While I guide my client during a 1:1 fitness class at Melbourne Massage and Treatment, a Myotherapy clinic in Coburg, on how to learn using bands or a single-column pulley machine to practice KLT (Kinetic Link Training), I often get asked how someone should or shouldn’t do a lunge. “Should my knee go ahead of my toes?” “Should my knee stay on top of my ankle?” “What about my back? Should I hinge or stay straight?” The answer to those questions lies in a simple fact: what part of the body are you trying to train? Are you aiming to build more glut (posterior chain) or quads (anterior chain)? No, because there is no perfect lunge, as either right or wrong. As per the squat, there is the lunge that works for you, for your presentation and for your goal. The Two Main Lunge Strategies (And Why They Matter) So, when we talk about lunges, most people are really debating between two variations: Knee Travels Forward (Past the Ankle Line) When going for this variation, we have to conceptualise that the knee is going into a deep flexion, right? Now, if the knee has to come out of flexion, the quads are the muscle that needs to be engaged. (Quads are the knee extensors). The deeper the knee flexion, the more quads fibres are engaged to do the reverse to get the extension done. In fact, what this type of lunge does is: Increases knee flexion Increases quadriceps demand Places more load through the patellar tendon Furthermore, research shows that when the knee moves forward, quadriceps force and knee joint stress increase significantly. In a super summary: This is a quad-dominant lunge. Vertical Shin (Knee Stays Over the Ankle) On the other hand, when delivering a lunge movement and the knee stays on top of the ankle, within a vertical shin line, there is a max of 90° knee flexion; therefore, the amount of fibre engaged for the quads is less, and what is than the primary mover for the ascending action, is the gluteus maximum, the biggest glut, which is going to help with the hip extension. So, in this variation, what we are going to achieve is: Shifting the load away from the knee Increases contribution from the hip extensors Encourages more posterior chain involvement Therefore, this will be a glute-focused lunge. What Biomechanics Actually Tell Us About The Lunge Exercise While we look at this movement, we may get triggered into thinking that the lunge exercise is knee-dominant because the knee does a lot of movement, right? Well, if we break it down a bit more, as Riemann et al. (2012) did, we find that yes, the knee moves a lot, but what really takes the load during the lunge movement is the hip. So this is how we can break it down: The knee moves more (kinematics). But the hip produces more force (kinetics). Why this is a thing, then(?) you may ask. Well is tru that the knee move a lot, it can flex up to 90° and still this can be a hip dominant exercises, but, we have to think that the knee, while it is moving that far, is not placing much load on the lower fibers of the quads, and the joint that has to push against gravity, in the ascending phase, are indeed the hip. That’s where all the load actually is. The weight of the upper body. The Lunge Game-Changer: Add a Hip Hinge And here is where we can add a twist to the lunge, by going into hip hinging. What happens if we do so? The glutes are placed under greater stretch at their origin. This increases mechanical tension. You get better glute recruitment and carryover in strength. In fact, this is not just theory, but it’s basic muscle physiology: Muscles produce more force when stretched under load. Therefore, by hinging at the hip, you are not only going to feel more burning sensation in the glutes, but you are going to train them even more effectively. Why Toe Mobility Is the Missing Piece Now let’s talk about something almost no one considers: Your toes. As often happens, the toes and feet are not taken into consideration when looking at functional movement. Even though every leg movement starts from there. In a proper lunge, especially for the rear leg, your toes need enough mobility (extension) to: Accept vertical load Stabilise the movement Prevent your body from shifting forward Indeed, if you lack toe mobility: The movement gets projected forward Load shifts into the front knee and quads You lose posterior chain contribution To support those statements, a study by Harato et al. (2019) examined how foot and toe positioning directly affects knee mechanics and load distribution. So to clarify, the mobility-stability joint chain must always be taken into consideration when we look at functional movement. In this case, your toes aren’t just along for the ride; they’re controlling where the force goes. So… Which Lunge Is Best? I hope that by now, you have an idea of what answer is coming up: Neither. There is no best lunge, as there is no best squat. The forward knee lunge is not “bad”; it’s a tool for quads. The vertical shin lunge is not “safer”; it’s a tool for glutes. The mistakes are thinking that: One can replace the other one. Having an injury in the knee, and thinking that lunges are not your thing anymore. That’s why, at my clinic, Melbourne Massage and Treatment, here in Coburg, I always emphasise to my clients to understand that: “Don’t chase perfect technique — chase the right stimulus.” And to get to a better technique, better than what your body can deliver for now, is a step-by-step journey. And when there is an injury, we have to be confident in the tissue’s healing timeline, and exercises with load are the best tools to help with that. How I Use This With My Clients Inside […]
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Mar
In Australia, Chronic Venous Insufficiency (CVI) affect more women than men, with a ratio of 25%–40% in women and 10%–20% in men (Al Shammeri et al., 2014). As a consequence of this condition, swollen legs are a common concern. CVI occurs when the veins in the legs struggle to return blood efficiently back to the heart, often leading to leg swelling, heaviness, aching, and visible varicose veins. At Melbourne Massage and Treatment in Coburg, since I specialised in Lymphoedema therapy, I regularly support clients experiencing leg swelling related to venous conditions too. Understanding how to manage the condition can significantly improve comfort, mobility and long-term leg health. What Is Chronic Venous Insufficiency? Chronic venous insufficiency is a condition defined as chronic when lasting for more than 3 months. CVI develops when the valves inside the leg veins become weakened or damaged and stop acting as they should, which is why blood finds difficulty in flowing back to the heart. This results in swelling in the lower legs. Common symptoms include: Persistent swelling in the lower legs or ankles Aching, heaviness or fatigue in the legs Skin changes such as dryness or discolouration Varicose veins Tightness or discomfort after prolonged sitting or standing Without appropriate management, CVI can progress and increase the risk of skin complications or infection. The Different Levels of Chronic Venous Insufficiency Find below a table that describes how Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classify chronic venous insufficiency. Stage Description C0 No visible/palpable signs of venous disease C1 Telangiectasias or reticular veins C2 Varicose veins C3 Oedema C4 Skin changes secondary to chronic venous disease (haemosiderin, lipodermatosclerosis, atrophie blanche) C5 Healed ulcer C6 Recurrent active venous ulcer The more advanced the stage, the more likely the hospitalisation of the patient for infections. This is not only a cost to the public health system, but to the Australia popolation too. Compression Therapy: A Key Part of Managing Swollen Legs The most effective way to manage swelling related to Chronic Vein Insufficiency is compression therapy. Compression garments are helpful as they apply controlled pressure to the legs, which supports the veins and encourages blood and fluid to move back toward the heart. Unfortunately, there is no quick fix for swollen limbs, and for many people with chronic swelling, compression becomes an essential part of daily management. But, you have to be aware that compression should always be prescribed and fitted appropriately. Indeed, the compression has to have the right gradient pressure, so stronger pressure at the bottom and weaker at the top; otherwise, we risk getting the liquid stuck in the leg and not moving. On the other hand, with certain arterial conditions, compression may not be suitable; therefore, it is important that you talk to your GP about getting a referral to a vein specialist to know what’s the best approach for your swollen legs. When Varicose Veins Are Present If varicose veins are present, low-level compression is often recommended initially. This provides gentle support to the venous system while remaining comfortable for everyday use. The goal is to: Support vein function Reduce fluid build-up Improve comfort during daily activities Help prevent worsening swelling In fact, each individual may require a different compression level depending on their condition and tolerance, but also the integrity of the skin. Compressions indeed are tight to put on, and for those with weak and fragile skin, it can be difficult to maintain skin integrity while wearing compression. Why Flat-Knit Compression Garments Are Often Recommended For clients with persistent swelling or changes in limb shape, flat-knit compression garments are frequently recommended. Flat-knit garments offer several advantages: They provide stronger containment for swelling They can be custom-fitted for better comfort and effectiveness – class 3 and 4 They help prevent fluid from accumulating in specific areas They are often more suitable for long-term management Because every leg shape and swelling pattern is different, proper measurement and fitting are essential. At Melbourne Massage and Treatment, Lymphoedema clinic in Coburg, I provide assessments and measurements for your swollen legs, so that I can provide garments that fit you for your specific presentation. Accessing Compression Garments Through the SWEP Program (Victoria) If you live in Victoria, you may be eligible to access compression garments through the SWEP program (State Wide Equipment Program). SWEP helps eligible residents obtain essential medical equipment, including compression garments used in the management of venous conditions and lymphatic swelling. As a SWEP-registered therapist, I can guide clients through the process, including: Clinical assessment Measurement for appropriate compression garments Assistance with the SWEP application process Ongoing monitoring and adjustments The SWEP is free to access and does provide funding for 4 garments a year, specifically: $150 per garment if off the shelf $300 per garment if made on measurements For Chronic Vein Insufficiency, most often the off-the-shelf garments are the ones to go for. But still, you have to know what class would best work for you, and what size would best work for you. Movement: An Often Overlooked Therapy Movement, as per my favourite medicine, is another important component in managing swollen legs. In fact, blood flow, but even lymph flow, happens better when muscles contract and work. For the legs, the calf muscles act as a natural pump, helping push blood and fluid upward when we walk or move. When we remain seated or standing for long periods, this pump becomes less effective. Simple strategies include: Regular walking Gentle ankle movements during long periods of sitting Light leg exercises Avoiding prolonged immobility when possible Even small amounts of regular movement can make a noticeable difference in managing swelling. Protecting the Skin: A Crucial Step in Preventing Infection People with chronic leg swelling are more vulnerable to skin breakdown and infection, and this is due to a series of reasons, such as: Increased venous pressure damages small blood vessels Reduced oxygen and nutrient delivery to the skin Chronic swelling stretches and weakens the skin Inflammation causes skin changes Keeping the skin healthy is […]
Feb
If you’re searching for lymphatic therapy in Coburg, it’s common to see terms like Manual Lymphatic Drainage (MLD) and Lymphatic Massage used interchangeably. As a clinical myotherapist with specialised training in lymphoedema management (MLD since Nov 2021; lymphoedema therapy since Oct 2024, trained with the Vodder Academy), I am here to clarify exactly what these treatments are and why one is clinically recommended over the other — especially for conditions like lymphoedema or post-surgical swelling. In fact, the importance of understanding the difference between MLD and Lymphatic Massage is vital when you want results that matter, and not just temporary relaxation. What Is Manual Lymphatic Drainage (Vodder Method)? Manual Lymphatic Drainage (MLD) is a specialised technique developed by Emil and Estrid Vodder in the early 20th century, and it is characterised by gentle, rhythmic hand movements to stimulate the lymphatic system. The reason behind the gentle and light movement is to ensure that during the treatment, we can stretch the skin and let it recoil naturally; therefore, we stimulate the lymphatic system at its full potential. Therefore, MLD is not a “massage” in the spa sense, it’s intentionally structured to follow physiological lymphatic pathways to support lymph flow. Key points about MLD: Trained practitioners follow evidence-based protocols. Movements are light, rhythmic, and intentional, not vigorous. The “Vodder method” is internationally recognised and taught with strict standards. It is often integrated into Complete Decongestive Therapy for lymphoedema. One recent article explains the theoretical physiology and clinical context of MLD in lymphoedema management. Manual lymphatic drainage: the evidence behind the efficacy (PubMed) What Is Lymphatic Massage? “Lymphatic Massage”, on the other hand, is more of a broad term used in wellness settings, like a SPA or massage parlour. The wordling is really similar to Manual Lymphatic Drainage, and is often followed by promises of “encourage fluid movement” or “before and after photos” but: Technique quality varies widely by practitioner. Some methods use deeper pressure and general strokes. It’s largely relaxation-focused, not always aligned with lymphatic anatomy. It isn’t generally part of evidence-based protocols for clinical conditions. In short, MLD is a clinically structured intervention; lymphatic massage is not. Indeed, who promotes Lymphatic massage as a service, often don’t know the pathway of the lymphatic system, and can’t tell you the difference between a Lymphoedema or a Lipoedema, and it may try to sell the fact that Lymphatic massage would detox your body (I will write a blog soon about this detox topic, as it is one of the biggest scam in the health and beauty industry). Side-by-Side: MLD vs Lymphatic Massage In the table below is a summary and a comparison between MLD and Lymphatic Massage features. Feature Manual Lymphatic Drainage (Vodder) MLD Lymphatic Massage Based on lymphatic anatomy ✔ ✖ Evidence-aligned technique ✔ ✖ Suitable for lymphoedema management ✔ ✖ Commonly used post-surgery ✔ ✖/varies Practised by trained therapists ✔ ✖ (wide variation) Relaxation / general wellness ✔ ✔ Clinical Evidence: What Research Shows About MLD and Lymphatic Massage As with any form of therapy, even in the case of MLD, the clinical research on MLD isn’t perfect, but the PubMed literature supports its role when used correctly within clinical programs. Lymphoedema Management A randomised controlled trial (RCT) reported that women with breast cancer–related lymphoedema experienced significant limb volume reduction and improved symptoms with MLD as part of therapy. A comprehensive systematic review found mixed outcomes but noted MLD’s accepted role in conservative lymphoedema treatment and generally positive effects on swelling and quality of life when integrated with other therapies. Inflammation & Post-Surgery Support MLD is also used, and clinical studies provide evidence in the setting of postoperative swelling and pain with orthopedic and cosmetic surgery. Indeed, post-surgery, the body responds with inflammation and swelling, which passes the acute phase, and the clearance of infections is better when moved to ensure the best recovery. Why MLD Is Clinically Preferred for Lymphoedema When lymphatic transport is impaired, as in lymphoedema or after surgery, the goal is not just temporary fluid “movement,” but supporting lymphatic drainage physiology. Here’s what clinical practice guidelines emphasise: Targeted Stimulation MLD uses gentle but precise hand movements that align with superficial lymphatic pathways and node groups. These are designed to: reduce interstitial fluid accumulation, activate lymphangiomotoricity, and facilitate fluid transport without trauma. This principle comes directly from the Vodder methodology as taught by the Vodder Academy. Part of a Larger Management Strategy Especially in lymphoedema, MLD is one component of a broader therapeutic approach that includes: ✔ compression therapy✔ movement and exercise✔ skin care and infection prevention This integrated strategy has been shown to improve outcomes more than any single therapy on its own. Post-Surgical Considerations As discussed in more depth in another blog, when heading for cosmetic and orthopaedic surgery, the recovery process is caractherised by an acute phase of swelling. That’s just teh body dping its thing. But, as we move away from the acute phase, it is essential to ensure that the oedema is reduced. That’s where MLD and compression therapy are essential. In fact, unlike a typical deep massage: MLD supports lymphatic flow without stressing fragile tissues. Studies show gentler lymphatic stimulation improves swelling and trismus after surgery. That’s why many rehabilitation specialists recommend structured MLD over general “lymphatic massage” in this context. So, What Should You Choose? As per everything, I reckon that your choice has to be aligned with your goal. Therefore: If you need clinical-grade lymphatic support for lymphoedema, post-surgical swelling, or ongoing fluid dysfunction, choose Manual Lymphatic Drainage (Vodder method) delivered by a trained clinician. If you want general relaxation and mild fluid support, a lymphatic massage in a wellness setting might feel nice — but it’s not a clinical substitute for MLD in these conditions. Conclusion From A Clinical Practitioner At Melbourne Massage and Treatment, Coburg, I integrate MLD with evidence-based clinical reasoning, and not just as a “feel-good massage.” My approach is rooted in training with the Vodder Academy and ongoing lymphoedema therapy practice. If you’re concerned about lymphatic […]
Jan
Compression therapy is essential for lymphoedema management, and therefore, is worth it write a blog where we are going to talk about what compression is ideal for what lymphoedema presentations, including the mmHg levels. I’m Giovanni, and I run Melbourne Massage and Treatment, a Myotherapy and Lymphoedema clinic in Coburg. I trained with the Vodder Academy in lymphoedema management, and I provide Complete Decongestive Therapy (CDT), which forms the foundation of effective lymphoedema treatment. What Does mmHg Mean in Lymphoedema Compression? As when measuring blood pressure, even when working with Lymphoedema, we use the measuring unit mmHg (millimetres of mercury) when talking about compression. Based on the type of presentation, as lymphoedema therapists, we would recommend different types of compression garments, including flat knit or circular knit. So, here is a short list of the purposes of compression garments: Support the lymphatic system Encourage lymphatic flow Prevent fluid from re-accumulating Maintain the results achieved through CDT Therefore, choosing the correct mmHg compression level is about balancing effectiveness, safety, and comfort, and not only apply some form of pressure on the affected limb. Compression Classes and Lymphoedema Management To simplify how compression garments work, companies like Sigvaris or Juzo grouped the compression into classes or levels, each corresponding to a specific mmHg range. Common Compression Levels Used in Lymphoedema Compression Lower compression levels – 15–20 mmHgOften considered in: Mild lymphoedema Early-stage swelling Fragile or sensitive skin Situations where tolerance is limited Moderate compression levels – 20–30 mmHgCommonly used for: Established lymphoedema Post-intensive CDT Long-term volume maintenance Daily functional support Higher compression levels – 30–40 mmHgUsually required for: Moderate to severe lymphoedema Fibrotic or hardened tissue Significant limb shape changes Swelling that rebounds quickly My personal suggestion is that the correct Compression Level should always be determined following a thorough clinical assessment, in order to avoid fluid retention and waste of money. Why Higher Compression Is Not Always Better Compression level in lymphoedema treatment, as mentioned above, has to be a balance of effectiveness and comfort, and different presentation, with or without fibrosis, mobile or immobile limb, comes with different compression needs. Indeed, applying the wrong type of compression can: Reduce comfort and compliance Increase skin irritation or skin breakdown Compromised lymph circulation Make garments difficult to don and doff In fact, effective Lymphoedema Compression works with the body, not against it, and that’s why for lymphedema presentation compression garments are recommended to be worn after taking specific measurements, that ensure a gradient pressure is applied on the limb, so that the lymph fluid is pushed in the right direction and not towards the extremity of the limb. Compression Levels and Complete Decongestive Therapy (CDT) At Melbourne Massage and Treatment, as part of lymphedema management, I offer MLD as a manual therapy to stimulate the lymphatic system, and CDT (Complete Decongestive Therapy), to reduce the swelling and limb size. More specifically, CDT, can help with: Reduce swelling after the delivery of Manual Lymphatic Drainage (MLD) Improve tissue quality Shape the limb appropriately Prepare the limb for long-term Lymphoedema Compression Help in the breakdown of fibrosis Once the limb has stabilised, compression garments help maintain volume reduction and prevent progression of lymphedema. Professional Assessment Is Essential Certain pharmacies or retail shops (including online one) may sell compression garments, but those are probably not specific enough for a Lymphoedema presentation. Indeed, the appropriate Compression Level depends on: Lymphoedema stage Limb shape and size Tissue texture and fibrosis Skin condition Functional needs and daily activity For compression garments, post MLD and CDT therapies, I refer patients to Sigvaris in West Melbourne, which specialises in medical compression for lymphoedema and ensures accurate fitting and garment selection. Lymphoedema Compression in Coburg Living with lymphoedema can be challenging, and you may find yourself in need of ongoing care and help in navigating information regarding the right compression strategy. At Melbourne Massage and Treatment in Coburg, I provide: Evidence-based CDT Personalised lymphoedema management Clear guidance on Lymphoedema Compressions Collaborative care with trusted compression garment providers So if you’re seeking professional lymphoedema treatment in Melbourne, or want clarity around compression levels and mmHg, I’m here to help. Accessing Compression Garments Through the SWEP Program For some people living with lymphoedema, the cost of Lymphoedema Compression garments can be a barrier to effective long-term management. In Victoria, eligible patients may access support through the State-Wide Equipment Program (SWEP), which provides funding for medically necessary aids, including compression garments for lymphoedema. As a Clinical Myotherapist, I can help you go through the SWEP program in collaboration with your GP. The role of the GP is to write a diagnosis and a referral to the SWEP program, and that’s where I can assist them. After that, you can refer to an approved compression provider, such as Sigvaris in West Melbourne, who can advise on garment selection and fitting. The Swep program for Lymphoedema patients can help with: Reduces the cost of Lymphoedema Compression garments for eligible patients Supports long-term lymphoedema management after Complete Decongestive Therapy (CDT) Ensures clinically appropriate compression through professional assessment FAQ – Lymphoedema Compression Levels
Jan
Once you have been diagnosed with lymphoedema (also known as lymphedema), you will soon learn that compression therapy plays a vital role in long-term management of this chronic condition, and one of the most common questions I hear in my clinic is: “What’s the difference between circular knit and flat knit lymphoedema compression garments?” In this blog, I will explain the difference between these two types of lymphoedema compression knit, so that it may help you understand better how your lymphoedema can be managed in the long term. Why Is Lymphoedema Compression Essential? As discussed in many more blogs, lymphoedema is a chronic condition caused by an impaired lymphatic system, which leads to the accumulation of lymph fluid and persistent swelling in one or more body parts. If not correctly managed, lymphoedema can progress and cause: Increased limb size – elephant leg Tissue fibrosis (hardening) Skin changes – including numbness Higher risk of infections – cellulitis is a common one Compression therapy is a cornerstone of CDT (Complete Decongestive Therapy), alongside: Manual Lymphatic Drainage (MLD) – ideal to boost your lymphatic system drainage capacity Skin care is essential to avoid skin cracks and infections Exercise and movement – especially if wearing circular knit compression Long-term compression – So in short, lymphedema compression supports lymphatic flow, helps maintain limb volume reduction, and prevents the worsening of lymphoedema. What Is Circular Knit Lymphoedema Compression? Circular knit compression refers to the method by which garments or bandages are made. In this case, the knit is made using a continuous circular weaving method, creating a seamless and highly elastic fabric. Benefits of circular knit compression: Lightweight and smooth texture Greater elasticity and stretch Often available off-the-shelf More discreet under clothing Circular knits are ideal for those lymphoedema patients who can and should move with the limb affected by lymphoedema. Indeed, the circular knits are designed to allow the lymphedema patient to move; therefore, while the limb is compressed, the lymphatic system is simultaneously boosted by compression and movement. When circular knitting may be suitable: Mild lymphoedema Early-stage lymphedema Limbs with minimal shape distortion Well-controlled swelling However, due to their elasticity, circular knit garments often lack the containment needed for more advanced lymphoedema, especially when fibrosis or limb shape changes are present. What Is Flat Knit Lymphoedema Compression? So, even in the case of Flat-knit compression, the name refers to the way the fabric is produced, like flat fabric and stitched together with a seam. This allows for higher stiffness and customised shaping. Benefits of flat knit compression: Firmer, more supportive structure Superior containment of swelling Custom-made to individual limb measurements Better control of irregular limb shapes Flat knit is usually recommended for: Moderate to severe lymphoedema Long-standing or progressive lymphedema Skin folds or lobes Fibrotic tissue Swelling that rebounds quickly A lymphoedema patient is unable to move much Therefore, based on the severity and lymphoedema stage, we would suggest using flat knit compression for more severe presentations or for someone who is unable to move the limb(s) affected. Compression Garments and Complete Decongestive Therapy (CDT) At Melbourne Massage and Treatment, in Coburg, I offer Complete Decongestive Therapy (CDT) as part of lymphoedema management, which is internationally recognised as the most effective approach to lymphoedema treatment. Here is a list of things that I would offer during a lymphoedema management appointment: Comprehensive lymphedema assessment Manual Lymphatic Drainage Swelling reduction during the intensive phase of CDT Preparing limbs for compression garments Education on long-term self-management To simplify the process of lymphoedema management, at Melbourne Massage and Treatment, I do offer a free 15-minute online consultation, where I can answer your questions and go through an initial assessment about your clinical history. Compression After CDT After we manage to reduce the swelling in the limb(s) affected by lymphoedema, via MLD and CDT, which can take 3 to 5 appointments, or more, depending on your presentation, we can then look into getting garment wear that can fit your limb(s), so that the swelling can be managed for a longer time. While I do not supply compression garments directly, I refer patients to Sigvaris in West Melbourne, specialists in medical compression for lymphoedema, ensuring accurate fitting and high-quality garments. Circular Knit vs Flat Knit: Which Is Right for You? The correct compression garment depends on several factors, including: Stage and severity of lymphoedema Limb shape and tissue texture Presence of fibrosis Skin health Lifestyle and daily activity This is why coming for an appointment and getting your lymphoedema assessed and treated, where needed, is essential before selecting compression. Lymphoedema Treatment in Coburg Living with lymphoedema can be challenging, but with the proper care, education, and treatment plan, it can be effectively managed. At Melbourne Massage and Treatment in Coburg, I focus on: Evidence-based CDT Individualised lymphedema management Clear guidance around compression therapy Collaborative care with trusted garment providers Therefore, if you are in need of professional lymphoedema treatment in Melbourne or need clarity around compression options, I’m here to support you. About myself: a Myotherapist specialised in Lymphoedema Management My name is Giovanni, and I run Melbourne Massage and Treatment, a Myotherapy and Lymphoedema clinic in Coburg. I trained with the Vodder Academy in lymphoedema management, and I provide Complete Decongestive Therapy (CDT), the gold standard for lymphedema treatment. My approach is tailored to each individual patient, to achieve objective results, and to help you enjoy more your life while dealing with Lymphoedema management.
Dec
As a therapist who works with Lymphatic Massage in Coburg and with post-cosmetic-surgery patients, I often get asked, “What’s the difference between MLD and Brazilian lymphatic drainage?” To answer this question, I often have to give people a background of my training as a Lymphatic Drainage therapist and what is happening to their body post-liposuction. What are the differences between Vodder MLD and Brazilian Lymphatic Drainage? Vodder MLD, which is the therapy I offer for post-cosmetic surgery and also Lymphoedema management, is a very light, rhythmical, skin-stretching technique. It has about 100 years of history, and it has a strong research base for lymphedema management and is useful in postoperative recovery, either in cosmetic or orthopedic surgery. Brazilian lymphatic drainage, on the other hand, tends to be firmer, more continuous, and pragmatically geared toward reducing swelling and bruising after cosmetic procedures, but it has less scientific evidence to support any benefits. For post-cosmetic surgery lymphatic massage (liposuction, abdominoplasty, facelifts, tummy tuck…) I would strongly recommend gentle Vodder-style MLD, and here is why: Any surgery, including cosmetic surgery, is highly invasive for the body, and therefore, you will present post-surgery with High skin sensitivity Swelling and bruising Pain A gentle approach, such as Vodder MLD, would allow: Reduce the swelling with a pain-free approach The takeaway exceeds inflammation Help reinforce skin sensitivity As the healing process progresses and you move from the acute to the sub-acute healing phase (week 2 to week 3), we can start applying stronger pressure to break down fibrosis. What people call “Brazilian Lymphatic Drainage” “Brazilian lymphatic drainage” (BLD) is a manual therapy that is getting famous thanks to social media presence and some influencers talking about it. It is a practice which often refers to faster, more continuous wave-like movements and sometimes firmer pressure than Vodder MLD, and involves the usage of oil too. Those who offer Brazilian Lymphatic Drainage claim a faster recovery after aesthetic procedures (reducing bruising, local oedema, and tissue stiffness), even though clinical literature that looked into BLD in aesthetic and post-op settings, like randomised trials, describes this technique as debatable, and furthermore, the evidence of its efficacy is limited compared with Vodder studies. What does the research say? Systematic reviews on MLD (Vodder used often) show MLD is commonly used for decongestive therapy in Lymphoedema patients. The quality of the evidence varies, while effect sizes are moderate for some outcomes. Randomised trials that compare Vodder MLD with other modalities (e.g., compression, pneumatic compression) report benefit for symptoms and arm volume in breast cancer-related lymphedema and postoperative swelling in some surgical contexts. An early RCT explicitly used the Vodder technique and showed benefits in arm lymphedema management. Recent reviews and clinical articles regarding plastic surgery literature highly support the use of postoperative lymphatic massage. The recommendations are to receive MLD one to three times a week, in the early recovery phase, for reducing swelling, pain, fibrosis and improving comfort. That said, often that information is shared by the surgery clinic staff after the surgery; therefore, it’s always better to choose a clinic that is clear and transparent about the post-surgery recovery, and not only about the surgery itself. When looking for studies about the Brazilian Lymphatic Drainage massage, it is hard to find something that is specific enough about this technique, and that doesn’t mix data and trials with other techniques, like bandaging and exercises. Therefore, it’s hard to evaluate the quality of this technique in terms of the RCT protocols. MLD – What works for what? Practical comparison For lymphedema (medical swelling after lymph node removal/cancer). When someone presents with lymphedema, the best choice is Vodder-style MLD as part of complete decongestive therapy. I don’t do this recommendation only because I offer this service, and I know its potential, but also because Most RCTs and meta-analyses have evaluated MLD (in Vodder style) as the safest and evidence-based treatment that has enough relevance for this type of presentation. For early post-operative care after cosmetic procedures (e.g., liposuction, abdominoplasty, facelifts, tummy tuck). In any given surgery, along the acute phase, the body is a high state of inflammation and the site of surgery would be delicate to touch for several weeks post surgery, indeed a gentle approach to the area is highly recommended, so Vodder-style MLD is way safer compare to Brazilian Lymphatic Drainage, because the tissues are fragile; MLD at this stage in time, it would helps reduce oedema and bruising and promotes comfort. Many plastic surgeons recommend MLD early and frequently in the first 2–6 weeks. Later phase (2–6+ weeks): While healing is progressing and you step into a sub-acute phase of recovery from the post-cosmetic surgery, firmer or more targeted techniques, which recall what Brazilian Lymphatic Drainage can be used to address residual fibrosis/stiffness, always with the surgeon’s clearance. That said When dealing with post-cosmetic surgery fibrosis, even Vodder MLD would include firm pressure. That’s how fibrosis is broken down. For general wellbeing, detox/relaxation, cellulite or fluid retention Gentle MLD (Vodder) is great for relaxation, reducing mild fluid retention, and supporting circulation without soreness. Good for regular wellness maintenance. Brazilian-style DLM is often used in aesthetic clinics for body contouring and cellulite care; people report feeling less heaviness and faster visual improvement, but high-quality evidence is more limited, and outcomes vary with practitioner technique. MLD Safety & Contraindications – What You Need To Know In my practice, I am selective about who I offer MLD, especially after cosmetic surgery, and here is what I would look out for: Active infection Uncontrolled heart failure Acute deep vein thrombosis (DVT) Untreated cancer without clearance Fever Recent major bleeding or unstable medical conditions Liver or Kidney conditions After cosmetic surgery, you have to make sure to follow the surgeon’s recommendation about antibiotic intake, and or other medications. MLD can not start unless you are cleared of all the above. So, which do I recommend, Vodder or Brazilian Lymphatic Drainage? It is now quite clear that at Melbourne Massage and Treatment, for MLD, […]
Oct
Functional movement is all those types of movement that you may have been training at the gym, like a squat, but really, those movements are what we are designed to deliver daily. Per the squat, think about sitting. Now, if you are young and fit, you may not need a great deal of mobility to sit on a chair, but as we get older, if we don’t train to maintain this form of mobility, things can really get difficult, and the risk of injury would increase. That’s where Myotherapy can really help you to understand which joints need more work in terms of mobility, but also which muscle groups you need to train to keep your stability at doc, so that your functional movement, especially when done under load, is going to be safe and with less risk of injury. What Is Myotherapy? Myotherapy is a form of manual therapy that focuses on assessing, treating, and managing musculoskeletal pain and dysfunction. At Melbourne Massage and Treatment in Coburg, I use techniques such as deep tissue massage, joint mobilisation, myofascial release, dry needling, and corrective exercise to restore normal movement and prevent pain from returning. What I love about being a Clinical Myotherapist is that when working with my clients, I have to deliver a tailored treatment plan, as everyone is different and everyone presents with a unique body, which may need a different approach to reach the same goal. All this, starting from joint mobility and stability. Why Joint Mobility and Stability Matter Let’s start by defining what mobility and stability are: Mobility: the ability to move through a full range of motion Stability: the control that keeps your joints aligned to the body plane and supported To move well under load and deliver safe exercises, you must have good mobility and stability where needed. For example, if your hips lack mobility, your lumbar spine might compensate, creating discomfort and increasing the injury. Furthermore, a lack of mobility, it means you can not fully engage your muscle fibres, as less movement means less contraction or elongation of the muscle fibres involved in that movement, so less power and less growth. On the other hand, lack of stability is given from your lumbar area, which is not able to support a heavy load, and that’s how you can hurt your back. How Myotherapy Enhances Functional Movement Here at my clinic in Coburg, as a clinical myotherapist I focus on helping you restoring balance through a whole-body approach. Here’s how Myotherapy helps: Comprehensive Movement AssessmentLet’s start with assessing posture, joint range of motion, and functional movement patterns to identify restrictions or weaknesses. Addressing the Root Cause of PainPain is central nervous system response to something that doesn’t work at is best. It may be an injury, or it may be a sensitization of the area. As a clinical myotherapist I help you break the cycle of compensation and discomfort, allowing more efficient, pain-free movement. Improving Joint MobilityUsing targeted soft tissue therapy, myofascial release, and gentle joint mobilisation, we help reduce tightness and restore freedom of movement across affected joints and muscles. Building Joint StabilityOnce mobility is restored, we focus on improving control and strength. Personalised exercises activate stabilising muscles, enhancing balance and coordination to prevent re-injury. Long-Term Support and EducationAfter every appointment I ensure to leave a detailed PDF file with the exercises we look into, so that you are able to reproduce our work at home or at your gym. But for every question, and for your progressions, I am always here ready to help. Who Can Benefit From A Myotherapy Session? Myotherapy is suitable for people of all activity levels. At our Coburg practice, I regularly help clients dealing with: Muscle tightness or restricted joint movement Neck, shoulder, or lower back pain Postural strain from office work Sports or exercise-related injuries Limited flexibility affecting daily performance The Takeaway on Myotherapy and Functional Movement To improve your functional movement starts working on the right balance between joint mobility and stability. Myotherapy offers a targeted, evidence-based way to achieve that balance, and I am here helping you move better, feel stronger, and prevent future injuries. If you’re ready to enhance your movement and reduce pain, book a Myotherapy session at Melbourne Massage and Treatment, Coburg today. Let’s get your body moving the way it’s meant to. And if you have any question, please use the form below to reach me out:
Oct
Exercise is the ultimate medicine for longevity and well-being. That said, there are different ways to exercise, and you should choose which one based on your goals and needs. Ultimately, even if you will prioritise one type of exercise over others, training in different ways, it is the best option to build resilience, strength and obtain the best results. But what are these main ways of training? Well, in this blog, we are talking about Strength Training and Hypertrophy. At Melbourne Massage and Treatment in Coburg, I help people achieve this goal, with tailored injury recovery Myotherapy plans that may start with hands-on treatment but aim to get the person moving and moving under load. What Is Strength Training? Strength training, in its pure form, is a type of training that aims to improve the body’s ability to produce maximal force. This is possible by optimising the nervous system’s capacity to communicate to the muscles what action has to be delivered when placed under load. In fact, the goal isn’t necessarily to make muscles bigger, but to make them stronger. Here is a breakdown of what a strength training session would be like: Typical rep range: 1–6 repetitions per set Load: Heavy (80–100% of your one-rep max) Rest periods: Longer (2–5 minutes) Primary outcome: Improved neural efficiency — your brain and muscles learn to work together more effectively. This type of training benefits everyone, from athletes to everyday movers, by: Enhancing joint stability Improving bone density Increasing functional power for daily tasks. What Is Hypertrophy Training? Now, we will examine another form of training that aims to increase muscle size. Indeed, hypertrophy focuses on creating controlled muscular fatigue that stimulates growth in the muscle fibres. Here’s how it works: Typical rep range: 6–12 repetitions per set Load: Moderate (60–80% of your one-rep max) Rest periods: Shorter (30–90 seconds) Primary outcome: Increased muscle cross-sectional area (growth). Hypertrophy is popular for aesthetic goals, but it also has significant benefits for: Joint support Posture Injury prevention, especially when paired with proper mobility and recovery practices like myotherapy. Who Would Benefit from Strength and Hypertrophy Training? Let’s be clear that both styles of resistance training can benefit a wide range of people — not just athletes or bodybuilders. But here is a clearer breakdown of which training belongs to which goals: You’ll benefit from strength training if you: Want to improve performance in sports or daily activities that require lifting, pushing, or pulling. You are seeking to increase bone density and joint stability, especially as you age. This is a big one for menopausal women. Need to enhance posture and core control to reduce the risk of back or shoulder pain. Are recovering from injury and looking to restore functional movement patterns safely under guidance. You’ll benefit from hypertrophy training if you: Want to build muscle mass for aesthetics, strength, or body composition. You are addressing muscle imbalances or weaknesses identified during myotherapy assessments. Need more joint support and stability through improved muscular structure. Aim to boost metabolism and energy expenditure through increased muscle tissue. At Melbourne Massage and Treatment, I often integrate tailored exercise advice with fitness class sessions, helping clients find the right balance between strength, mobility, and recovery for their individual goals. Massage Therapy, Dry Needling, and the Role of Passive Treatment Massage therapy, dry needling, and other forms of passive therapy are valuable tools during the recovery phase of an injury or when pain and tension are high. They help by: Reducing muscle tension and spasm Improving blood flow and assisting with tissue healing Calming the nervous system and reducing protective muscle guarding Restoring short-term mobility to prepare the body for movement At my Coburg clinic, these treatments are often used early in a client’s recovery journey to reduce pain and restore comfort. However, while these therapies are excellent for short-term relief and acute recovery, they must eventually be paired with movement under load to create lasting change. Why Movement Under Load Is Essential for Long-Term Wellness Passive treatments can help you feel better, but loaded movement enables you to function better. When you progressively load muscles, tendons, and joints, your body adapts and becomes stronger and more resilient. This is what keeps pain away in the long term. Here is a practical and simplified explanation: “You have to think that the body, while it does age, it does slow down in any form of its metabolism, including the regeneration of tissues, which gets worn down, and finds it difficult to be regenerated. This is where movement under load plays a crucial role. Movement under load indeed, it is the stimulus that the central nervous system needs to maintain the body’s regeneration active and effective”. A further breakdown of why movement under load matters beyond recovery: Builds tissue resilience: Strengthens muscles and connective tissue to handle daily demands. Supports nervous system retraining: Teaches your body to move efficiently and safely. Improves joint health and posture: Strengthens stabilising muscles that protect joints. Reduces recurrence of pain: Prevents the same issues from returning by addressing root causes, not just symptoms. Another way I would express the difference between passive therapy and exercises (under load) to my patient is: “Massage and needling help you feel good now, but movement under load helps you stay good later.” That’s why our approach combines hands-on therapy to relieve pain with movement education and strengthening to keep you moving well long after your treatment. How Myotherapy Complements Strength and Hypertrophy Training Myotherapy is a form of manual therapy that aims to improve the performance of any individual who has gone through an injury or someone who wants to maintain functionality and wellbeing. In a Myotherapy session, we would start with some form of testing to evaluate the person’s capacity in mobility and strength and from there we create a treatment plan that aims to improve the current presentation. A treatment plan may include: Soft tissue therapy Corrective exercise Movement assessment Goals of myotherapy: Address muscular imbalances from repetitive […]
Oct
Experiencing a vertebral fracture can be an overwhelming and challenging experience to recover from, but this doesn’t mean there is no safe protocol and successful treatment pathway out there. At Melbourne Massage and Treatment, I am here to assist you in this complex journey, which could be by offering MLD treatment, Myotherapy or Fitness Class. But let’s first understand what fractured vertebrae mean, and what we have to be aware of when working with this type of injury. Spinal Damage vs. No Spinal Damage Let’s start to look into what difference makes to have a spinal fracture where the spinal cord was injured and where it was not. With spinal cord damage, a fracture may injure the spinal cord or nerves, leading to severe symptoms such as numbness, weakness, or paralysis. These cases are medical emergencies requiring hospital care. The rehabilitation process for someone who encounters spinal damage varies based on the severity of the injury. Surgery may be necessary to repair the nerve, but there is also the fact to consider that there may not be a recovery option and life paralysis (quadriplegic or paraplegic) as an outcome. Without spinal cord damage, it is a result of a bone fracture only, without affecting the cord. These are painful but often managed with an initial period of rest and bracing and gradual rehabilitation. At our Coburg clinic, Giovanni carefully assesses your needs and works alongside your medical team to provide safe and effective rehabilitation. Cervical, Thoracic, and Lumbar Vertebrae Your spine has three main regions, and fractures behave differently depending on location: Cervical (neck): Mobile but delicate; fractures here can have severe consequences. Thoracic (mid-back): Stabilised by the rib cage, but injuries here often come from higher-energy impacts. Lumbar (lower back): These vertebrae carry the body’s weight, so fractures here cause significant pain and restricted movement. Based on where the fracture is, the treatment and recovery options and plans differ. Scans for Diagnosis To properly understand the type of fracture and the severity of the fracture itself, scans are essential. Here is a short list of what diagnostic scans are available and which are most commonly used, and why: X-ray: The first step to confirm a fracture. This type of test is good to see the fracture at the bond level; it is quick, but as a downside, it exposes you to radiation. CT scan: Provides detailed 3D imaging to assess the fracture’s stability. The downside of a CT scan is that, as it is based on X-Ray technology, it can still expose you to radiation, and it can take longer to be delivered, and it is essential to be lying down while receiving the scan. MRI scan: Compared to X-Ray technology, MRI scan would not expose you to radiation, and is used to detect any involvement of nerves, discs, or the spinal cord along the fracture, as this type of scan is used for water-based tissue in the body, and not bones. These scans help guide safe rehabilitation, ensuring the right treatment approach from day one. Something else to keep in mind from the result of the scan is that not everything that a scan shows must impact your life. Indeed, a building disk may show in your scan, but that doesn’t mean that that specific pathology is something related to your spine fracture (it may have been there already before), and that doesn’t mean the body would not look after it while you are recovering from the spine injury. Types of Vertebral Fracture Common fracture types include: Compression fracture – vertebra collapses, often linked to osteoporosis (also called a wedging fracture). Burst fracture – bone shatters outward, sometimes threatening the spinal cord. Flexion-distraction fracture – usually from high-speed accidents where the spine bends suddenly. Fracture-dislocation – bone and soft tissues are displaced, often requiring surgery. Avulsion – It is a type of stress fracture, characterised by a small piece of bone pulled away from the main bone by a muscle or ligament (typical along the transverse process). Mechanism of Injury Fractures can occur from: High-energy trauma – car accidents, falls, sports collisions. Low-energy stress – in osteoporosis, even coughing or bending can trigger a fracture. Scheuermann’s disease – in this specific condition, the vertebrae may grow at different heights compared to the sagittal plane. A meticulous clinical history intake can help in figuring out he chance of you suffering from a vertebral fracture. Healing Time and Recovery As per all non-complex bone fractures, most vertebral fractures take 8–12 weeks to heal, even if recovery varies depending on age, bone health, and whether surgery was required. What we know is that nothing can actually boost the healing, but different therapies, active and passive, can help in assisting the healing process, ensuring a positive outcome. What then can be done during the recovery time is: Early phase: Pain management and protection of the fracture. Rehabilitation phase: Gentle guided movement, strengthening, and improving mobility. With myotherapy support, clients can return to safe daily activities while minimising the risk of re-injury. What to Avoid in the Early Stages of a Vertebral Fracture As mentioned earlier, in the early stage of vertebral fracture, it is important to prevent further damage to the spine and wear a corset that helps in stabilising the spine, while the body is starting the calcification of the bone. Even though you may wear a support, you will want to avoid: Heavy lifting, twisting, or bending movements. Prolonged sitting without support. High-impact exercise or activities. Movement is still recommended, as it can still promote fluid movement and relaxation. Therefore, it is possible to go for walks, move your arms, and move your legs even if in a seated position. Manual Lymphatic Drainage Massage in the Early Phase of a Vertebral Fracture At Melbourne Massage and Treatment, I got to offer MLD as a form of treatment for relaxation, which can have a positive impact on pain perception and tension relief from the spine area. MLD is a gentle touch, […]
Sep
Within the last few years, cosmetic surgeries have been on the rise in Australia. These types of interventions can be helpful for quick body changes. Still, the recovery process post-surgery is often underestimated and misinterpreted, especially when, past a couple of days or just a few weeks, the body’s response to surgery leaves behind hard lumps, thick skin, and reduced sensitivity. The thickened skin and lumps are simply fibrosis, and the reduced sensitivity results from damaged nervous system endings. At Melbourne Massage and Treatment in Coburg, I specialise in Manual Lymphatic Drainage (MLD) using the Vodder technique, helping clients reduce swelling, assisting with recovery, and breaking down fibrosis post-cosmetic surgery, safely and effectively. If you’re looking for post-surgery care in Coburg or Melbourne, here’s how MLD can support your recovery and improve your results. What is Fibrosis After Cosmetic Surgery? Fibrosis formation post-cosmetic surgery is the result of tissue damage that occurred during the surgery. When going for an intervention like liposuction, where fat is removed from the body (either at the abdominal level, arms, legs or elsewhere), the body, to replace the void left by the fat removal, builds up fibrotic tissue. The fibrotic tissue is mainly made of collagen. While this reaction is natural, it can often cause: Hard lumps or nodules under the skin; Uneven skin contour or texture; Tightness or restricted mobility; Tenderness or discomfort. There is no real way around those types of side effects post-liposuction, at least in the short term, and the body would take weeks to recover fully (up to 3 months). That said, everybody reacts differently to this type of intervention, and based on the type of intervention received, the recovery process can vary. Who Benefits Most From Lymphatic Drainage Massage After Cosmetic Surgery? Here is a short list of cosmetic surgery interventions that are going to leave you with fibrosis in the post-surgery time, and that would benefit from Lymphatic Drainage Massage intervention: Liposuction (abdomen, thighs, arms, chin) – This includes liposuction for Lipoedema management too. Tummy tuck – Either due to post-liposuction or from severe weight loss. Breast surgery (augmentation, reduction, reconstruction) – If this is due to breast cancer, one should be aware of any risk of Lymphoedema development. Facelifts and neck lifts Brazilian Butt Lift (BBL) – This type of intervention requires fat to be removed from other body parts, as the abdomen, and that’s where fibrosis would build up. How MLD Helps Reduce Fibrosis Manual Lymphatic Drainage (MLD) is a gentle, specialised technique that stimulates the lymphatic system to clear excess fluid, reduce swelling, and assist with the healing process. After surgery, your lymphatic system could be damaged and can struggle to keep up with its work, and that’s where MLD makes a big difference. Indeed, the stimulation of the Lymphatic System, via MLD therapy, can help in assisting your recovery and ensure that the fibrotic tissue gets absorbed and dismissed, restoring freedom of movement and leaving you soon after treatment in a deep relaxation state. I trained in the MLD with the Vodder style; therefore, I can provide precise, tailored treatments that are safe for sensitive post-operative tissue. Book your post-surgery lymphatic drainage in Coburg today to safely reduce fibrosis. When can I start MLD treatment post-cosmetic surgery? Generally, MLD is safe to start as soon as the antibiotic cycle is completed post-cosmetic surgery. Given the light touch of this type of therapy, we aim to produce no pain during the treatment, so we can work close to the surgical side, without affecting the recovery process. On the other hand, I found myself occasionally referring patients to the local nurse or GP, as their recovery immediately post-surgery was compromised by misleading suggestions and procedures offered by overseas cosmetic clinic surgery. If you are not sure about what’s going on with your recovery, please, before placing a booking for an MLD treatment, talk to your GP about your recovery state, and if you have any questions regarding MLD treatment, you can always reach out to me via the contact page. How Many MLD Sessions Do I Need To Reduce The Fibrosis? As mentioned earlier, everyone responds differently to cosmetic surgery, but in my experience, it would take at least 4 to 6 weeks to start seeing a significant difference in fibrous tissue presence. That said, the number of sessions and the length of the sessions can vary based on the area where you received the surgery. Abdominal surgery only: I will recommend 2 to 3 treatment per week, for the first 3 weeks. Within the first week, we may spend 1 hour per session, and from the 2nd week onwards, we reduce the treatment to 45 minutes. Multiple liposuction sites: as there are multiple areas where you received surgery, we may need to extend the time of treatment up to 1 and a half hours initially, or go for multiple sessions, each for a different area. The first few treatment may take longer as we want to spend some extra time trying to break down the fibrosis with a gentler touch, due to the high sensitivity of the body, which is high due to post-surgery. As the sensitivity decreases, and we can apply further pressure, we can achieve the same result in fibrosis reduction in less time. If you are not sure what works best for you, you can book a 15-minute free online consultation, so we can discuss your needs and work out a treatment plan in accordance with them. MLD Prices in Coburg All my services are offered at the same rate and are as follows: 90 mins – $175 1 hour – $125 45 mins – $ 115 30 mins – $90 All those prices are inclusive of GST. The 90-minute option is available only if required and not via the booking system. Why Choose MLD at Melbourne Massage and Treatment in Coburg? Not all lymphatic massage techniques are safe after surgery. I have been working with MLD since November 2021, and […]