Knee pain is a common presentation for clients of any range of age and gender. Knee pain indeed is a vast topic. So in this post, we are going to go through how to identify the reason why we can experience knee pain. For doing so we are going to look at some special testing, that we use for the knee joints. Next, in a further post, we may analyse individual conditions. What about the Knee Joint? The knee is the strongest joint in the body. It takes a lot of pressure from the upper body and still has to handle the shock coming from the lower leg session, shock as walking, running and jumping. Indeed, whenever we do one of these actions, the knee plays a big role. Knee Anatomy Bond: Above: Femur Below: Medially the Tibia, laterally the Fibula. Patellar is the front “floating bond” Ligaments: Anterior Crucial Ligament Posterior Crucial Ligament Posterior Menisco-Femoral Ligament Fibular Collateral Ligament Tibial Collateral Ligament Transverse Ligament (this one is visible only from the front side of the knee, below the patella). In between the bonds we have: Medial Meniscus Lateral Meniscus If this post is talking to you, book your next massage session by clicking here. So, the knee joint can be divided into two parts: Tibiofemoral joint Connects through the collateral ligaments, cruciate ligaments and menisci; Patellofemoral joint Gives stability to the medial and lateral retinaculum and allows the extension mechanism through the tendons of the quadriceps f.. Now that we have a better idea of what the knee anatomy is, we can look into his functionality. Knee ROM are: Extension: 0° Flexion: 140° Internal Rotation: 30° External Rotation: 40° Abduction/Adduction: 15° Said so, we can see that the major movement that the knee can accomplish is, flexion. Even if the Internal and External rotation since to be a big move for the knee, in the reality, that’s not always the case. The older we get, easily this motion actively gets tighter. Indeed, one of the main reason for meniscus injury is the twisting of the knee, when the feet is holding the ground and the body rotates. But as previously mentioned in this post we would look into the knee special test. What knee functional test have to tell us? As we already mentioned in another post, a generic active, passive or resisted ROM tell us about muscle functionality. On the other hand, a special test for the knee can show us if a ligament or a meniscus is loose, in the case of ligament or injured. Furthermore, special tests, on the knee are essential to prevent further injury and reduce joint degeneration. To start with we have the drawer test: Anterior Draw test and Posterior Draw test. The Anterior one is to test the anterior crucial ligament, and the posterior, obviously, is for the crucial posterior ligament. Both these tests are done with the client lying supine on the table, with a hip and knee flexed, and foot on the table. The therapist will ensure that the foot doesn’t move and will place its hands around the knee, with the fingers (except the thumb) seating at the top of the calf and the thumbs seating on the patella. For the A.D. test, the therapist will lightly pull the knee joint away from the patient body. On the other hand, for the P.D. test, the therapist will push the knee towards the patient’s body. These tests are positive if there is a loose movement within the knee, in the direction of pull or push. If the client has a history of injuries, to the ACL or PCL the therapist wants to make sure not to push or pull with great effort, or injury could occur. Vagus and varus test. Those tests analyse the status of the medial and lateral ligaments. For the valgus test, the therapist places one hand above the knee laterally, and the other hand above the ankle on the medial side. By applying opposite pressure in the 2 directions we put the medial ligament under stress. If pain is reproduced, or there is a loose movement the test is positive. The same action is for the Varus test. In this case, the hands are placed still above the knee and ankle, but the bottom hand is placed laterally and the top one, is placed medially. Apleys Test This test is used to evaluate the state of the meniscus. The client, in this case, would be lying in a prone position, with the knee flexed. The therapist will be standing next to the client, on the side of the knee flexed and will apply pressure to the knee. If no pain is reproduced with pressure only, the therapist can gently apply a rotation movement to the flexed knee. The test is positive if the pain is reproduced. McMurray test. This is luckily the most efficient and most used knee test used by therapists in case of meniscus injury Here is how it works: The patient lies in the supine position with the knee completely flexed (heel to glute). Lateral Meniscus: the examiner then medially rotates the tibia and extends the knee. Medial Meniscus: the examiner then laterally rotates the tibia and extends the knee. McMurray is a positive test if the pain is reproduced. There are still a couple of tests that can be done for the knee, but so far we did cover the most important. About the therapy that I can offer for releasing knee pain, MLD is what I would suggest the most. Especially for acute pain and swelling or oedema reduction. Whereas, Myotherapy or Remedial Massage and Thai Massage can be used too but more to facilitate and or strengthen the muscle surrounding the area.
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Mar
As already mentioned earlier MLD is a fantastic manual technique that can be used to improve the healing of many conditions. Along with the conditions that MLD is useful for there is bone fracture. Said so, in order to understand how MLD can help to speed up the recovery from a bone fracture we have to analyse what’s happening within the body when such trauma happens. A bone fracture is an injury that can happen at any age, due to an accident or trauma. The main type of bone fractures are: Displaced Angulated Shortened Rotate Symptoms of bone fracture Pain Swelling Bruising Deformity Inability to use the limb. The fracture so can be a crack side to side or in the middle of the bone. Eventually, the bone can crumble too, or break in multiple areas. At the worst, the bone can also cut the skin, and come out of the body. If this post is talking to you, book your next massage session by clicking here. Depending on where the fracture is, and what type of fracture it is, surgery could be required. Independently if surgery is required or not, still MLD can help to boost the recovery. Indeed, when a fracture happens the body recognises a trauma to its system. As long as the body won’t know exactly what the trauma is, and if the trauma does involve a skin crack or not, to prevent infections and external bacteria or pathogens to enter the body, the vein, capillaries and the lymphatic system around the trauma area get restricted. As per result, the body does swell. In fact, this explains why, when oedema happens the body does swell. It is an automatic body response to prevent further damage to happen. As the body then, realise what the issue is, slowly does reactivate the lymphatic system, and does fully reopen veins and capillaries, so that the blood can start circulating again freely. But the time that the body can reduce the swelling by itself, with a lymphatic system that works at regular speed (about 7 to 8 bits per minute) it would take a while to reduce the swelling. Furthermore, when I bone is broken that body part would have to stay still for a while, weeks or months. As per result, the blood and lymph flow would be slower than usual. And here is where MLD comes to be useful. If by reading this post, you feel like MLD is what you need now to recover from your injuries, click here to book now your next session. As MLD therapists indeed, we would check that there is no acute infection in the area where we want to apply MLD. If that’s the case, then, we can start our work. By boosting the lymphatic system, up to 3 to 4 times its normal ratio, we can quickly reduce the swelling. And what about if the area affected is covered with a plaster cast? Well, let’s not forget that the lymphatic system works as a vacuum and the area of loads is below the clavicle. So, stimulating the Lymphatic system at the top can actually already improve its suction ability till down the feet. For example, if the fracture is at the foot, initially MLD can be applied at the neck, to open the Lymphatic System duct that reverses in the veins, and secondly can be applied to the abdominal level and down the legs, just before the foot. Now, that swelling reduction, come’s with many benefits. For example, in the area treated, there is a transaction of extra oxygen, protein, vitamins, blood and other essential elements useful for the bone to heal. And occasionally, depending on the type of fracture is not only the bone the one that has to heal. In fact, along with a bone fracture, the body part fractured stays steel for weeks and months. That would create a weakness in the muscle that would then require rehabilitation. As a Remedial Massage therapist, I would have to refer the client to a Physiotherapist for rehabilitation. Even so, as a Remedial Massage therapist, I can still deliver massage services that can help in restoring muscle functionality. In conclusion, MLD can help with: reducing the swelling along a bone fracture; help in speeding up the recovery of the skin damaged by the fracture and or by the operation; Speeding up the healing of muscles and soft tissue around the fracture; Ultimately, by increasing relaxation, MLD is also useful to keep the humour of the person at ease, as often happens that after a trauma such as a bone fracture, the person can feel anxious and demoralised due to poor mobility and difficulties in moving.
Mar
As Massage Therapist, I often see people who come in for treatment due to pain and discomfort. Indeed, I am more than happy to be that person who, by manual therapy, can alleviate others’ agony. Exercises post-treatment. At the end of the treatment, I tend to show the client a series of corrective exercises and, most of the time, a straightforward one. Those corrective exercises must be done to help maintain the change we created in the body along the massage session. Massage treatments like Myotherapy, Remedial Massage, Thai Massage or MLD can be a good starting point to change the musculoskeletal unbalance of the body. Even though the changes we created will not last long unless there is constant work done on it. So, when the client returns to routine life, those change tends to disappear quickly. That’s why we give clients exercises. How can exercises help? Exercise can help address everyday muscle weakness, joint stiffness and or painful presentation on your own time. And yes, I understand it’s hard to find the time to do exercises, but would you rather live a life in pain or find a way to feel better about yourself? It’s part of our behaviour to want the fast, quick and immediate change we want. Isn’t it?! But nothing comes easy in life. We must learn that changes take time, and along this time, we must work hard for it. Said so, I am more than happy, and I feel honoured to treat people. I feel like Massage skill is one of the skills that can change people’s life. And when I do run a Thai Yoga class and teach people the exercises, I feel even more accomplished as a massage therapist. Book your next massage session by clicking here if this post talks to you. In conclusion, postural exercises are the key if you are willing to get rid of the body ache and pain. Then, working at the gym or doing sports activities is still as important. But those activities, if not monitored by a coach or done professionally and with full awareness, can lead to injury and pain. Indeed, when doing strengthening exercises, you want to ensure you correctly use the body biomechanics. But not only that. Indeed, you want to make sure that your joint has enough range of motion to deliver that action correctly. Following this link will give you access to the Thai Yoga Class videos.
Feb
Neck Pain. Neck pain is something that we all did experience at some point in life and is not fun. Neck pain can manifest for very different reasons, it can be chronic, it can come and go and can debilitate our day. How we can prevent neck pain to happen? And, if I am in pain, what I can do? Firstly we should have an understanding of the neck anatomy. The neck is made from the cervical vertebrae that run from C0 to C7. The first 3, so C0, C1, C2 are a bit unique. Due to their position and to the muscle that they connect, they can be considered the upper portion of the neck. Along those 3 vertebrae, we find the Occipital Muscle Group, which we did talk about in this blog post. From C3 to C7, indeed we have the lower portion of the neck. Along those vertebrae, we find different muscle groups. Some of those connect cervical vertebrae to the thoracic one, like Splenius Cervicis. Others connect the vertebrae to the scapula or to the skull, like Levator Scapulae, and Splenius Capitis. As of last we then have the upper portion of the Erector Spinae group, which connects the rib cage to the Cervical and Skull area. Like, Longissimus Capitis, Longissimus Cervis, Illiocostalis Cervis and Semispinalis Capitis. Now that we are a bit more aware of what is where, we can start to understand that neck pain can be for many, many, and many reasons. So, what to do then? Well, a massage therapist can be the one that thanks to orthopaedic tests and Range of Motion analysis can tell you what’s going on and where. For booking now your next appointment with Melbourne Massage and Treatment click here. Indeed, neck pain can be present because of the rounding of the shoulders. Or even because of a flat foot instead. “And what about the wrong pillow?!” Yes, the pillow can influence the neck life, that’s for sure. But maybe is the way that you sleep, and not the pillow only. Said so, with either a Remedial massage or a Thai Massage neck pain can be healed and cured. Both those techniques can address the issue and help in preventing the flare-up of the pain. In regards to the Remedial Massage, it can be applied in a prone, supine or seated position, using hands and elbow mainly. When it comes to Thai Massage then, there is more fun. Well, at least for the therapist. In the Thai Massage that I offer here at Melbourne Thai Treatment, I can use my hands, elbow, or even my feet to work on the neck. Obviously, I did train for it. And let me tell you, not because I use my foot it means is a stronger work. Actually, it is a more delicate and accurate touch than what you may expect. If then the person presents with a bulging disk in the cervical area, then things get a bit more complicated. To receive a massage there, I would request the clearance of the GP, and I may proceed by using MLD only. MLD can be a fabulous technique to work on to the neck. It can help in reducing swelling and speed up the recovery of the building disk too. In conclusion, to avoid neck pain is good to take some precautions. Like, spending less time on the phone, moving the neck with gentle movement and stretching, taking regular breaks from the computer if working too many hours at the PC, make your deep flexor stronger (see the blog post about the Front Head Carriage).
Jan
Water after a massage. Have you ever noticed that after a massage you feel thirsty and depending on the treatment you may have an urgency to go to the toilet? Well, massages are diuretics, that’s why. Indeed, independently of the type of treatment that you receive, whether is MLD, Remedial Massage, or Thai Massage, the body fluid gets pushed and pumped around the all body. As per consequence, all these substances moved around need to find their way out. So, after any session, you wanna make sure to rehydrate your body. Drink water after a massage. Why water and not orange juice? Or an energy drink? Or coffee? Water is what is recommended after a massage because it’s what can at the best re-oxygenate the muscle and re-hydrate the body. Drinking a sugary drink, or a really acid beverage as it can be coffee will just dry off the body even more. Furthermore, water is quicker to be absorbed and can help the stomach to keep its natural PH balance. If this post is talking to you, book your next massage session by clicking here. Another effect of the massage can be the deep relaxation of the body, which can affect the stomach and abdominal feeling. Indeed, adding sugar or other substances to the PH of a stomach that feels so relaxed, may not work at the best. What about the water temperature then? Cold or warm? Well, let’s take down the myth that cold water makes you feel fresher. Sorry, it doesn’t. Drinking cold water brings the body temperature down, increasing then the difference in temperature between within the body and outside the body. That will make you feel even hotter. But I do understand that hot water unless is herbal tea, doesn’t feel so nice. Even though, warm water would be ideal, as its temperature would be the same as one of our inner organs. So, temperature-wise just drinks water at room temperature if you can’t stand hot water.
Sep
Thai Yoga, is an exercise practice that would take you to a place of relaxation and better physical and mental well-being. As you may already read on the website page about Thai Yoga, this exercise aims to improve your mobility, motility, and body awareness. Those exercises are based on the principle of Thai Massage and Myotherapy approach. I did study Thai Massage with Arjan Pichest Boonthumme, at his home school in Chiang Mai. Indeed is Pichest the pioneer of this type of exercise. Book now your next private Thai Yoga class with Giovanni. He teaches his students to practice those exercises in order to help us, students, to understand how to reduce physical tension from the body, and to be a better practitioner. Even though he doesn’t call them Thai Yoga. When I left Thailand after my 1st period of training with Pichest (early 2018), I start practising these exercises nearly daily. I was not following a specific sequence, and I was not offering yet the workshop. As I kept working as a massage therapist, and I was suggesting these exercises to my clients, to keep tensions low and enforce the job done with the Thai Massage, I then realise how all these exercises put together, could actually help others heal their bodies and improve their health. I start then offering these classes at the Dancehouse in Carlton, and occasionally I will offer free classes at the Carlton Garden too. So how it works a Thay Yoga class? Well, as per Thai Massage based, those exercises aim to work on muscle’s tensions and reproduce physiological responses that massage would usually generate. Said so, as you work on your body, and you feel in first person the stimulus and the response given to the stimulus, you would be able to improve your body awareness. How it does differ from a regular Yoga class? The difference from a regular Yoga class is that along with a Thai Yoga class, most of the exercises don’t require a specific elasticity or mobility capacity, even though, once you practice them you would realize how easier is to move a joint and how freer the body is feeling. This happens because during the class, as we stimulate the blood flow starting from the upper limb, and moving down the lower limb, the body gets warmer, and the stiffness gets cleared away. Furthermore, during the class, I would show how the usage of the breathing wave technique helps in mastering the practice. This way of breathing, not only improves the oxygenation of the body, and so the healing of it, but also helps the participant to learn how to deal with the body sensation that arises along with the workshop. Yes, I would not lie to you, some of these exercises can reproduce pain. But hey, have you ever heard of a Thai Massage pain-free? Well, Thai Yoga exercises are not so different from it. In conclusion, Thai Yoga is not recommended for those with conditions like hypertension, osteoporosis and or diabetes n. 1 or whilst pregnant.
Jul
In this post we are going to talk about “Dive in, let it go” Often we get told that we should ” let it go “. How easy it is to say such a thing, but how hard it is to do so. When I was studying in Thailand to be a Thai Massage therapist, our teacher, Pichest, was making so much fun of us students when we were trying to approach his massage technique. And he was right to laugh. What students there are trying to do, is copy his movement without having his fluidity in approaching the Thai Massage technique itself. So, how does he teach others to let it go? This is how I did find a way to interpret Pichest teachings. Let’s start exploring the meaning of “let it go”. Let it go stands for no holding back on something/someone. No holding on to a loved one, an object, a situation or a feeling. So how we can recognise the fact that we are holding on to something then? This, I think, is the starting point. Recognize where and when we do hold on to something. From here, we can understand how to let it go. We tend to hold on to situations and feelings that make us feel safe, happy or protected. As these situations get exposed/under threat, we tend to tense up with our bodies. The first step, in order to recognise those tensions, we have to live in a clear state of mind, by reducing the body/mind intoxication to a safe/personal level. As the connection with the body gets clearer and deeper, we can start facing how that attachment affects our being. As you feel the body’s sensation arises, you should learn how to breathe through it. Let your breath be. Often when I do give Thai Massage or teach a Self Thai Massage class I have to recall the client of the importance of the breath. Breathe in and out from the nose and focus on the body area that is requiring your attention. Don’t feed the hunger or the fears that would arise, but do not either feed the excitement and joy of understanding the tensions, just feed your breath. As this cycle of understanding of the body takes place, we will automatically learn how to release the emotional tension/s related to the body’s sensation. Furthermore working from outside, just on the body level such as exercises and work-out is just a shallow approach to the let-go action. The strong work on the body will actually disconnect the body/mind connection. This is because hormones produced during physical exercise will fake up the body’s feelings. In conclusion, that’s how we can dive in to let it go, by slowing down the intake of sensorial input and by focusing on the body sensation that arises from discomfort situations.
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