A pain response is a signal created by the brain to let you know that something within the body is not right, or at least, that something, potentially, is not right. This means that pain is a sensation that can also be there when no actual damage is present in the first place. But when you feel pain in the neck, in the shoulder, in the knee or somewhere, how can you differentiate if it is a pain given by muscles or by a joint? In this blog, I want to talk about the difference between muscle pain and joint pain. Muscle and Joint Pain: Let’s Start With Clinical History Intake When someone presents to the clinic in pain, the first thing I do is to track down their medical history, which includes their daily activities, previous injuries (old and recent), sports history, medications, quality of sleep, etc.. From there, I start to narrow down when they have been experiencing the pain, and what caused it in the first place, and where they feel it. Already, that information can give a good perspective of what we are looking at, in terms of muscle pain and joint pain. Knowing the time frame of the pain, the location of the pain can already give an answer. But before jumping to conclusions, we need to do some testing Active and Passive Movement: The Differences In Pain Response After an accurate intake of the clinical history, we would proceed with some testing, including active and passive range of motions. Active range of motions (AROM) are those movements that the patient would do on their own, like flexing the shoulder, rotating the hip, etc Passive range of motions (PROM), on the other hand, are movements that the therapist would do with the patient’s body. So you will be asked to keep your arm and shoulder relaxed, and it will be the therapist who moves the arm. Here is where things start to get interesting. If you respond with pain with AROM, we know that you are using both your muscle and joint to deliver the movement, so the pain response that you feel could be either from the muscle or the joint. But if you respond with pain with a PROM, then we know that the response is from the joint, because the muscle, in that specific motion, is not working. How about tendon? So, when delivering a PROM, we may push the movement to its limit, creating a stretch motion. This specific endpoint of movement, if it reproduces a really pinpoint specific pain, that is sitting right on to what we can recall as a tendon (the insertion point of the muscle), it is another differential tool to understand what the pain is caused by. So yes, to simplify, we use PROM to identify a joint pain, but in that joint pain, we include the tendon itself, not only the ligaments. Ligaments, per clarification, are the tissues that hold the bones together and make up the joint. Orthopedic testing: another tool for differentiating muscle pain from joint pain But the rabbit hole of understanding where that pain is from doesn’t stop here. That’s why we also use orthopedic testing when looking at a pain presentation. Ortopedic testing is a test that places stress on a specific structure, and can have a range of sensitivity and specificity. Sensitivity refers to the test’s ability to identify individuals who have the condition being tested for. Specificity refers to its ability to identify individuals who do not have the condition. Those two terms, that get evaluated in %, can tell us how valuable a test is. And most often, to validate a hypothesis of what can cause the pain, we have to use multiple forms of testing, from AROM to PROM to orthopedic testing and Clinical History. Neck Pain: Muscle Pain or Joint Pain – A case study Neck or upper shoulder pain is one of those common presentations, where the patient presents thinking that it is due to a muscle issue, but then, you prove to them that it is actually their joint that is the issue. Who is Peter, and with what pain does he present himself? Let’s examine a case study of Peter (name of fantasy), a 43-year-old office worker presenting with pain radiating from his right neck to the upper shoulder. Despite various stretches, the pain persists. He tried many pillows, he tried any sleep position, but this pain comes and goes, and has been on for years. Peter presents with a pain level today of 7/10, complaining that certain neck movements are limited and painful. It is hard, for example, to do a head check while driving. Clinical History So, first thing I would do is go through Peter’s clinical history and find out that his pain started about 10 years ago, after a whiplash accident, and that at that time, more than having a collar on his neck for a week or two, he hadn’t done much about it. Hi pain, which occasionally radiates to the neck, also gives him a headache. Sport history includes playing AFL from when he was a kid till his mid-twenties, and nowadays the occasional swim, yoga and pilates class. He spends most of his days working from home or at the office, sitting in a chair. In addition to this, we also know that: No pain radiating down the arms, no pins and needles in the hands; Pain is worst in the morning; Stretching gives an initial relief, but then it gets worse. Differential Diagnoses (DD) Differential diagnoses are the hypotheses we think of when someone presents with pain. Let’s say that is what we think we could find as a problem, given the patient’s complaint we received. And out of 3 or 4 DD’s, we will draw a line that connects all the results and get a Working Diagnosis (WD), which is the most plausible answer given the results we obtained. This said, this […]
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Modern life places ongoing pressure on both body and mind, leaving many Australians searching for natural ways to restore calm. Muscle tightness, fatigue, and poor sleep are often signs that stress has taken hold. At Melbourne Massage and Treatment, remedial massage is used as a practical therapy to release tension, regulate the nervous system, and support wellbeing, offering a balanced pathway to sustained relaxation and resilience. Key Takeaways Stress affects both body and mind Remedial massage releases tension and restores balance Circulation and sleep improve with regular sessions The nervous system resets during treatment Melbourne Massage and Treatment offers expert support What is Remedial Massage? Remedial massage is a form of therapeutic massage that targets specific muscles and tissues to relieve pain, promote healing, and improve function. It combines various techniques, including deep tissue work, trigger point therapy, myofascial release, and stretching, to address both acute and chronic conditions. Unlike relaxation massage, which focuses on general relaxation, remedial massage is tailored to treat specific problems in the body, such as muscular tension, joint pain, and postural imbalances. The key difference between remedial and other types of massage is that it aims to treat underlying physical issues and dysfunctions, which can, in turn, help to alleviate the mental and emotional effects of stress. Stress can manifest physically in the body in various ways, including muscle tension, headaches, poor posture, and fatigue. Remedial massage directly addresses these physical symptoms, creating a ripple effect that helps to calm the mind and restore balance. How Remedial Massage Reduces Stress? Stress doesn’t just impact your mind; it can manifest physically in the body, resulting in tight muscles, headaches, neck pain, back discomfort, and other ailments. When the body is under stress, it produces higher levels of cortisol harmone, a hormone linked to the body’s “fight or flight” response. This can lead to increased muscle tension, heart rate, and even digestive issues. Remedial massage works by targeting these physical manifestations of stress and promoting relaxation in several ways. 1. Reduces Muscle Tension One of the most immediate and noticeable benefits of remedial massage is its ability to reduce muscle tension. When we experience stress, we often unconsciously tighten our muscles, especially in areas like the neck, shoulders, back, and jaw. Over time, this chronic muscle tightness can lead to pain, discomfort, and restricted movement. Remedial massage helps to release this built-up tension by applying pressure to specific muscle groups, promoting blood flow, and encouraging the muscles to relax. Targeted Techniques: Techniques such as deep tissue massage and trigger point therapy can focus on areas where muscle tightness tends to accumulate due to stress. These methods help to break up muscle knots and reduce the overall tension in the body. Increased Blood Flow: By improving circulation, remedial massage enhances the delivery of oxygen and nutrients to tissues, promoting healing and relaxation. 2. Activates the Parasympathetic Nervous System The autonomic nervous system consists of two branches: the sympathetic nervous system (SNS), which triggers the ‘fight or flight’ response, and the parasympathetic nervous system (PNS), which manages the ‘rest and digest’ state. Chronic stress keeps the SNS activated, which can leave the body in a constant state of alertness. Remedial massage stimulates the PNS, encouraging the body to relax and return to a state of calm. Relaxation Response: When the PNS is activated, heart rate and blood pressure drop, and the body enters a state of relaxation. This not only helps with muscle relaxation but also reduces anxiety and promotes overall mental well-being. Lowering Cortisol Levels: By activating the PNS, remedial massage helps to lower cortisol levels in the body. This reduction in cortisol can help combat the harmful effects of prolonged stress, such as anxiety, poor sleep, and immune system suppression. 3. Improves Sleep Quality Stress often leads to poor sleep, whether through difficulty falling asleep or waking up throughout the night. One of the ways that remedial massage helps to combat stress is by promoting better sleep. Through its calming effects on the nervous system and muscle relaxation, massage encourages a deeper, more restful sleep. Relaxation Before Bed: A remedial massage session before bed can help you unwind from the day’s stress, allowing you to go to sleep feeling relaxed and at ease. Improved Sleep Cycle: By reducing tension and lowering cortisol levels, remedial massage helps to improve the quality of sleep, leading to more restorative rest and reduced feelings of stress the following day. 4. Reduces Anxiety and Enhances Mood Stress and anxiety often go hand in hand. While stress tends to be a response to external pressures, anxiety can become a persistent feeling that affects your mental health. Remedial massage has been shown to have a positive impact on mental health, particularly by reducing anxiety and boosting mood. Endorphin Release: Massage stimulates the release of endorphins, natural chemicals in the brain that promote feelings of well-being and happiness. This helps to counteract the negative effects of stress and anxiety, providing a natural mood lift. Emotional Release: For some individuals, massage can facilitate an emotional release, allowing pent-up emotions from stress to surface. This can be therapeutic and contribute to a feeling of emotional lightness and mental clarity. 5. Improves Posture and Reduces Pain Chronic stress can lead to poor posture, which, in turn, can contribute to musculoskeletal pain. When we’re stressed, we tend to slouch or hunch over, especially when working at a desk for long periods. This poor posture can lead to discomfort in the back, shoulders, and neck, further exacerbating stress. Remedial massage works by improving posture and reducing musculoskeletal pain. Postural Correction: Remedial massage helps to release tight muscles and realign the body, improving posture and reducing the discomfort associated with poor alignment. Pain Relief: By targeting specific areas of pain, remedial massage can relieve discomfort in muscles, joints, and connective tissue, contributing to an overall sense of well-being. Additional Benefits of Remedial Massage for Stress Relief In addition to the direct effects on the body and mind, remedial massage offers […]
Aug
Thai yoga combines assisted stretching with mindful breathing to restore mobility, release tension, and create deep relaxation. At Melbourne Massage and Treatment, this approach blends traditional techniques with professional care, allowing clients to experience greater freedom of movement and a calmer state of mind. With its unique mix of yoga-inspired postures and therapeutic massage, Thai yoga holistically supports both body and mind. Key Takeaways Thai yoga blends stretching, mobility, and relaxation It improves flexibility and posture Stress relief is a core benefit Sessions are fully guided and accessible to all Melbourne Massage and Treatment tailors each session to your needs What is Thai Yoga? Thai Yoga, also known as Thai yoga massage or Thai bodywork, is a traditional healing practice that originated in Thailand over 2,500 years ago. It combines elements of: Yoga-style stretching Acupressure Mindful breathing Meditative touch Unlike a regular massage or a typical yoga class, Thai Yoga is a partner-based practice. The practitioner gently guides you through yoga-like stretches and poses while applying pressure to specific points along the body’s energy lines, known in Thai tradition as Sen lines. The result is a deeply restorative experience that helps release tension, increase range of motion, and calm the nervous system, all without you having to lift a finger. At Melbourne Massage and Treatment, Thai yoga is offered as part of a tailored approach to mobility, posture, and recovery. Mobility: Loosening Up the Joints and Muscles One of the biggest benefits of Thai Yoga is improved mobility. Many of us deal with tight hips, sore backs, or stiff shoulders, whether from sitting all day, overtraining, or simply getting older. Thai Yoga works to gently open up these areas by: Stretching muscles in a passive and supported way Mobilising joints through guided movement Increasing circulation and blood flow to tight or stagnant areas This kind of assisted stretching helps lengthen muscles and fascia (the connective tissue that surrounds your muscles), which improves flexibility and reduces the risk of injury. And because you’re not doing the work yourself, your body can fully relax into each movement, allowing for a deeper and safer stretch than you might achieve on your own. Relaxation: More Than Just Taking It Easy Sure, we all love a good nap or a lie-down on the couch. But true relaxation goes deeper than just stopping activity, it’s about letting the body and mind fully switch off, so healing and recovery can happen. Thai Yoga encourages this state of deep rest through: Rhythmic, flowing movements that calm the nervous system Mindful breathing to slow the heart rate and promote stillness Gentle compression and touch that creates a sense of grounding and safety After a session, many people report feeling lighter, looser, and mentally clearer. Some describe it as a moving meditation or a “body reset.” If you’ve been feeling strung out, overwhelmed, or physically tight, Thai Yoga might be the reset button you didn’t know you needed. Who Can Benefit from Thai Yoga? Thai Yoga is suitable for a wide range of people, including: Office workers who sit for long hours and need to improve posture and mobility Athletes or gym-goers looking to aid recovery and reduce tightness Older adults want gentle movement and joint support People dealing with stress, anxiety, or sleep issues Anyone wanting to improve flexibility, body awareness, or simply relax The best part? You don’t need any yoga experience. Thai Yoga is fully guided, and each session can be adapted to suit your body, flexibility, and needs on the day. What Happens in a Thai Yoga Session? Here’s what you can expect during a typical Thai Yoga session: You stay fully clothed in comfortable attire (like gym or yoga wear) The session takes place on a mat on the floor, not a massage table The practitioner uses their hands, thumbs, elbows, knees, or feet to stretch, rock, and apply pressure Sessions can last anywhere from 60 to 90 minutes The experience is quiet, meditative, and deeply calming You’ll be gently moved through a series of postures, from seated twists to spinal stretches, hip openers, and shoulder releases, all while lying down and breathing deeply. For those seeking greater depth, advanced thai yoga practices may also be introduced, incorporating more complex stretches, dynamic flows, and breathwork techniques to further enhance mobility and relaxation. Thai Yoga vs. Traditional Yoga: What’s the Difference? While both practices aim to support flexibility, relaxation, and body awareness, the key difference is that Thai Yoga is done to you, not by you. Traditional yoga involves actively moving into and holding poses, while Thai Yoga is a passive, assisted experience. This makes it ideal for people who: Are you new to yoga or struggle with certain movements Are you recovering from an injury or managing chronic conditions? Prefer a more hands-on approach to bodywork and healing In many ways, Thai Yoga bridges the gap between yoga and massage, offering the best of both worlds. Bringing Thai Yoga into Your Life You don’t have to travel to Thailand to reap the benefits. Thai yoga practitioners are available in cities and regional areas across Australia. Many yoga studios, wellness centres, and massage therapists now offer Thai yoga classes as part of their services. If you’re interested in giving it a go, here are some tips: Look for a certified Thai Yoga practitioner with experience and good reviews Wear loose, comfy clothing (like leggings and a tee) Stay hydrated before and after your session Speak up during the session if any movement feels uncomfortable Approach it with an open mind and no expectations, every session is different Conclusion Thai yoga is more than stretching, it is a practice that restores balance, enhances movement, and promotes deep relaxation. Combining mindful breathing with guided mobility creates space for the body to release tension and recover naturally. Ready to experience the benefits for yourself? Contact us today and book a session designed to improve both mobility and relaxation. FAQ
Aug
As a Lymphoedema therapist, I often get asked what the difference is between Lymphoedema and Lipedema. In this blog, we will explore the differences, the similarities, and what can be done for prevention, management and treatment of those presentations. Furthermore, we will look into how Lipoedema can degenerate into a Lipo-Lymphoedema, and why this is not the case for everyone. What is Lipoedema? Lipoedema is a chronic adipose tissue disorder that primarily affects women. On a global scale, we know that about 11% of women are affected by this presentation, and it often runs in families as it has a strong genetic component. The major characteristics of Lipoedema are an abnormal and symmetrical accumulation of fat around the hips, buttocks, thighs, and legs, and upper arms. On the leg area, the fat appears in abundance in the medial side of the knee, too. Where feet are completely untouched by the fat accumulation, this fat is resistant to diet and exercise and is often painful to touch. The pain is due to the cutaneous nerve entrapped in the fatty tissue, and so delivers a pain response when stimulated. Other Lipoedema key features: Often triggered or worsened by hormonal changes Symmetrical fat distribution Soft, nodular, or lumpy tissue Pain and easy bruising – as per the pain, bruising is due to blood capillary compression from the fat, and so, is easily damaged by touch No skin thickening or pitting in the early stages Nowadays, there is increasing awareness about this presentation, and more and more women find benefit from a management protocol that is not only about cardio and exercise. Part of the Lipoedema management includes: Movement Compression stocking Antiinflammatory diet Skin care Where and if needed, cosmetic surgery intervantion What is Lymphoedema? Lymphoedema, on the other hand, is a condition where lymphatic fluid builds up in the tissues due to a malfunctioning lymphatic system, causing chronic swelling. Compared to Lipoedema, Lymphoedema is strictly related to the Lymphatic system. It can be primary (congenital or hereditary) or secondary (due to trauma, surgery, radiation, or infection affecting the lymphatic system). Lymphoedema characteristics: Unilateral or asymmetrical swelling (though it can be bilateral) Pitting edema – It consists of deep indentation (pitting) left behind on the skin when pressure is applied Skin changes over time (fibrosis, hyperkeratosis, papillomatosis) Affects feet and hands as well – primary lymphedema would start from the extremity Heaviness or tightness in the affected area – can potentially be pain-free, but the limb/s may feel very heavy It does affect men and women – only primary lymphedema has a genetic component Lymphoedema Management The management of Lymphoedema is more tricky than lipoedema, as everyone may react differently to the management, it can be related to other health issue which needs to be considered, and requires the patient to be active in the management side of things. At Melbourne Massage and Treatment, I treat different types of lymphedema, as per the upper and lower body, focusing on an initial reduction of the swelling via a combination of Manual Lymphatic Drainage (MLD) and compression with Combined Decongestive Therapy (CDT). The management of this presentation can take anywhere between 3 and 5 or more appointments, depending on the severity of the presentation. The treatments are better done in close proximity, 24 to 48 hours one after the other, so that we give no time to the body to accumulate fluid back under the skin. Once the combination of treatment allows us to achieve the desired result, which is bringing the limb/s to a thinner size, you will be scheduled for a custom garment wear compression, which will guarantee to maintain the results achieved. This is usually done at other clinics, like Sigvaris or Juzo clinics. Those clinics are specialised in the making of garment wear. Custom garments wear last about 6 months, so twice a year, you will need to change them, and if needed, because the limb/s may start swelling again (especially in summer, when there is a change of atmospheric pressure, due to the heat), a short series of MLD and CDT therapy may be needed. Key Differences between Lymphoedema and Lipoedema Feature Lipedema Lymphoedema Cause Abnormal fat metabolism Lymphatic dysfunction Gender prevalence Almost exclusively women Affects both sexes Onset Often at puberty, pregnancy, or menopause Can be congenital or triggered by injury/surgery Distribution Symmetrical, lower limbs and arms Can be asymmetrical; any body part Feet/Hands Spared Usually involved Pain Tender, painful fat Often painless, heavy feeling Skin texture Soft, nodular fat Skin thickens over time (fibrosis) Pitting Rare (early) Common (early) Response to elevation Minimal improvement Often improves with elevation (if early stage) Bruising Common Not typical Common Characteristics of Lymphoedema and Lipoedema As seen above, the characteristics of Lipoedema and Lymphoedema are different, but, both conditions share chronic swelling, potential functional limitations, and a need for long-term management: Both can cause leg discomfort, heaviness, and swelling Both may lead to reduced mobility Neither condition improves with calorie restriction or exercise alone – it is more about stop the intake of inflammatory food Compression therapy is often used for both Both can have a progressive nature if not managed properly – especially lymphoedema Misdiagnosis is common, often delaying effective treatment When Lipedema Becomes Lipo-Lymphoedema If we stick to a vision of Lipoedema progression, that is possible when no management is put in place, this presentation can degenerate into secondary lymphatic impairment, resulting in a combined condition known as Lipo-Lymphoedema. How this happens: As the fat keeps accumulating under the skin, and there is an increase in inflammation, the lymphatic vessels are put under major load and potential damage Over time, this leads to fluid retention and swelling due to the lymphatic system failing to do its job As the lymphatic system becomes overwhelmed, the person may start experiencing lymphedema symptoms (Example: swelling in the extremities, feet and or hands) Patients now experience both fat deposition and fluid buildup, making treatment more complex Signs that Lipedema has progressed: Swelling starts in the feet […]
Aug
When we think of losing fat, the first action we picture in our head is to start running, walking, swimming or any form of cardio training. But is that actually the best fat loss solution? In this blog, we are going to look into why cardiovascular exercise has many benefits, but when it comes to losing fat mass effectively and sustainably, lifting weights deserves the spotlight. For fat loss, total body weight should not be your target: Focus on Body Composition Another go-to habit, when we focus on losing weight, is to check with a scale where we are at. But the reality of the fact is not as simple. When using a regular scale, you are looking at the total mass of your body, which includes not only your fat, but also your muscle mass, bone mass, etc… Indeed, losing weight isn’t the same as fat loss. Therefore, you should know that when you restrict calories, up to 50% of the weight you lose may come from muscle, not fat–unless you intentionally preserve it through strength training. Muscle is essential for more than movement – it’s a metabolically active tissue. That means it burns more calories at rest than fat. The more muscle you have, the higher your basal metabolic rate (BMR), making it easier to maintain fat loss long-term. Muscles Are Our Metabolic Engine When talking about muscles, we need to change the perspective on their functionality. The locomotive aspect of muscles, which means the ability of the muscles to move the skeletal system, is just one aspect of them, but not the only one. Therefore, when thinking about muscles, start considering that they are also glucose-hungry machines; indeed, they pull sugar out of the bloodstream and help convert it into usable energy. This process is critical for managing blood sugar and inflammation, which are two major drivers of fat storage and chronic disease. So to simplify it, less muscle mass means less body efficiency at using energy, therefore becoming more prone to storing excess calories as fat. Behind this mechanism lies the reason why losing weight without building muscle mass is not a long-term solution, as you will gain weight back. The Double Side of Cardio (When done on its own) When trying to lose weight, it becomes a combination of cardio and less energy intake (a certain type of diet), and to it you add the fact that muscles are not loaded, and by loaded I mean put under strength activities, it becomes easier to lose muscle mass. This happens because the body goes into a calorie deficit, and in order to keep functioning, it is going to take energy off the muscles themselves, reducing their size. This is an extra reason to ensure you are loading those muscles, to ensure the energy to burn is taken from fatty tissue. All of this does end up with yes, a weight loss, but also weakens the very system that helps keep fat off. It’s Never Too Late – Muscle Responds at Any Age This is a topic that we have seen in other blogs, and it is time to remember that age is only a perspective and not a mandatory fail. The body is designed to respond to stimulus, and get stronger and stronger under new and constant stimulus; it doesn’t matter the age. In fact, even older adults, including those in their 60s, 70s, and 80s, can gain strength and improve body composition with the right program. Muscle stem cells (satellite cells) remain responsive well into late adulthood. You don’t need to be a lifelong athlete – many people start lifting in midlife and see dramatic improvements in energy, mobility, and fat loss. How to Lift for Fat Loss As per all the forms of training, there are certain aspects that need to be respected to achieve the desired goal. For fat loss, then, you may want to look into: Focus on compound lifts such as Squats, deadlifts, bench press, and rows, so that you work multiple muscles and burn more calories. Train to near failure, which means from 4 heavy reps or 10 moderate ones, but with progressive overload. Lift 3–5 times per week as consistency beats intensity. And if a week you can do less, it’s ok, don’t be hard on yourself. Look into your eating habits, talk to your local GP about your eating habits and see if you need a referral to a specialist for improving your food habits. Add sprint intervals twice weekly: Brief, high-intensity cardio can enhance fat burning and insulin sensitivity without causing muscle loss. Fitness Class at Melbourne Massage and Treatment At Melbourne Massage and Treatment, in Coburg, I got the skills and the equipment needed to help you achieve your goal, but also, help you learning how to deliver safe exercises for your wellbeing and your athletic preparation. Indeed, when talking about lifting weights, we always want to look at first where your training level is, what your abilities are, and with no judgment, take the first step from there and help you to achieve your short-term and long-term goals. If you are keen to learn more and want to have a chat about your goals, book a 15-minute free online consultation now, so that we can discuss how I can help you and where we can get you with your exercise routine. In Conclusion: Lift First, Then Move More In this blog, we emphasised how strength training is ideal for fat loss, and what we want to tell you with this is that cardio has a place for heart health and endurance, but it’s not the most effective path to long-term fat loss. Prioritising strength training, especially as you age, helps preserve muscle, boost your metabolism, and shift your body into a fat-burning machine. And most importantly, let’s stop chasing a number on the scale. Instead, start chasing strength, power, and metabolic resilience.
Jul
The term “inflammation” originates from the Latin word “inflammare”, meaning “to set on fire” or “to ignite”. And this is why it may sound scary, and sounds like a bad thing to go through, but in the initial phase of an injury, the inflammation is actually a necessary part of healing. Indeed, this initial step is how your body signals that something is wrong and starts the repair process. On the other hand, if the injury is not looked after, especially when we talk about major injury, the inflammatory process can become problematic. In this blog, we are going to look into what the steps are to take when going through an injury, which can be a sprained ankle, recovering from surgery, or managing chronic pain, in order to have the best recovery. The 0–72 Hour Rule: Respect the Acute Phase When going through the initial phase of an inflammation, which is the first 72 hours post-injury, the body enters the acute inflammatory phase, and this is absolutely normal and necessary for the body to start taking action towards safe healing. In this process, the immune system rushes white blood cells and inflammatory mediators to the area to begin cleanup and repair. Things to avoid: Avoid anti-inflammatories (NSAIDs or corticosteroids): As this process is needed from the body to understand what has happened and to clear up the area from eventual pathogens, taking something that suppresses the process is not ideal. Avoid ice: Ice is a vessel restrictor, which means it would slow the amount of blood that is sent to the area. Yes, it may reduce the swelling, but that swelling is innoquos compare to the consequence of not having blood rushing to the area with the nutrience and substance needed to start the healing process. Things you can do: Protect and rest the area. Avoid using the injured area and place weight on it. Rest it and where possible do really some minimal movement that may not cause pain or disconfort. Compression and elevation help reduce fluid buildup. If your goal is to reduce swelling, you can apply compression and keep the area elevated. After 72 Hours: Shift to Recovery Support Past the first 72 hours, the inflammatory response was meant to be settled. If that’s not the case, that’s when it ok to take anti-inflammatories. That would help manage the pain in the long term and allow you to start moving freely. That said, before you take any medication, always consult your GP or pharmacist. Moving forward, this second phase of the injury recovery is called remodelling and repair. In this phase, it is the time to: Introduce gentle movement and rehabilitation exercises – most often isometric hold, which we spoke about in another blog. Use anti-inflammatory agents (if needed) under professional guidance. Massage therapy and heat packs become helpful — they promote circulation, lymphatic drainage, and tissue flexibility. While the remodelling and repair phase starts past the 72h post injury, the recovery itself may last weeks or months, depends on the type of injury. For more details about the healing process of different tissues, read this blog. What Are The Symptoms of Inflammation Post-Injury You may notice that soon after an injury the body has a really specific way to respond to what just happened. This response include: Swelling – more blood is sent to the area; Skin redness Pain to touch or movement Those are some of the visible or more noticeable aspects of an inflammatory response post injury, but on the macroscopic level, there is more happening, such as the rush of white cells to the injured area, and the increase of blood clotting cells, if the skin is cracked. Food, Fats, and Chronic Inflammation: The Lymphatic Link An inflammation is not a process that comes only from an injury. The food and drinks that we intake are a significant source of chronic, low-grade inflammation, especially when they include excessive amounts of long-chain fatty acids found in ultra-processed foods, deep-fried items, and fast food. Given the chemical structure of those fats, which are made from a chain of 16 carbon atoms (therefore long-chain), they can be absorbed directly by the capillary of the bloodstream, due to the narrow passage at the capillary end. Indeed, those fats would get absorbed by the lymphatic system, which capillaries have a wider aperture. That said, once the fat is travelling along the lymphatic system, it would be recognised as an external element and attacked by immune cells such as macrophages, and this is an inflammatory response. Now, when the lymphatic system becomes overburdened with inflammatory fats, it can lead to chronic inflammation. This is also why some people feel bloated, puffy, or in pain even without any injury. This also explains why, when seeing people with Lymphoedema, we refer them to a GP to discuss an anti-inflammatory diet. Given the excess load of the lymphatic system along this presentation, it is better not aggravating it. And to loop back on the topic of this blog, even when you hurt yourself badly with a major injury, or you may be suffering from chronic pain, a balanced diet rich in veggies and fruit, grain and fresh food, is recommended over junk food and inflammatory meals. Top Pro-Inflammatory Foods to Watch Out For: Highly refined vegetable oils Fried foods High-sugar snacks and drinks Ultra-Processed meats How Massage Therapy Helps (and Why Sometimes Hurts) Many forms of massage, especially those where you may experience discomfort and pain, like Remedial Massage or Thai Massage, or even technique like Dry Needling, aim to reproduce microinflammatory response, and that’s why they are effective in helping you with recovery. Indeed, that pain response, is an alarm for your nervous system, which is pushed to send nutrience to the area affected by the pain. Now, what is important is to understand the time frame of healing, the subjective history of the patient we are working with and the level of injury they are presenting with. Massage helps by: […]
Jul
When the space between the collarbone and first rib gets tight, during movement or even at complete rest, it can lead to Thoracic Outlet Syndrome (TOS). Between the two structures mentioned above, we have the passage of the thoracic plexus (nerves) and blood vessels. The compression of those structure, can result in pain, weakness and numbness radiating down the shoulder, arm, and hand. Because TOS has multiple causes and presentations, effective treatment depends heavily on accurate assessment and an individualised approach, and that’s where myotherapy can play a crucial role. What Causes Thoracic Outlet Syndrome? As there are different tissues passing by this space, the nature of TOS can be broadly categorised into three types: Neurogenic TOS: Compression of the brachial plexus (nerves). Venous TOS: Compression of the subclavian vein. Arterial TOS: Compression of the subclavian artery. But not only can different tissues be compressed, but different structures can be responsible for the compression. Indeed, the compression can be due to the scalene muscle, pectoralis minor or bone. And here are some common causes: Muscle imbalances that lead to poor posture (forward head/rounded shoulders); Repetitive overhead activities (which lead to constant compression of the tissues); Trauma (e.g. whiplash or clavicle fracture); Anatomical variations (such as a cervical rib). The Role of Myotherapy in TOS Assessment As a myotherapist, when treating someone with suspicious TOS, we go for a series of assessments that we compare to the clinical history and symptoms. The test itself would aim to reproduce the patient’s symptoms and guide us on what potential structure is compressed. If we are suspicious of TOS, we can aim to reduce tension in soft tissue and give exercises that can reinforce those structures to alleviate any compression in the area. Orthopedic Testing & Myotome Assessment Some common assessments include: Adson’s Test (for scalene involvement) – It consists of reproducing a drop of heart bit in the wrist (affected side) by asking the patient to abduct and extend the arm while rotating (same side) and extending the neck. This would add extra compression on the suspected structures. Roos/Elevated Arm Stress Test (to reproduce vascular or neural symptoms) – It is about asking the patient to lift the arm at 90°/90° and start closing and opening their hands repetitively for 30 seconds to 1 minute. A drop of strength or symptom reproduction would lead to a positive test. Costoclavicular Maneuver (to assess space between clavicle and first rib) – It is delivered by having the patient with depressed and retracted shoulders. The positivity of this test is given by the reproduction of symptoms or a reduction in the distal wrist. Wright’s Hyperabduction Test (for pectoralis minor tightness) – The patients get asked to lift their arm (affected side) above their head while the therapist stands behind and keeps count of the wrist heartbeat. Any symptoms, reproduction, or drop in bit is considered positive. In addition to those tests, we would use: Myotome testing: which assesses the motor function of specific spinal nerve roots; Clinical history: Any history of previous injury, surgeries, work and sport loads; Type and timing of symptoms: When and how those symptoms are reproduced on daily life. All this said, we always have to consider that as therapists, myo or physio as per osteo exc… we can assume that the positivity of many of those test leads to a positive or negative conclusion regarding TOS. Hands-on treatment and exercises in combination can be the easy steps to take to treat the presentation, but can not always guarantee the best outcome, due to each individual’s unique presentation. Hands-On Treatment and Exercise Prescription Once we have more understanding of what is potentially happening in terms of compression, a myotherapy treatment focuses on addressing the underlying causes: Manual Therapy Myofascial release of the scalene, pectoralis minor, and upper trapezius muscles. Trigger point therapy to reduce local and referred pain patterns. Joint mobilisation to improve scapular movement and rib mechanics. Neural gliding techniques to encourage nerve mobility and reduce irritation. Exercise Rehabilitation Postural re-education, particularly strengthening the deep neck flexors and lower trapezius. Scapular stabilisation exercises to improve shoulder mechanics. Breathing retraining is necessary if dysfunctional patterns (like apical breathing) are contributing to compression. Neurodynamic stretches are appropriate for nerve mobility. Together, these interventions help reduce symptoms, improve function, and support long-term recovery. The time frame for improvement, if not complete reduction of the symptoms, can be different per individual, but we can estimate a period of time that goes between 12 and 16 weeks. If no changes are reproduced within this time frame, that’s where we would refer the patient elsewhere for further investigations, like a scan. When Is Surgery Needed for Thoracic Outlet Syndrome? Surgical intervention is typically reserved for cases where conservative care fails or in cases of vascular TOS, where there’s a risk of thrombosis or embolism, but also where anatomical variations, like a cervical rib is present. Surgical procedures may include: Scalenectomy (removal of the scalene muscles) First rib resection Clavicle decompression or repair if there’s previous trauma These operations aim to create more space in the thoracic outlet, thus relieving the compression. Post-Surgical Recovery and the Role of Myotherapy In case of surgery, as a myotherapist, we can still help and ensure a correct recovery post-intervention. Treatment like MLD can help in flushing excess liquid out of the surgery area, but again, we would look into exercises as a form of recovery and rehabilitation of the area affected by the surgery and or affected by the lack of strength that is a consequence of a prolonged period of muscle weakness. More broadly, myotherapy treatment can help with: Pain management Scar tissue Muscle guarding or weakness Neurological symptoms that may persist or reappear Do You Need a Scan if we’re suspicious of TOS? Imaging, as discussed in other blogs, may be recommended when we are suspicious of other presentations, or if standard method are not creating any difference. For example: To rule out cervical disc herniation, tumours, or other causes of neurovascular symptoms. When […]
Jun
Cosmetic surgeries have become increasingly common, with procedures such as liposuction, tummy tucks, facelifts, and breast augmentations helping people achieve their desired aesthetic goals. However, while the surgical aspect gets most of the attention, what often goes under-discussed is the importance of post-operative care, especially Manual Lymphatic Drainage (MLD) in promoting faster, smoother recovery and reducing the risk of ending with fibrosis tissue build up underneath the skin. What Is Manual Lymphatic Drainage (MLD)? MLD is a gentle, rhythmic massage technique designed to stimulate the lymphatic system and encourage the natural drainage of lymph fluid. The lymphatic system plays a crucial role in immune function and fluid balance. After cosmetic surgery, lymphatic flow can become disrupted due to inflammation, surgical trauma, or temporary damage to lymph vessels. While the first few days post-surgery are dedicated to acute recovery and the taking of Antibiotic to reduce the risk of infection post-surgery, as soon as this risk is passed, that’s when you want to start your MLD journey. Why Is MLD Important After Cosmetic Procedures? Cosmetic surgeries often cause swelling, bruising, and fluid accumulation (known as seroma or edema). This is due to the body reacting to an invasive procedure and removing tissue beneath the skin. MLD helps: ✅ Reduce post-surgical swelling ✅ Accelerate the removal of metabolic waste and excess fluid ✅ Improve skin texture and reduce fibrosis (hardened tissue) ✅ Speed up visible results by enhancing contour definition ✅ Decrease discomfort by reducing pressure from trapped fluids As with any surgery, when lymphatic drainage massage is applied, no pain is to be experienced. While I treat someone with MLD I always pass this information up front, to ensure that if they experience any type of pain, I get told about it, so that I can go lighter with pressure. Which Procedures Benefit Most from Lymphatic Drainage? MLD is commonly recommended after: Liposuction (including 360 lipo or Brazilian Butt Lift – BBL) Tummy tucks (abdominoplasty) Facial surgeries (rhinoplasty, facelifts, blepharoplasty) Breast augmentation or reduction Body contouring procedures As a Lymphoedema therapist, I do get surgeons referring me patients to assist them with post-op management, especially when swelling or fibrosis is a concern. When Should You Start Lymphatic Drainage? As briefly explained above, the ideal time to begin MLD is as soon as you stop your antibiotic cycle, and is your surgeon or GP call to when you are safe to do so. On the other hand: Typically, MLD is started 3 to 5 days post-surgery, once acute inflammation has settled and the incision sites are closed or protected. A full course may include 6–10 sessions spaced out over a few weeks for optimal results. Always follow the advise of the surgeon about post surgery, but, when you safe to do, the more movement we add to Lymphatic Draiange, the better the recovery would go. Is MLD Safe post-cosmetic surgery? When performed by a qualified lymphatic therapist, lymphatic drainage is non-invasive, safe, and effective. It’s gentle enough for delicate post-op tissue and can significantly improve comfort and healing time. My qualification in Lymphatic Drainage was done with the Vodder Academy whicg holds the gold standards for MLD practice, and is worldwide well known for the quality of their practice. On the other hand, I also hold a qualification in Clinical Myotherapy, which allows me to help people recover from injury and stick to their fitness goals via training and exercises. When Can I Book My Appointment for Post-Cosmetic Surgery Recovery? My studio, Melbourne Massage and Treatment, is located in Coburg. I work Monday to Saturday, and to book an appointment, you can just head online to the booking page and choose the best time/days that work for you. Given the number of session needed for this type of work, I always suggest to book a series of session in a raw, from to 3 session per week for the first 2 weeks. Session by session we do evaluate together the progress, and chose together what’s the next step. If you have any questions, please do not hesitate to contact me. FAQs – Cosmetic Surgery & Lymphatic Drainage
Jun
Temporomandibular Joint (TMJ) disorders are a common source of jaw pain, clicking, and discomfort that can impact anyone at any age. At Melbourne Massage and Treatment in Coburg, I see many clients presenting with TMJ clicking and associated symptoms. One of the key factors behind the painful symptoms is retrodiscal tissue compression, a condition that not only causes joint noises but may also lead to chronic jaw pain. What Causes TMJ Clicking? Let’s start understanding why TMJ clicks. When looking at the TMJ, we can see that between the two bones that make up the joint, there is a disk, called the articular disc, which is made of cartilage and is meant to keep the bones apart (the temporal bone and the mandibular condyle). In a healthy joint, the disc moves smoothly with the jaw during opening and closing. But when the disc is out of alignment, the condyle may snap over it, creating that characteristic “click.” For reference, a condyle is a rounded protuberance at the end of a bone, which in this case, fits into a cavity. The Role of Retrodiscal Tissue Compression in TMJ Clicking and Pain Right behind the disc lies a tissue known as the retrodiscal tissue, which contains blood vessels, nerves, and connective tissue. When the disc is displaced anteriorly, the condyle may compress this sensitive area during jaw movements. This compression can lead to: Inflammation Persistent pain Increased joint stiffness Neurovascular irritation This is possible because the tissue, as mentioned earlier, is innervated, whereas the disk is not. Therefore, the disk compression on its own is not going to replicate any pain, as there is no nerve to pick up any stimulus in there. Forward Head Posture Would Not Help. Forward head posture is a common presentation linked to TMJ clicking. Forward head posture is characterised by the head sitting forwards compared to the midline of the body, and is often due to a lack of strength in deeper neck flexor muscles. This presentation can make the TMJ presentation worse because of the excessive load placed on the muscles that surround the TMJ (masseter and temporalis muscles). Other reasons include the misalignment of the teeth, which can make the chewing action more difficult and over time, create strain along the TMJ tissues (muscles, ligaments and tendons), but also referral pain from the cervical joint tension can lead to manifest stress in the jaw and face muscle due to constant pain and discomfort. How Myotherapy Can Help At Melbourne Massage and Treatment, I offer a combination of evidence-based manual techniques and exercise therapy to address the root causes of TMJ dysfunction, aiming not just to manage symptoms but to promote long-term recovery. 1. Joint Mobilisation Gentle mobilisation techniques to the jaw, cervical spine, and upper neck can reduce joint restriction, improve mobility, and relieve the pressure on retrodiscal tissue. Mobilisation helps restore normal disc-condyle mechanics, reducing clicking and improving range of motion. 2. Dry Needling Dry needling of trigger points in the masseter, temporalis, and lateral pterygoid muscles can reduce hypertonicity and relieve pain referred to the jaw and head. Targeting myofascial restrictions can also indirectly reduce stress on the TMJ itself. 3. Targeted Exercise Therapy Specific exercises for jaw control and cervical strength are crucial for maintaining results between sessions. Jaw isometric exercises are ideal for pain management and quick relief. Resistance bend exercises for jaw opening. Relaxation techniques for parafunctional habits like clenching Over time, these exercises can enhance joint stability, reduce overloading, and in some cases improve mild degenerative changes by promoting better joint mechanics and tissue resilience. 4. Deep Tissue Massage Massaging the muscles surrounding TMJ and the cervical muscles can help reduce tension, stimulate the nervous system to relax and give a break from pain and discomfort, while improving mobility. As always, there is not one solution for the common presentation of many. Each individual is different, and the treatment results can be different. But what we can expect is that, if we balance the usage of hands-on treatment and exercises, we can create some real change with some great benefits. TMJ Clicking and Menopause Menopause is a topic I have already spoken about in my blogs. Briefly, we can refer to menopause as the period of 12 months or more of missing menstrual periods in a woman’s life cycle. Before that is called perimenopause, and after that, we talk about post-menopause. This step is achieved when a woman has no more eggs to release, and her menstruation has stopped. While it is not the same journey for each woman and there are many changes that women can go through, a common one is stiffness of ligaments. Again, this is not happening in one day, but is a change that comes with time and is different person to person. This is possible because of the lack of estrogen. Indeed, estrogen, along with controlling many other aspects of the biological life of a woman, is also responsible for the elasticity of the ligament. Put: less estrogen, less elasticity. This can explain why, during this phase, women start experiencing more TMJ pain and potentially TMJ clicking. On the other hand, we have no yet enough evidence to say that Hormonal Replacement Therapy is effective for establishing this presentation (Robinson et al., 2019). FAQ – TMJ Clicking 1. What causes the clicking sound in the TMJ?The clicking occurs when the articular disc in the jaw joint becomes displaced, and the mandibular condyle snaps over it during jaw movement. This is often due to disc misalignment. 2. Why does retrodiscal tissue compression cause TMJ pain?The retrodiscal tissue contains nerves and blood vessels. When compressed due to disc displacement, it can lead to inflammation, pain, and stiffness in the TMJ area. 3. Can TMJ clicking happen without pain?Yes. If the articular disc is displaced but the retrodiscal tissue isn’t compressed or irritated, the joint may click without producing pain. 4. How does forward head posture affect TMJ?Forward head posture strains neck muscles and […]
Jun
Bone fractures are a common injury, but with proper care and rehabilitation, bones can heal and regain strength. Strength exercise is a crucial component of this healing process, aiding in bone regeneration and restoring mobility and function. How can a bone fracture? Bones can fracture when placed under a load or force that they can’t tolerate. The load tolerance is subjective, person to person, and can vary based on the individual medical presentation and clinical history. Age it is only a circumstance that at the current moment in our society is seen as an increase the chance of fracture, but if we learn to age by keeping our feet via strength training, age would not be anylonger a risk component. Indeed, during the aging process, the bone can become weaker if not stimulate to positive stress, such as load active loads. The less load they received, the less the bone would keep regenerating, due to a slower metabolism. Therefor, as explained in other blogs, strength training is a key to longevity and better health. How can bone fractures heal? When a bone fractures, the body initiates a complex healing process involving several stages: Inflammation: Immediately after the fracture, blood clots form, initiating the healing process. Soft Callus Formation: Fibrocartilaginous tissue begins to bridge the fracture gap. Hard Callus Formation: The soft callus is replaced by a hard bony callus made of woven bone. Remodelling: The bone gradually remodels into its original shape and structure. This process can take several weeks to months, depending on factors like age, overall health, previous clinical history, medication intake and the severity of the fracture. Even though there is nothing that can speed up the recovery, as this is a body’s natural process, there are things that can be done to assist the recovery and ensure that the healing happens as smoothly as possible. Exercises are one of those factors that are part of the healing journey, but have to be incorporated under supervision, to ensure not to aggravate the presentation. The Role of Exercise in Bone Regeneration As mentioned above, and in other blog exercises, specifically strengthening exercises are a positive load for the body tissues, including bone, which can help stimulate the regeneration of those tissues. Obviously, different phases of healing require and can accept different types of strength exercises. So yes, you would not start with a single-leg jump on a broken tibia Stimulates Bone Formation: Mechanical stress from exercise promotes osteoblast activity, leading to new bone formation. Enhances Strength and Flexibility: Regular movement prevents joint stiffness and muscle atrophy. Improves Balance and Coordination: Reducing the risk of future falls and fractures. A systematic review by Kuijlaars et al. (2019) highlighted that physical therapy exercises, whether home-based or supervised, significantly improve functional mobility and strength post-fracture. Recommended Exercises for Recovery At Melbourne Massage and Treatment, I offer assistance with bone fracture recovery exercises throughout the Myotherapy and Fitness class treatment plan. What I would focus on, too, when aiming for recovery, would be: Weight-Bearing Exercises: Including walking or gentle jogging (if we are talking about lower limb injury), to stimulate bone growth; Resistance Training: Using bands or light weights to strengthen muscles supporting the bone, or the joint to which the bone is attached. Flexibility and Balance Exercises: Again, using weights and machinery, we aim to strengthen the muscles that control your overall equilibrium and stability to prevent further falls and reduce the risk of injury. Plyometrics which is most often towards the end of a recovery process from anytype of injury, where we focus on motion that are more close to return to daily activity, and we load your tendon as springs, as per can be doing jumping on the spot or repetitive explosive motions with arms. Clinical Evidence Supporting Exercise in Recovery from Bone Fractures Research, as already mentioned in the Kuijlaars et al. (2019) systematic review, shows the benefits of incorporating exercise into fracture rehabilitation, and below we look into more details about what exercises have to offer in terms of recovery: Improved Healing Rates: Patients engaging in structured physical therapy often experience more robust bone healing (Song, 2022). Reduced Complications: Regular movement decreases the risk of complications like deep vein thrombosis or joint stiffness (Ruan et al., 2023). Enhanced Quality of Life: Maintaining physical activity levels improves overall well-being and independence (Mahindru et al., 2023). What to consider when doing exercises post-bone fractures. While exercise is beneficial, it is always important to approach the recovery process with care: Follow Medical Advice: Always adhere to the guidelines provided by healthcare professionals. Avoid Overexertion: Pushing too hard can hinder healing or cause re-injury. Going hard or going home is not how recovery works. Monitor Pain Levels: Some discomfort is normal, but sharp or persistent pain should be addressed immediately. Pain-wise, on a scale of 0 to 10, we usually aim to get you to experience a comfortable discomfort, based on your worst pain experienced as a maximum threshold. Recovery from an injury, including a bone fracture, is a personal journey, and therefore is unique to everyone, in terms of how quickly it can be and what considerations to take into place during the exercise recovery. FAQs – Bone Fractures Recovery and Strength Training 1. How do bones fracture?Bones can fracture when exposed to forces they cannot tolerate. This tolerance varies from person to person, depending on factors like health history, bone density, and physical condition. While age is often seen as a risk factor, it’s more about reduced activity levels. With consistent strength training, the risk of fractures can be lowered significantly, regardless of age. 2. How does a fractured bone heal?Bone healing occurs in four key stages: Inflammation: Blood clots form to protect and initiate healing. Soft Callus Formation: Fibrous tissue bridges the fracture. Hard Callus Formation: New bone begins forming. Remodelling: The bone reshapes to its original form.This process varies in duration based on the severity of the fracture and individual health factors. 3. Can exercise speed […]