“I was lifting the box from the floor, and then, ouch I did my back”! How often have you heard this? What’s going on here? Lower back pain is a common presentation that affects many people all around the world. But hurting your back when picking a box, or even a lightweight as the key, or tightening the shoes, is an injury that doesn’t affect only those with lower back pain. So to explain the mechanism behind these incidents, we have to look into what we call “proprioceptors”, specifically “muscle spindle”. Proprioceptors are body receptors within the skin, muscles and joints that reveal information about the body’s movement and send this information to the brain. How that information is transmitted to the brain is by different types of a pathway that we will see in a future post. In specific, today, we are going to look at the “muscle spindle”. So muscle spindles are proprioceptors that can tell the brain how the body is moving, specifically a muscle, and a proprioceptor that can tell a muscle to relax and change to stretch. Indeed, muscle spindles are different from other proprioceptors, as they can alter their sensitivity as needed. What did Muscle Spindles have to do with my back then? As mentioned above, a muscle spindle can alter muscle consistency. So, when banding forward to pick up the key or do the shoes lase, the back muscle must relax, as they have to stretch. But, if the muscle spindle doesn’t tell the back muscle to relax as you bend, those muscles will stay contracted, and guess what happens next? “Ouch, I did my back.” How to prevent the injury then? To prevent an injury as such, movement is the answer. Movement, as simple as a cat and cow exercise, would create that feedback response between your lower back area and the brain that, in the long term, would ensure your brain knows that when bending, the posterior portion of the body needs to be told to relax. Said so simple movement can prevent the injury, but further exercises, like a deadlift, can help your entire posterior chain to get stronger and get you to the next level of strengthening. But before lifting heavy weights, let’s not forget the importance of looking into mobility. In conclusion, to prevent this injury from happening, start moving. Incorporate regular breaks from your seating at the desk. Have a timer on your desk that, every 45 minutes, remind you to stand up, have a stretch and short walk, a water sip and get back to work. Book your next massage session at Melbourne Massage and Treatment if this post talks to you. How can Massage help? Massage therapy can help in different ways. First, it can help reduce the muscular tension within the lower back area. Second, the massage touch can help increase that body awareness, preventing further injury. The recovery process from an injury does depend from person to person. But within a few sessions within 1 to 2 months, using a mix of techniques, like MLD, Myotherapy and or Thai Massage, there is a good chance of good recovery and injury prevention. Exercises play an important role too in this recovery phase. How Many Sessions would I need? As already mentioned, everyone is different. Based on my experience, to help someone recover from an injury, initially, it can take up to 5 sessions spread over two months to achieve a good result. And again, this is not only about Massage but also about corrective exercises. Therefore, I offer a treatment plan allowing you to uptake five sessions of any treatment type at a discount rate of 10%. This offer is valid for returning clients who already had an initial consultation. This would allow me, as a therapist, to ensure I am the right therapist for you and that we can create a treatment plan that works for you and that you can use for your benefit.
Tag Archives: lower back
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Dec
As previously spoken in another blog post, sitting on the floor and working at the pc would be a better anatomical position than sitting on a chair. Why does sitting on the floor work better than sitting on a chair? Sitting on a chair is uncomfortable, especially in the long term. As a massage therapist, most of my clients are people who have cervical pain or suffer from headaches. Sitting at a desk for hours does more damage than you may realise. So, let’s start with the lower body portion. Staying seated on a chair does direct pressure on the thigh, and by doing so, muscles like the hamstring and gluteus muscles get compressed. By compressing this group of muscles, they get weak and stop functioning as they should. In addition, direct pressure is also applied to the sciatica nerve, the main nerve of the lower body portion. The piriformis often compresses the Sciatica nerve. This muscle runs beneath the Gluteus Max and connects the medial portion of the sacrum to the greater trochanter of the femur. So, the deactivation of those muscles would then manifest itself when we try to walk or, in any case, extend the leg. As the “firing pattern” blog post shows, the hamstring and gluteus max muscles are crucial in leg extension and help prevent lower back pain. This is what happens to the muscle part of the lower body portion. But this is not the only issue the body faces with so many hours sitting on a chair. There is more. So sitting on a chair does limit the body’s movement. The decline of the body’s movement creates a cascade of side effects, including mobility reduction in joints like the Hip, Ankle, Feet, and Thoracic. As all those joints don’t move, there is also a diminish in the proprioception body/brain. Another issue is the compensation of the stability joint over the mobility joint. Indeed, when a mobility joint gets stiff, the stability joint above and below would try to compensate. What’s a common finding pain-wise with sitting on a chair for long hours? The prevalent finding is a sore neck. The sore neck happens as the thoracic stuff up. Indeed the lower cervical portion of the vertebrae, which are stability joints, try to compensate for the thoracic stiffness and, in the long term, would cause neck pain, shoulder pain and headaches. Sitting on the floor can improve mobility. Sitting on the floor can help improve your mobility by allowing you to move your body in many different ways without the need to stand up. That movements are what your body needs as mobility exercises. That movement is your body’s way of improving its posture. Indeed, movement is a crucial component in pain prevention. And this doesn’t happen on a chair. How to switch habits? As for all the habit changes, this has to be gradual and not radical. So, start sitting on the floor for 1 hour a day. Give yourself the time to adapt to the change. Slowly you can incorporate more hours, but not in a row. Maybe one hour in the morning and one in the afternoon. Also, incorporate some standing time to sitting on the chair and floor. Implement change, too, within your training. You are doing something new, and your body needs to adapt. As shown in this clip, start, start implementing a habit of sitting on the floor by doing step-by-step movements: Step 1: Move one leg forward, and bend down the other knee. Step 2: Bring both knees down Step 3: Swing the lower leg to the side (either Lx or Rx) Step 4: Let your body weight go, and sit down Step 5: Now let your lower leg come forward and sit cross-leg. Step 6: Do from step 5 to step 1 in reverse By clicking here, and here you will find the links to a Thai Yoga exercise that can help a lot with improving hip mobility.
Oct
Joint mobilisations are manual therapy techniques that improve joint mobility and flexibility and reduce joint pain. Joint mobilisation can be applied to many body joints. Some contraindications have to be taken into consideration for mobilisation: Joint swelling Osteo Arthritis Bone Fracture Bulge disk (if the mobs are intended on a vertebra) Mobilisation VS Adjustment. Mobilisations are different from Chiropractic adjustment. The difference is that Chiropractic adjustments are fast movements applied with more significant pressure. Mobilisations are constant slow, repetitive movements applied to the joint. Along with a Myotherapy treatment, Giovanni would evaluate if mobilisation is the proper treatment for your condition. For example, mobilisation along the spine is recommended when someone presents with a stiff back in the sacrum, lumbar, thoracic or lower cervical area. Giovanni would always double-check with you about what the mobs felt like. Types of Mobilisation. As we already know, the body is made of different types of joints. Given the different types of joints, like socket joints, plane joints and more, others are the type of mobilisation. For example: For a joint like the hip, we can apply mobility like a distraction, anterior-to-posterior pressure or posterior-to-anterior pull, internal rotation or superior-to-inferior pull. Some of these techniques can be applied to other joints, and each way of using a mobilisation aims to improve a specific range of motion. So, all up, the type of mobilisation that we have are: Superior to Inferior; Inferior to superior; Distraction; Posterior to Anterior; Anterior to Posterior; Posterior glide; Anterior glide; Lateral glide; Medial glide. Mobilisation Belt. A mobilisation belt can be used to deliver the mobilisation based on the joint we aim to work on. A belt is a tool wrapped around the designated joint we want to work on and is used to apply stretches that would not be as easy to achieve by hand. An example is a hip distraction. For distraction, we refer to it as a force that pulls a joint apart. In the case of a hip, the head of the femur is pulled away from the hip’s socket from the medial to the lateral direction. As you would imagine, using bare hands for applying this technique not only could result in an uncomfortable approach to the intimacy of the patient, but it would requireFr too much effort for the therapist, resulting in poor mobilisation delivery and risk of injury. Therefore, the best tool is a belt wrapped around the patient’s hip and the therapist’s waist. Why use the mobilisation technique? The mobilisation technique aims not to reproduce pain, cracking sound, or sharp sensation. Indeed, the aim is to reproduce a firm pressure/pull on the joint area. Regarding the thoracic area, if any of those vertebrae reproduce pain or sharp sensation, applying the mobs along the vertebrae/ribs joint would be better. Doing so would still possible to affect spine mobility indirectly. Giovanni’s training for this type of modality started during the Advance Diploma in Myotherapy at RMIT and continued at the Bachelor of Health Science at Torrens University. Mobilisations technique can be applied to Big Toe, Ankle, Shoulder, Feet, Hip, Wrist, Elbow, Vertebrae, SIJ joint, Facet Joint, Clavicle and other body areas. An example of joint mobilisation for the feet. Mobilisations at the ankle area are used for improving ankle mobility. Indeed, improving ankle mobility is to better support during the walk, standing and or running. Always talking about the feet area, the mobilisation applied to the Big Toes is used along the Metatasolphalangeal Joint. Do you feel your joints stiff? Your booking for a Myotherapy treatment with Giovanni is just a click away. This mobilisation is applied by creating a distraction movement within the joint, pulling the toes away and then using it for passive flexion and extension. As mentioned in another blog post about wearing bear foot shoes, the Big toes are meant to extend from 65° to 70°. Conclusion The Big Toes are the feet joint that should push the most in the feet strike as we walk. In conclusion, mobilisations are a great way to increase mobility within a joint allowing better movement and improving the range of motion.
Apr
First Massage Appointment. At Melbourne Thai Treatment, a first massage appointment session does last a bit longer than a regular appointment. Indeed, if you go on the booking page, you may notice that the first appointment lasted 75mins. Why so?! Well, within the first appointment, as a therapist my aim is to track down your Clinical History. For doing so there is initially a form to fill in and in a second stage few subjective questions that I am going to ask. Questions are like: “What do you do for work?” “What sports activity do you do or did?” “On what side do you sleep?” “Are you Right or Left Handed?” Ext… These and other questions, relevant always to the presentation that you come in with, are for me therapist essential to understand how you end up having the pain or discomfort that I have to remove or reduce. Obviously, those questions asked during the first massage appointment can take a bit of time to be answered Occasionally an answer gives space to a new question. Said so, the more specific are the answer more I can narrow down the clinical situation. If this post is talking to you, book your next massage session by clicking here. As per result, will be easier to find a path to alleviate pain and discomfort. On the other hand, as the session last longer than a regular visit, as a therapist I charge a bit more. For a Remedial Massage and a Thai Massage a first appointment session would last 75mins. About MLD a first Massage session would last 60 minutes. Indeed, with this post, I would like to share and explain to any clients that the first appointment is not more expensive because I am greedy. Is through, the time we spend doing the massage itself is per usual the same time that we would spend during a general consultation. But, that initial time that we spend working out your Clinical History, will save time after actually treating the condition. In conclusion, I would not see the first appointment as an extra expense, but as an investment in your health. Before we find out what’s the cause of your pain, and discomfort before I can create a proper treatment for it.
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.
Jan
Massage History. Massage history dates back many centuries ago. The association between touch and healing is longer than what you may expect. In fact, the history of massage goes back to 5000 years ago. As per the result of the first finding, the first appearance of massage as a healing technique is founded in India. Is the Ayurveda history then that can be pushed so far. Along the millennia and centuries, this healing technique gets spread all around. Firstly the massage approach spreads to China ( 2700BCE ) and is here that the technique starts to be mixed with martial arts and spiritual yoga. Indeed, this will create the base for Chinese Medicine. From China then, the massage techniques and knowledge moved to Japan, and that’s when Shiatsu was born. Shiatsu is a technique that regulates and strengthens organs by moving energy levels through the stimulation of pressure points aiming to bring natural resistance to illness. If this post is talking to you, book your next massage session by clicking here. Along with the eastern culture, let’s not forget the Thai Massage. About this specific technique, I did dedicate a full blog post. In regards to the western culture were Egyptians the first who start practising massage then influence the Greeks and the Romans (800BCE). As per result, the Greeks put the base for western medicine. Thanks to the passion and devotion to sports (Olympics game) figures like Hippocrates start to associate facts with time in nature, music, rest, good food, and massage as a good practice for the body and essential for healing. Hippocrates can be considered the father of modern medicine. In regards to the Romans, made massage was a popular practice. The reach people could get a massage as a private service, whereas, everybody else would have a massage at the public bath. The Roman public bath is the precursor of the modern SPA. Timepass by and massage lose its popularity, especially in the western world. We have to wait till the 19th century. Is then when a Swedish doctor Per Henrik Ling, developed the base for the Sweedish massage or better known as relaxation massage. From this time onward than all the modern medicine techniques start developing. Remedial Massage (19th century) Myotherapy (1970) Osteopathy (1874) MLD (1930) In conclusion, several are the technique of massage available today. There is a massage that works better than others? Possibly yes, like some massage techniques can work more deeply than others. Said so, depending on the need of the person and the body conditions that may a specific technique is recommended more than others.
Dec
Quietly often I still get asked what is cupping and how does cupping work? Firstly, Cupping is a type of alternative therapy based on placing cups on the skin to create suction. Indeed, the suction would pull the skin up from the muscle layer, drugging back the fascia layer seating below it. Cupping is gentle work on the body, not invasive and at the same time is an amazing technique to stimulate and facilitate the fascia. We did look into the fascia in a previous blog post. If you have missed it, you may wanna click here. On the other hand, there are different types of beliefs and methodologies about cupping’s functionality. Some of those can be a bit more invasive, and dangerous too. Said so, I guarantee my clients that these are not practices that are available at Melbourne Massage and Treatment. For how I got trained in giving cupping, my aiming as giving cupping is: – Leave no marks – No cutting the skin – Painfree – No blood stagnation Now, by following the order of the action listed here above: Marks are a sign of blood stagnation. Accidentally can happen to leave a mark on someone’s skin, and many are factors involved in it: Skin type is one and another one is if the area that received cup was already massaged or not. As Remedial Massage therapists or Thai Massage Therapists, we are NOT trained to cut anyone’s skin. Furthermore, you have to think that when this practice is involved there is a great risk of skin infection. Why do some practitioners do so?! None of my business. I just don’t believe it is necessary, and I don’t believe it has any benefit. As per many detox diets and detox programs, the body is your best allay and best detoxer of itself. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. In regards to pain, Cupping must be pain-free. Along a cupping session, you may feel a strong pull along the skin, but no sharp, ache or pinch sensation should be present at any moment. Indeed, to help the cup slide easily oil or cream oil-based get used. When happens that a mark gets left behind, doesn’t necessarily create pain or discomfort. Another cupping precaution is to avoid over-pass a cup on joints and or tendons. The cupping force could rip or damage those areas, resulting in permanent damage and pain. Lastly, no blood stagnation. Cupping’s desired result as per many massage modalities is to generate a physiological response that would reduce tissue stress. Through the gentle tissue stress, muscles relaxed and the chain of manual therapy benefits starts.
Sep
Scoliosis is a sideways curvature of the spine that most often is diagnosed in adolescents. Firstly, let’s say that there are 2 main types of scoliosis: Functional and Structural. Indeed, Functional S. is a type of scoliosis due to a muscular unbalance in the body. The spine presents a curvature but no rotations. On the other hand, Structural scoliosis is due to a structural abnormality, like a bond deformation along with the skeleton and it diverges from a functional S. due to rotation in the spine, and not just a curve. Said so, to diagnose the differences between functional and structural, we can ask the client to band forwards from a standing-up position, by trying to reach the floor with the hands. As the client band forward, if there is torsion in the torso, that’s a sign of structural scoliosis. About 80% of scoliosis, is structural. There are then different levels of scoliosis: Mild Cobb angle measurement of between 10 and 25 degrees Moderate: Cobb angle measurement of between 25 and 40 degrees Severe: Cobb angle measurement of 40+ degrees Very severe: Cobb angle measurement of 80+ degrees The Cobb angle is the most widely used measurement to quantify the magnitude of spinal deformities, on plain radiographs. Scoliosis is defined as a lateral spinal curvature with a Cobb angle of >10°. Furthermore, the different levels of scoliosis can be defined as: Idiopathic This is the most common type of scoliosis and as it doesn’t reproduce any pain at a young age, it is often missed diagnosed becoming the cause of pain in the adult stage of life. It does affect more women than men. Are you struggling with pain and or body ache? Book now your next massage appointment at Fitzroy North Clinic. Neuromuscular As per the name, in this case, scoliosis is associated with neuromuscular issues. Often it is diagnosed at a young age, and the 2 conditions have to be treated separately. Degenerative As per the name, this type of S. is due to a bond degeneration at the level of the facet joint. As per the result, the symptoms are like: lower back pain, (that’s where most commonly a degenerative facet can happen), sciatica pain, and difficulties in walking. Congenital Congenital scoliosis is a condition that affects a child that is not born yet. As the fetus is forming, one or more vertebrae may fuse together, or bony spinal segments or vertebrae fail to form properly. Traumatic Traumatic scoliosis, as the term already described, can be the result of an accident or a major physical trauma. Like a car accident. Given now a clear explanation of this condition, we are a bit more aware of what a curve in the spine is about. Corrective exercises are the key answer to scoliosis. Physiotherapy is probably the best medical practitioner to refer to for corrective exercises related to this condition. Said so: Q: “I got lower back pain. That means I got scoliosis?” A: “No. Lower back pain is one of the symptoms of scoliosis, but there are several reasons why you may suffer from lower back pain.”
Sep
The Lower Cross Syndrome as for the Upper Cross Syndrome is an unbalance between the forces of muscle groups that cross each other between the anterior and posterior of the body. For Lower Cross Syndrome, we look into the Pelvic area. The pelvis’s role The pelvis acts as a hinge between the upper and lower limbs. It is made from a group of bones, ilium, ischium, sacrum, and coccyx interconnected by ligaments. The pelvis is constantly under the force of pressure or force of pull, which either comes from the upper limb or the lower limb muscle group. Said so, we have to point out that, between women and men there is a difference in pelvic shape. The women have a more rounded girdle than men, this is obviously for evolutionary reasons, due to the fact the woman gives birth. Furthermore for a woman is more common to have a wider range for Anterior pelvic tilt. For Women is acceptable an anterior pelvic tilt between 1 and 2 cm, wherein man it should be up to 1cm. This is because of the girdle shape. In fact, when we look into the pelvic level from the side point of view, we expect to find an anterior pelvis tilt, that doesn’t take over the parameters mentioned above. This anterior pelvis position, allows the lumbar spine to be slightly arched, so that it can better take the pressure, without the risk to create injury to the lower back. How to measure the A or P pelvic tilt? To do so we look sidewise at the difference in high between the ASIS (Anterior Superior Illica spine) and the PSIS (Posterior Superior Illiac Spine). As the L and R sides of the pelvis are independent of one another one, we can find a dissociation in the tilt of the opposite side. That means that L can be anteriorly tilted and R. posteriorly tilt, or vice versa. Moving on, now we can analyze what muscles are involved in Lower Cross Syndrome. For an Anterior Pelvic tilt, we look into tensions for this group of muscles: Erector spinae group Iliopsoas muscles Rectus Femoris Are you struggling with pain and or body ache? Book now your next massage appointment, at North Fitzroy clinic. For a Posterior Pelvic Tilt, we look into tensions for this other group of muscles: Gluteus Max Hamstring Rectus Abdominus External Oblique As one or the other group of muscles is tense, the other one as consequence would be weaker. For example, a person that drives for long hours, or an office worker would commonly suffer from an Anterior Pelvic tilt from Lower Cross Syndrome. That’s because their Psoas is in constantly forced contraction (hip flexor) and the hamstrings are constantly weakened from the long seating hours. So when I treat someone with Thai Massage, before the treatment I always make sure to analyze the pelvis level. This would instantly give me an idea of the balance and unbalance that the person eventually suffers from. The work that I would do for this type of dysfunction involved the relative muscles, mentioned above, but not only. During the Thai Massage, as the client lying on a side position, to access areas like the back and or gluteus, I would also work on the client’s shoulders. If initially, I would not work on the shoulders, after a few minutes the client will find discomfort in the area. What I like about this Thai Massage technique, is that is not demanding on my body and give me a wider range of access to the client’s body. Because I can use my feet, knees, elbows, and hands to give a massage, I can freely change the type of pressure to the client’s needs. Whereas if I was working with a Remedial Massage, the limitations are broader. Working with a table would make it much harder to access certain body muscles. Furthermore, it would be hard if not impossible to use feet or knees for massaging.
Aug
Lower Back Pain Lower back pain is a condition which can deliver lots of stress and can affect our daily habits. It can be a terrible experience to live, as it can make many tasks difficult or impossible to take. Here below you will find a series of questions and answers in regard to my experience with lower back pain, as a person and as a practitioner. Q: Did/do you ever experience lower back pain? A: Yes, I did suffer from lower back pain when I was a teenager and that was a trigger for my massage career.Said so, at the age of 16, I was not thinking yet to become a massage therapist.More experience was needed before I did decide to step into the massage career. Q: How common is lower back pain within the Australian population? A: It is estimated that in Australia between 2017 and 2018 4.0 million people did suffer from back pain, whereas 70-90% out of those 4 million did suffer from the lower back itself. Q: What are the causes of Lower back pain? A: Lower back pain can come from different causes. Here below are the most common: bulge disk muscle strain fascia tightness trigger points muscular-skeletal unbalance physical trauma stress Q: I feel pain on my Rx or Lx side on a horizontal line. What can be? A: That’s what we call a red flag. A pain that spread on a horizontal line can be given by a bulging disk. More tests must be put in place to confirm a diagnosis. As a massage therapist is not in our scope of practice to diagnose a bulging disk. Our next step would be to refer you to a GP for further investigations. Q: So, what is a bulging disk? A: A bulging disk is a condition (hernia) where the disk that seat between the vertebrae, gets a tear in it. As a consequence, the disk touches the nerve running along the spine and creates a pain sensation. There are 4 different stages of herniation of the disk. Disc protrusion Prolapsed disc Disc extrusion Sequestered disc. Q: What are other symptoms related to a bulging disk (for the lower back)? A: Other symptoms of a bulging disk (for the lower back) can be: Numbness in the glutes, legs, feet. Weakness in the leg/feet movement Pain increases when seating, like the disk, gets compressed and decreases if standing, like the disk, gets decompressed and less pressure is applied to the nerve root. Difficulties in going to urinate, it is a strong sign that there could be a bulging disk in the lower side of the lumbar area. Medical attention is urgently recommended. Q: Why a bulging disk can occur urine blockage? A: The nerve that controls the spasm of the bladder is rooted between L1 and L2. Indeed, Pressure on the main root, between these 2 vertebrae, would then transform into nerve dysfunction. This condition is called Cauda Equina Syndrome. Q: My lower back pain moves vertically. Why is that? A: A sign of lower back pain that moves vertically is more luckily related to muscular inflammation. In fact, there is a group of back muscle called Erectus Spinae, (Spinalis, Longissimus, Illiocostalis) that originates in the lower side of the lumbar area and extend vertically along the cervical area. Q: What triggers muscle inflammation? A: Many are the reason why muscles can get inflamed.Repetitive movements pour posture, the incorrect firing pattern of a muscle group, in specific the leg extension firing pattern. Q: How massage can help? A: Massage can be an effective approach to release tension along the lower back. Given the training that I did go for, I would ensure to use the knowledge learned along the Remedial Massage and Myotherapy course to identify what back pain is related to. Based on the finding and on the willingness of the clients, we can then disgust with the client what technique of massage they may prefer, Remedial Massage, Dry Needling (if applicable), Mobilisation (if applicable) or Thai Massage. Even MLD can be an effective technique, as it can be used to reduce inflammation, swelling, tension and stress. As previously mentioned, if I got suspicious of a bulging disk, I would not hesitate to refer the client to a GP for further investigation. In regards to the Thai massage technique, I will ensure to warm up the area first with some simple passives stretch and or cupping and then work on the muscle that needs some tension released if it is safe to do so, or on the muscle surrounding the area, like gluteus, hamstrings and or shoulder muscles. Q: Would you use your knee to massage my back? A: The use of the knee is not compulsory. If it is safe to do so, yes, I may use my knee to massage the back. A correct and proper evaluation of the injury must be applied before doing so. If you are in pain or even just feel tight along your lower back, don’t hesitate to book a massage appointment. Any of the techniques offered at Melbourne Thai Treatment can be really effective in reducing pain and ache and giving you back the mobility lost. Said so, for chronic conditions their massage can help till a certain point. Exercises and other treatment options have to be evaluated.