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Lymphedema Melbourne

Posted on by Giovanni La Rocca
Leg with Lymphedema
13
Aug

Lymphedema is a health condition that develops when the lymphatic system gets dysfunctional. Compared with lipoedema, Lymphoedema presents disproportional swelling in 1 limb per side. As stated above, what’s behind the swelling is a malfunctioning lymphatic system that leads to an increased amount of protein below the skin (lymph liquid). As already discussed in a previous post about MLD, the lymphatic system has the function of taking away the lymph liquid and pass it on to the bloodstream. Indeed, from the bloodstream, it will all get filtered from the organs such as kidneys and liver to be disposed of. The lymph liquid is mainly made of water, protein and dirt. How MLD works? The Manual Lymphatic Drainage technique stimulates the lymphatic system that can also be boosted by muscular movement. Indeed a 30-minute to 1-hour walk can speed up the Lymphatic System to double speed. This happens due to the capillary (pre-collector) of the lymphatic system, which constantly opens and closes to suck away the lymph. The faster the opening and closing of the doors of the capillary, the quicker the suctions would be. How may lymphedema develop? Where things can go wrong is when the lymphatic system stops working or doesn’t work strong enough in one or more than one area of the body. The reason why the LS stop working and cause lymphodema is as follow: Missing lymph nodes can happen after surgery for cancer removal Genetics missing lymph nodes as per genetic Parasites Surgery damages the pre-collector/collector or lymph nodes with invasive surgery. Radiation due to cancer treatment Are there risk factors? Older age Excess weight or obesity Rheumatoid or psoriatic arthritis When Lymohodema starts developing, an intervention of a professional carer is essential. Here is a link to a Manual Lymphatic Drainage therapist worldwide that can help you with that. Seeing a GP is also recommended. For intervention, I refer to MLD as a manual technique to boost the lymphatic system, compression bandaging and garments wear. The consequence of letting go of Lymphodema is quite severe. As the skin keeps swelling, it will stop receiving oxygen from the bloodstream sooner or later. As per result, the skin would start drying out, cracking, and possibly getting infected. Said so, the consequence can be even more severe and lead to Cancer too. MLD at Melbourne Massage and Treatment Regarding my training as an MLD therapist, I can’t treat clients with Lymphodema yet. My skills within the MLD technique are limited to working with a patient with an intact and fully functioning Lymphatic System. But don’t hesitate to contact me if you need more information about Lymphodema, as I can put you in touch with a therapist who can help.    

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Ice Pack

Posted on by Giovanni La Rocca
Ice pack
16
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.

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Muscle Tear

Posted on by Giovanni La Rocca
Muscle Tear
02
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.

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Calf Muscles

Posted on by Giovanni La Rocca
17
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.  

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Blog

Scap-Off Load

Posted on by Giovanni La Rocca
Scap Off Load Remedial Massage SetUp
11
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.

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First Massage Appointment

Posted on by Giovanni La Rocca
Giovanni giving a Thai Massage as part of treatment plan to a client
01
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.

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Bone Fracture and MLD

Posted on by Giovanni La Rocca
bone fracture
25
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.  

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Neck Pain

Posted on by Giovanni La Rocca
neck pain
26
Feb

Neck Pain. Neck pain is something that we all did experience at some point in life and is not fun. Neck pain can manifest for very different reasons, it can be chronic, it can come and go and can debilitate our day. How we can prevent neck pain to happen? And, if I am in pain, what I can do? Firstly we should have an understanding of the neck anatomy. The neck is made from the cervical vertebrae that run from C0 to C7. The first 3, so C0, C1, C2 are a bit unique. Due to their position and to the muscle that they connect, they can be considered the upper portion of the neck. Along those 3 vertebrae, we find the Occipital Muscle Group, which we did talk about in this blog post. From C3 to C7, indeed we have the lower portion of the neck. Along those vertebrae, we find different muscle groups. Some of those connect cervical vertebrae to the thoracic one, like Splenius Cervicis. Others connect the vertebrae to the scapula or to the skull, like Levator Scapulae, and Splenius Capitis. As of last we then have the upper portion of the Erector Spinae group, which connects the rib cage to the Cervical and Skull area. Like, Longissimus Capitis, Longissimus Cervis, Illiocostalis Cervis and Semispinalis Capitis. Now that we are a bit more aware of what is where, we can start to understand that neck pain can be for many, many, and many reasons. So, what to do then? Well, a massage therapist can be the one that thanks to orthopaedic tests and Range of Motion analysis can tell you what’s going on and where. For booking now your next appointment with Melbourne Massage and Treatment click here. Indeed, neck pain can be present because of the rounding of the shoulders. Or even because of a flat foot instead. “And what about the wrong pillow?!” Yes, the pillow can influence the neck life, that’s for sure. But maybe is the way that you sleep, and not the pillow only. Said so, with either a Remedial massage or a Thai Massage neck pain can be healed and cured. Both those techniques can address the issue and help in preventing the flare-up of the pain. In regards to the Remedial Massage, it can be applied in a prone, supine or seated position, using hands and elbow mainly. When it comes to Thai Massage then, there is more fun. Well, at least for the therapist. In the Thai Massage that I offer here at Melbourne Thai Treatment, I can use my hands, elbow, or even my feet to work on the neck. Obviously, I did train for it. And let me tell you, not because I use my foot it means is a stronger work. Actually, it is a more delicate and accurate touch than what you may expect. If then the person presents with a bulging disk in the cervical area, then things get a bit more complicated. To receive a massage there, I would request the clearance of the GP, and I may proceed by using MLD only. MLD can be a fabulous technique to work on to the neck. It can help in reducing swelling and speed up the recovery of the building disk too. In conclusion, to avoid neck pain is good to take some precautions. Like, spending less time on the phone, moving the neck with gentle movement and stretching, taking regular breaks from the computer if working too many hours at the PC, make your deep flexor stronger (see the blog post about the Front Head Carriage).

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Sunburn and MLD

Posted on by Giovanni La Rocca
Sunburn on back
12
Feb

MLD and Sunburn. As already mentioned earlier, MLD stands for Manual Lymphatic Drainage and is a great technique to treat sunburn. Indeed MLD is a technique that works with a gentle touch and has a multitude of benefits, including the healing from sunburn. Firstly, we analyse what sunburn is about. So, a sunburn is the skin’s reaction to too much exposure to ultraviolet (UV) radiation from the sun. Here in Australia, the amount of UV radiation is higher than elsewhere in the world. As per result, in Australia, we have to be extra careful. If the sunburn reaches the 3rd degree of burn, medical attention is required immediately. During summer or even winter when we expose our skin to the sun. You can have a sign of sunburn within minutes from overexposure. The first symptoms are skin redness, burning sensation and pain to the touch. Long-term sunburn can lead to bad scar or even to skin cancer. If this post is talking to you, book your next massage session by clicking here. So, How MLD can help if I get sunburned? MLD thanks to the light touch, firstly, will avoid the patients being in pain during the touch. Furthermore, by activating the suction effect of the Lymphatic System, MLD boosts the healing process. This is possible by removing the liquid from under the sunburned skin area. The lymphatic system would then, clear up the excess liquid and would allow the skin to get oxygenated once again. Said so, when treating someone with sunburn, as therapists we always have to look for possible skin infections and other absolute contraindications. If the skin over the sunburn area is craked and infected, then we will have to wait for the infection to heal. In addition to this, if the sunburn is as bad as 3rd-degree burn, we may don’t wanna touch the sunburn directly, but applying MLD in a close area can still help the lymphatic system to be activated remotely or on the area affected. In conclusion, remember always to put sun cream before exposing yourself to sunlight. Put the cream 30 mins before having a bath. Either in the sea or swimming pool, in order for the cream not to be absorbed and not be washed away. Avoid the hottest hours. Check the UV exposure on the Victoria Government weather website (https://www.bom.gov.au/vic/forecasts/melbourne.shtml). Stay in the shade and drink plenty of water.

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Altar within a Massage Clinic

Posted on by Giovanni La Rocca
Altar with in a massage clinic
07
Feb

Altar within a Massage Clinic. As you may already know, part of my training was done in Thailand at Pichest Boonthumme Thai Massage School. That’s where I learn about Altar within a Massage Clinic Pichest, as already mentioned in a previous blog post, is a unique way of teaching. In fact, he doesn’t only share the massage knowledge. He included in his teaching a methodology of life. Included in this methodology there is the dedication to prayer and meditation. Even though I haven’t included the prayer yet in my experience, I did include the meditation. In order to do so, in order to build a stronger attitude toward those practices, at Melbourne massage and Treatment clinic there is a little altar the clinic. On the altar, based on the teaching of Pichest, I do expose my offer and memory to the Buddha, to Mamma and Papa’, and to the Teacher. In addition, I did decide to place objects or pictures that recall for me a special time, a memory o a person that someone, shared with me some teaching. Furthermore, just below the altar, there are the products that I sell as the Incenses. But you know what’s the funny thing about the altar present at the Home Clinic here in Blair St? Well, it was already there. I didn’t have to install it. If this post is talking to you, book your next massage session by clicking here. True fact is that, when we came for the house inspection, we right away address that room as the clinic, due to the presence of the wooden altar. A few days after we did move in, I did find out the truth about our neighbour that someone else, before us, already was running a massage studio in the same room. What a coincidence, right?! In conclusion, I am working on my way to improving my practice, and not as a massage therapist only, by taking the Myotherapy course, but also by improving my meditation practice and my prayer practice. I can’t define myself as a religious person, but even though I believe in trust and faith. Thanks again for reading my blog, Giovanni

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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.