatment Does Giovanni Recommend? At Melbourne Massage and Treatment in Coburg, I recommend treatment based on your goal, not only on my opinion. If you’re experiencing persistent pain, recurring injuries, reduced strength, or difficulty moving, Myotherapy is usually the most appropriate starting point. If you’re feeling generally tight after work, training, or simply want to help your body recover and relax, Remedial Massage is often the better choice. And if you are unsure which service is right for you, please do not hesitate to ask Giovanni what would work best for you. During your initial consultation, we’ll discuss your symptoms, assess your movement, and recommend the treatment that best suits your needs. My goal, as an Allied Health practitioner, is to help my clients move more and live well. And this can start with a massage, and move on too exercises and fitness class. Myotherapy vs Remedial Massage Coburg Cost and Prices Cost and prices of Myotherapy or Remedial Massage at Melbourne Massage and Treatment, for simplification, are the same. Find below a table with the prices: Myotherapy vs Remedial Massage Coburg – Price Initial consultation – 60 mins – $125 Return consultation – 45 mins – $115 […]
Jul
There is no worse way to start the day than with a wry neck. Wry neck is a common term used to describe a painful neck that limits the way you can move. Medically speaking, we call the same presentation acute torticollis. At my Myotherapy clinic in Coburg, Melbourne Massage and Treatment, I get to hear clients often telling me: “This has happened on and off for years.” And this is the first piece of the clinical history that tells me we’re probably not dealing with a simple muscle spasm, and that’s where we start looking for why the neck keeps becoming irritated in the first place. Wry Neck Is Often Acute on Chronic The first misconception we need to clear away is that wry neck comes out of nowhere. The reality of the fact is that many people have developed underlying dysfunction over months or years. Therefore, the neck has been compensating until one day something relatively small, sleeping awkwardly, reaching for something, reversing the car or even sneezing, is enough to trigger the painful episode. The acute pain is simply the last straw that broke the camel’s back. So the million-dollar question is: Why did your neck become vulnerable in the first place? That’s where an initial consultation is important, and that’s why I spend my time investigating during an assessment. A Previous Whiplash Injury Could Still Be Affecting You A common overlooked cause for wry neck that I get to see here at my clinic is a previous whiplash injury. Indeed, while someone may recover fine from this type of incident, others develop subtle changes in how their neck moves and how the muscles coordinate movement. So yes, it can be either a physical strain or irritation of the ligaments, or even neurodegeneration at the muscle level. That’s why, even years later, the body may continue protecting certain joints while overloading others. Research by Woodhouse and Vasseljen (2008) has shown that people with chronic whiplash often demonstrate altered cervical motor control, reduced movement quality and persistent dysfunction long after the original injury. That’s why, if you’ve ever had a rear-end collision, even if it happened ten years ago, even if it was due to a contact sport injury, it’s worth mentioning during your assessment, as it is an important piece of information. Hypermobility Can Also Play a Role Another presentation that I come across in my clinic, for people who suffer from wry neck, is hypermobility. Indeed, being flexible isn’t always an advantage. This is because if some joints move excessively, your muscles have to work much harder to provide stability. Over time, these muscles become overworked and fatigued, especially around the neck and upper back, which is an area where muscles already work hard most of the time, as they have to ensure we can stay straight while we stand or sit. When stability can’t keep up with mobility, the body often responds by developing muscle guarding. That’s when the neck suddenly “locks.” On the other hand, the lack of stability also creates an overload of joints, which may get easily irritated, and then initiate the pain response. Your Neck Doesn’t Work Alone Another important thing to be aware of is that we should stop focusing only on where the pain is, as the source of the problem. In fact, the cervical spine is part of a much larger movement system. So, poor movement through the upper back, reduced thoracic mobility, rib restrictions, shoulder dysfunction or altered control through the lower spine can all change the workload placed on the neck. And this is a long time game, not something that happen in one night of bad sleep. A way to conceptualise this is: If one link in a chain doesn’t move well, another link has to move more than it should, and eventually that overloaded area becomes painful. That’s why my assessment as a myotherapist doesn’t stop at your neck. I look at how your entire spine works together. The goal is to improve the balance between mobility, where mobility is needed, and stability, where stability is required. And this can only be done and maintained via exercises. Can a Better Pillow Fix a Wry Neck? I did already dedicate a full blog post about the pillow topic, but it is worth it to touch base about it even here, as this is probably one of the most common questions I get when talking about wry neck. A supportive pillow can certainly help reduce stress on your neck while you sleep; however, a pillow doesn’t: Change how your joints move. Improve muscular control. Restore stability. Correct movement patterns that have developed over the years. Therefore, think of a good pillow as something that is improving the environment rather than fixing the cause. If the underlying issue is poor movement control or spinal dysfunction, changing pillows alone usually won’t stop the episodes from returning, and it can end up being an expensive search. Your Workstation Might Be Causing the Problem Another issue that I get to see mostly with office workers is for those who work with multiple screens, like two or even three computer screens. This setup becomes a problem when the main screen isn’t positioned directly in front of you, and you end up spending eight or more hours each day with your head slightly rotated toward one side or the other. Now, try to think about what that means for your joints and muscles on that side. Until you repeat that position every day for months or years. The muscles on one side of the neck become overloaded because they are constantly contracted, while the muscles on the other side are constantly stretched. One of the simplest changes you can make is ensuring your primary monitor sits directly in front of your body, or if that’s not an option, then make sure to swap your screen software-wise. So you end up having even days looking at right, and uneven days, looking to the […]
Jul
I had been looking for a new space to relocate my Myotherapy Clinic, and when I found one in Coburg, I knew it was the right choice. As I started telling my client and friends about my relocation plan from Fitzroy North to Coburg, the question they ask is: “Why Coburg?” And the answer is actually quite simple. In many ways, it feels like coming home. A New Chapter, in a Familiar Place For who has been following me for a while, you may know that in the last couple of years my clinic, Melbourne Massage and Treatment, wsa based in Fitzroy North for the last couple of years. But my professional journey didn’t begin there. Long before opening the Fitzroy North clinic, I had already been practising in Coburg for 3 years. And I was practising at home. I came to know the area well, and over the years, I built relationships with many local clients and healthcare professionals. Returning to Coburg wasn’t about moving somewhere new; it was about returning to a community where I already felt connected, and where I still live, actually. More Space Means Better Care Another bigger reason behind the move was the opportunity to create a clinic that better reflects the way I like to work. Myotherapy isn’t about rushing people through appointments, and is more about yes, hands-on treatment, but exercises play a crucial role in your recovery journey, Whether you’re coming in with persistent neck pain, recovering from a sporting injury, managing lymphoedema, or seeking Manual Lymphatic Drainage, treatment works best when both practitioner and client have a calm, comfortable environment. The new clinic at 325A Moreland Road, Coburg, gives me exactly that. Indeed, there is a dedicated waiting room as soon as you walk in. From there, you can access the studio, which is presented with a dedicated fitness class space, and again, a third space, which is only for massage. This all set up, gives me the opportunity to keep expanding the quality treatment for Melbourne Massage and Treatment while maintaining the one-on-one care that has always been at the centre of my practice. Easier to Reach Another advantage of the Coburg location is accessibility. Many of my clients travel from the surrounding suburbs, including: Pascoe Vale Brunswick Preston Reservoir Fawkner Thornbury Essendon Kew Fawkner Being located on Moreland Road makes the clinic easy to reach, regardless of whether you’re driving or using public transport. In fact, parking is straightforward, with unlimited parking on Haig Ave, the side street of the clinic. At the old location in Fitzroy North, I know, parking was a bit of a challenge. After all, arriving stressed because you’ve spent twenty minutes looking for a parking spot isn’t the ideal way to start a treatment session. And if you don’t drive, and you want to opt for public transport, you can easily reach the clinic via tram, bus or train. The trams that stop close by are 6,19 and 58, and the train stop close by is Moreland Station. The bus 510 stops right in front of the clinic. Staying Close to Melbourne’s Northern Community Throughout my career, I’ve enjoyed working with people from all walks of life; indeed, I learned many treatment techniques, which would give me the opportunity to get to know more people and more conditions. Among those presentations, we find: Office workers dealing with chronic neck and shoulder pain Athletes wanting to improve recovery People living with lymphoedema who need ongoing management Clients recovering from surgery People simply want to move more comfortably again Coburg sits right in the heart of Melbourne’s northern suburbs, making it an ideal location to continue supporting this diverse community. More Than Just a Change of Address Again, this relocation is not just about changing the clinic’s postcode. It was about creating a space that allows Melbourne Massage and Treatment to continue growing while staying true to the philosophy I’ve always believed in: “Step by step – Move More, Live Well”. I don’t believe treatment should be rushed, and if you know me, you know that well. I don’t believe every client fits into the same treatment plan; indeed, everyone needs a different level of care and attention to detail for their best performance and well-being. Lastly, I don’t believe pain should simply be masked without understanding why it’s there; therefore, I always share with my client my clinical reasoning and the “why” I take a certain approach to their presentation. How is all of this implemented in my Myotherapy Coburg Clinic? Well, the answer is easy: every appointment starts with listening to your concern. Only then do we decide together on the most appropriate treatment approach, because the treatment that works best for you, may differ from the one that works best for someone else. Looking Forward This move represents an exciting new chapter for Melbourne Massage and Treatment. I’m grateful to every client who has supported the clinic over the years, whether you’ve been seeing me since my earlier days in Coburg, joined me in Fitzroy North, or are discovering the clinic for the very first time. If you’re looking for a Myotherapist in Coburg, or you’re seeking treatment for lymphoedema, Manual Lymphatic Drainage, remedial massage or musculoskeletal pain, I’d be delighted to welcome you to the new clinic. I look forward to helping you move better, feel better, and get back to doing the things that matter most. FAQ – Myotherapy and Lymphoedema Clinic Coburg
Jul
Lipalgia Syndrome is a name for a condition that most often, and more commonly, we all call Lipoedema. But why so? And why Lipalgia Syndrome would be more accurate than Lipoedema? My name is Giovanni, and I am a Myotherapy and Lymphoedema therapist who runs Melbourne Massage and Treatment in Coburg. Here at my clinic, I get to work often with clients who have been diagnosed with Lipoedema or clients who are suspicious of having Lipoedema. That said, it can happen that the client themself, are confusing one condition (Lipaglia Syndrome or Lipoedema) for something else, and that’s also because they see oedema in their limb, and associate that with having Lipoedema. But we now know that oedema is not a symptom of Lipoedema unless we are looking at Lipo-Lymphoedema, a really advanced stage of the syndrome, which is not as common as we think. Let’s break down the names: Lipoedema and Lipalgia Syndrome The term Lipoedema combines the Greek word lipo (fat) with oedema (swelling). Unfortunately, as mentioned above, this terminology can be misleading. This happens because by reading the name, we think we have to see an oedema in this presentation, where an oedema, actually, should not be. Because an oedema is caused by a dysfunctional lymphatic system, which is not what we look at when talking about Lipoedema. In fact, Lipoedema is actually a chronic, painful disorder of abnormal adipose (fat) tissue. This is why an increasing number of clinicians have suggested that the condition would be more accurately described as Lipalgia Syndrome, meaning Lip (fat) algia (pain), therefore, painful fat. Then, all this said, to clarify what’s going on with the lymphatic system, there are several investigations that look into the exact role of the lymphatic system in lipoedema, and by now, it is well established that lipoedema is a different condition from lymphoedema. This is because the lymphatic system is generally intact in the early and moderate stages of lipoedema, although secondary lymphatic overload can develop in advanced disease, leading to lipolymphoedema. This distinction is important because the diagnosis, because the treatment approach is different for lipoedema than for lipolymphoedema. Pain Is the Hallmark Symptom for Lipalgia Syndrome One symptom that can be used to mark the difference between Lipalgia Syndrome (or Lipoedema) and other conditions is pain. Patients commonly describe their legs, hips, buttocks or arms as: aching heavy tender to touch painful even with light pressure bruising easily feeling constantly sore without a clear injury In fact, unlike obesity, where enlarged fat tissue is usually painless, Lipalgia presents with diffuse, persistent pain throughout the affected tissues. If someone presents with some of the above symptoms and with a body that mimics the look of Lipoedema, but they don’t experience any pain, well, they don’t have Lipoedema. And again, that’s why we should call it Lipalgia Syndrome, because what we have to look for, is not oedema, but pain, as main symptom. That said, this pain often limits exercise tolerance and significantly affects quality of life. Current research consistently identifies pain as one of the defining characteristics that separate lipoedema from obesity and many other fat disorders. Therefore, from a clinical perspective, this symptom (pain) is essential to diagnose someone with Lipalgia Syndrome (Lipoedema). On the other hand, if a patient presents with enlarged legs or arms without pain, it is worth carefully considering whether the diagnosis is truly Lipalgia Syndrome (Lipoedema). Other conditions may be more likely, including: obesity with disproportionate fat distribution lipohypertrophy lymphoedema chronic venous disorders mixed presentations involving more than one condition Therefore, don’t try to self-diagnose with social media or a simple Google or AI search, as the reality of facts is way more complicated. Why the Name “Lipalgia” Makes More Sense The use and understanding of language influence how diseases are understood. In fact, the word lipoedema understandably directs attention towards swelling and fluid accumulation, when in fact the most disabling symptom for many patients is pain. That’s where the term Lipalgia shifts the focus towards what patients actually experience every day: chronic painful adipose tissue tenderness heaviness impaired movement reduced quality of life Although Lipalgia has not yet become the internationally accepted medical terminology, many clinicians believe it better reflects the clinical presentation and may help reduce confusion with lymphoedema. What Is Lipohypertrophy? One of the conditions that is often mistaken for Lipoedema is Lipohypertrophy, because both conditions involve a symmetrical increase in subcutaneous fat, particularly in the legs and sometimes the arms. The key difference is that Lipohypertrophy is generally not painful. So yes, those conditions are really similar, and the people with lipohypertrophy usually have enlarged limbs but do not experience the diffuse tenderness, aching, easy bruising and persistent discomfort that characterise Lipalgia. For this reason, recognising the presence or absence of pain is one of the most valuable aspects of the clinical assessment. And again, an accurate diagnosis is important because management strategies differ depending on the underlying condition. Assessment at Melbourne Massage and Treatment At Melbourne Massage and Treatment in Coburg, I provide comprehensive assessments (not diagnoses) for people experiencing leg or arm enlargement, chronic pain, lymphatic conditions and soft tissue disorders. What I refer to as assessment, and not diagnosis, is the fact that I don’t have the clinical possibility to diagnose anyone with anything, but I can point you in the direction of further investigations to get to understand what is happening to your body. Further investigation can involve talking to your GP about specific tests or referral to a specialist, who can assist you in understanding what your body is going through. Every assessment aims to distinguish between conditions such as Lipalgia (Lipoedema), Lipohypertrophy, obesity-related fat accumulation and lymphoedema so that treatment can be tailored to your individual presentation. Early recognition, education and appropriate management can significantly improve comfort, mobility and long-term outcomes. On my end, I can still offer MLD to overcome pain and where present oedema, and Fitness Class to help you and your body get stronger […]
After two wonderful years in Fitzroy North, I am now ready to announce that Melbourne Massage and Treatment is officially relocating back to Coburg from 1 July 2026. This move marks an exciting new chapter for my clinic, moving into a larger, dedicated treatment space at: 325A Moreland Road, Coburg, VIC, 3058 The new location gives Melbourne Massage and Treatment, Myotherapy and Lymphoedema clinic, the opportunity to grow independently in a space designed specifically for client care, wellbeing, and long-term community connection. A New Space In Coburg for Your Well-Being While Fitzroy North has been an important part of my clinic’s journey, the move back to Coburg comes with exciting opportunities. To start with, the location is a shop-front, and so it provides more visibility. There are still plenty of options to reach the clinic via public transport, and greater potential for the clinic to continue growing. Having a standalone clinic also means clients will now be visiting a dedicated wellness space rather than a room inside a GP clinic. This allows for a calmer and more personalised treatment environment focused entirely on massage, myotherapy, recovery, and movement. At this stage, Melbourne Massage and Treatment will continue operating as a single-practitioner clinic, yes, still only me, but ensuring the same personalised care and attention clients have always received. And you are a Melbourne Massage and Treatment client, you know the effort I put in my work. Thank You to the Fitzroy North Community The support from the Fitzroy North community over the past two years has been genuinely appreciated. Every returning client, referral, conversation, and recommendation has helped Melbourne Massage and Treatment grow. Although relocating back to Coburg was ultimately the right decision for the clinic’s future, the connection with the Fitzroy North community will always remain an important part of the business journey. And luckily, the distance between the old and new locations is only a few minutes by car, or a short public transport journey. Services Available at the New Coburg Clinic All current services will continue to be offered at the new Coburg location, including: Clinical Myotherapy Remedial Massage Fitness Classes Manual Lymphatic Drainage (MLD) Lymphoedema Management Lipoedema Management Thai Massage Thai Yoga Importantly, there will be no price increases to any services following the relocation. Clinic Opening Hours In the new location in Coburg, Melbourne Massage and Treatment will maintain the regular operating hours: Monday to Friday: 9:00 am – 7:00 pm Saturday: 10:00 am – 7:00 pm As I currently work by myself, bookings are highly recommended. However, walk-ins are still welcome whenever availability allows. Clients can check live availability through the online booking system. Parking and Public Transport Now, of course, how can you get there? Well, getting to the new clinic is simple, whether driving or using public transport. Parking 1-hour parking is available directly in front of the clinic: Monday to Friday: 8:00 am – 6:00 pm Saturday: 8:00 am – 4:00 pm There is also plenty of unrestricted parking available on Haig Avenue, located directly next to the clinic. Public Transport Options The clinic is well connected by bus, tram, and train services: Bus 510 – Shamrock St/Moreland Rd stop directly in front of the clinic Tram 19 – Stop 28 (Moreland Rd/Sydney Rd), approximately 10 minutes’ walk Tram 6 – Stop 133 (Moreland Station/Moreland Rd), approximately 10 minutes’ walk Tram 58 – Stop 40 (Moreland Rd/Melville Rd), approximately 11 minutes’ walk Moreland Station – Approximately 10 minutes’ walk Accessibility Information The new clinic space in Coburg is larger and more comfortable; however, please note that the premises currently do not have disabled toilet access. Clients with accessibility concerns are encouraged to get in touch before attending so arrangements and suitability can be discussed. Looking Ahead Returning to Coburg feels like coming home for Melbourne Massage and Treatment. The move represents a fresh start, greater independence, and an opportunity to continue building a trusted local clinic focused on high-quality treatment and personalised care. From clinical myotherapy and remedial massage to lymphatic care and Thai massage, Melbourne Massage and Treatment looks forward to welcoming both returning and new clients to the new Coburg location from 1 July 2026. FAQ
Apr
Neck pain and or upper back pain often originates from a disbalance of mobility and stability joints along the spine, including poor scapula-thoracic joint stability and thoracic mobility. Indeed, a hypermobile scapula can lead to instability, muscular imbalances, and chronic tension in either the shoulder joints or the cervical. Therefore, assuming that neck pain is only a neck issue is a bit limiting. We need to look at the bigger picture and target the right reason why you are in pain. In this blog, we are going to look at how scapular stabilisation exercises can restore balance, enhance posture, and reduce neck pain. Understanding Scapular Stability and Hypermobility The scapula, or shoulder blade, plays a vital role in upper-body movement and stability. It acts as the foundation for arm motion, connecting the humerus to the thorax through the scapulothoracic joint. When control is compromised, which is common for those with general hypermobility or for those who have scapular hypermobility, the result can be excessive movement and discomfort. Consequences of having a hypermobile scapula are: Neck and shoulder pain Reduced athletic performance Increased injury risk Muscle fatigue and tension As is often recommended, we need to look at strengthening as a way to improve muscular control of the joint, and in this case, we would look at: rhomboids, trapezius (upper, middle and lower), and latissimus dorsi, which is essential for restoring balance and function. Mobility Comes First: The Foundation of Stability As already mentioned in so many other blogs, and as I educate my clients all the time, before introducing strengthening exercises, mobility must be addressed. A stiff thoracic spine forces the scapula to compensate for many shoulder movements, leading to muscles originating and or inserting in the scapula to be overused, leading to pain and discomfort. Essential Thoracic Mobility Exercises There are some really easy exercises that you can do to pick up on thoracic mobility. Here is a short list: Foam Roller Thoracic Extensions Open Book Rotations Thread-the-Needle Cat-Cow Mobility Drill Diaphragmatic Breathing Exercises Those exercises would help in restoring thoracic mobility, preparing the groundwork for effective scapulothoracic stability exercises. Key Muscles for Scapular Stabilisation Now we can look at the muscle that we would need to strengthen to create a better scapular stabilisation. Rhomboids Function: Scapular retraction and stabilisation. Importance: Provide postural support and control during pulling movements. Recommended Exercises: Resistance Band Rows Prone T Raises Seated Cable Rows All those exercises can be easily delivered at home, with some decent resistance bands, or with light weights. But don’t let the simplicity of these rhomboid exercises fool you, as prone T raises, to start with, are enough even with no weights, as the weight of your arm is already enough. Trapezius (Upper, Middle, and Lower) Function: Elevation, retraction, and upward rotation of the scapula. Each fibre group has a different role regarding the scapula movement.Importance: The lower trapezius is essential for shoulder stability and posture. Recommended Exercises: Prone Y Raises Wall Angels Face Pulls Shoulder Shrugs Again, those exercises don’t require a full gym set-up, but some strong resistance bands and light weights would do. Latissimus Dorsi Function: Shoulder extension, adduction, and thoracic stability.Importance: Connects the upper limbs to the trunk and supports efficient movement. Recommended Exercises: Straight-Arm Pulldowns Lat Pulldowns Assisted Pull-Ups Resistance Band Pulldowns Scapular Stabilisation Exercises for a Hypermobile Scapula Now that we have looked at which exercises are ideal for what muscle or muscle group, we can look at a combination of those based on generic fitness levels. Those exercise lists are obviously a generic recommendation, and unless we have already done some work and assessment, I would not suggest picking and choosing an exercise routine and trying your best to sort out your pain. Beginner Level Scapular Setting Exercises Wall Slides Isometric Holds Against a Wall Serratus Anterior Punches Intermediate Level Prone Y and T Raises Resistance Band Pull-Aparts Face Pulls Incline Dumbbell Rows Advanced Level Landmine Presses Farmer’s Carries Overhead Carries Pull-Ups with Controlled Scapular Movement Furthermore, these exercises for scapular stability enhance neuromuscular coordination and are particularly beneficial for individuals with hypermobility. How Scapular Stability Reduces Neck Pain While we can’t directly associate hypermobility of the scapula with neck pain, we also know that poor scapular control often leads to overactivation of the upper trapezius and cervical muscles, contributing to neck pain. By strengthening the stabilisers of the scapulothoracic joint, mechanical stress on the neck is reduced. Therefore, here is a list of the benefits of scapular stabilisation exercises: Improved posture Reduced neck and shoulder pain Enhanced thoracic control Increased muscular endurance Better movement efficiency Lower risk of injury How We Support Scapular Stabilisation at Melbourne Massage and Treatment At Melbourne Massage and Treatment, in Coburg, the treatment of scapular stabilisation starts from a tailored assessment of your presentation, looking at: Overall hypermobility Your clinical history Past and present sports activities Site of pain Pain time frame That and more information are essential to understand what your experience is, and what we can do about it. Hands-on treatment, like remedial massage or myotherapy, would be the first step to relax the body and allow you to feel and move better. The next step from that would be guiding you throughout exercises that you can deliver at home or at the gym, at your own time, so that you can take control of your pain and your presentation. All of this can be easily delivered along a treatment plan. And to simplify the whole process, I also offer a FREE 15-minute Online Consultation, where we can start looking into your presentation and understand what has been done till now and what needs to be done at this stage.
Apr
If you have been at the clinic most recently, you may have heard me talk about LLLT (Low-Level Laser Therapy). LLLT is one of those tools that quietly adds a lot of value to any treatment modalities I get to offer, without making a big fuss, and without increasing the service fees. So yes, in this blog, we are going to look into why I use it, what the science says, and, most importantly, what it can do for you. First Things First: What Is Low-Level Laser Therapy? The simplest explanation I can share is that LLLT (also called photobiomodulation) uses specific wavelengths of light to stimulate your body at a cellular level. Indeed, LLLT is not a hot or burning type of laser, but it is a low-intensity, non-invasive light that interacts with your tissues to encourage healing and reduce pain. This is possible because LLLT stimulates the cell in producing more ATP energy (cell energy) which than can be used for the cell to replicate. Simply, it helps your body do what it’s already trying to do, just more efficiently. What Does the Science Say About Low-Level Laser Therapy? As a practitioner who offers his service based on scientific recommendations, I’m very particular about what I bring into the clinic. If it’s not backed by solid research, it doesn’t stay. Therefore, here’s what recent PubMed evidence tells us: Pain Reduction In a systematic review by Diaz et al. (2025), they looked at 44 randomised clinical trials and found that LLLT can reduce pain by 60–70% in certain musculoskeletal conditions (in this case, TMJ) while also improving function. When a systematic review shows such results, it is considered strong evidence. Supports Injury Recovery & Reduces Inflammation When looking at Lawrence J. Sorra K., (2024) review, that did focus on Low-Level Laser Therapy (LLLT) for Acute Tissue Injury or Sport Performance Recovery the highlighted facts about LLLT are: Modulate inflammation Improve tissue repair Support recovery after injury All with minimal risk or side effects. That said, in this review, it is also highlighted how, in acute injury, there is a lack of evidence for LLLT effectiveness. In conclusion, than, is shown how no side effects are present and how LLLT is a safe therapy to be add to other modalities, especially fitness classes. Works Best as an Add-On (Not a Replacement) About this last statement, that LLLT is not a substitute for other modalities, we have a meta-analysis by Awotidebe A. et al. (2019), which shows how LLLT can provide additional short-term pain relief when combined with exercise or therapy, even if it doesn’t always change long-term function on its own. And this is the key point most people miss. LLT is not magic; It’s a multiplier. Exercises are the medicine. Why I Use LLLT at Melbourne Massage and Treatment? I decided to invest in the usage of Low-Level Laser Therapy SymbyxBiome DuoCare 904, which operates in a wavelength range consistent with what research suggests is effective (typically around 800–900nm), as it can be an effective treatment modality to help my patient feel better, reduce their inflammation and pain, so that they can move better and be able to deliver exercises without bein in too much pain. And here is another important part: I don’t charge extra for it. Why? The answer is simpler than you may think. LLLT is not a “standalone service” in my philosophy; it’s a value-add. If it can: Reduce your pain faster Help your tissues recover better Improve your overall outcome Then, as with any other therapy, it belongs inside your session, not on top of your invoice. What LLLT Does Feel Like? When telling people what LLLT feels like, I respond with: “Drop your expectation”. In fact, you will feel: No heat No discomfort No downtime And yet, underneath the surface, your cells are being stimulated to: Produce more energy (ATP) Improve circulation Reduce inflammatory markers That’s where the real magic happens. It is a way to make your body do what it does normally, only faster. And there is no side effect. What Condition Can Benefit Best From LLLT? Conditions where LLLT is recommended for are: Persistent muscle pain Tendinopathies Jaw pain (TMJ) Post-injury recovery Fibrosis Scar tissue Any presentation would need treatment that lasts 10 to 20 minutes, and the frequency of treatment can be 2 to 5 times a week, with results of pain relief after 3 to 6 weeks. Those numbers vary depending on the type and location of the injury. What we know is that for the early stage, it is better to have more frequent treatment, and after week 1, the treatment can drop from 4 to 5 times a week to 3 times a week, till once a week for major injury if the treatment has to go on for 5 to 6 weeks. Why Frequency Matters As mentioned above, LLLT works by stimulating your cells, particularly the mitochondria, to produce more energy (ATP), which helps with: Tissue repair Reducing inflammation Pain modulation But that effect doesn’t last forever; cells need a more frequent stimulation to obtain the best results. Therefore, if sessions are too far apart, you lose momentum, but if they’re too close without reason, you’re not adding extra benefit. So that’s why, in the initial phase of an injury, we work more often to boost the recovery, and once the recovery is nearly optimal, and you are doing your exercises and structural strength, then the LLLT session can be placed further apart. What Is The Bottom Line Regarding Low-Level Laser Therapy? After so many years in the massage industry, and after all the research and studies of different modalities, there is one thing that I have learned. There’s no single “miracle treatment.” But, on the other hand, there are combinations that work extremely well together. Hands-on therapy + movement + the right adjunct tools, that’s where results happen. And LLLT is one of those tools. So drop your expectation of magic and no effort […]