Tag Archives: lower back pain

I did my back

“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.  

Giovanni’s Massage Qualifications

Qualifications Advance Diploma Myotherapy RMIT

I spent the last seven years achieving different massage qualifications to offer a service that is different from the standard massage. Why I started studying Massage therapy. My interest in the massage profession started as a curiosity and a desire for a career change. Indeed, before getting into the massage profession, I worked as Pizza Maker for a decade or so. That did allow me to get permanent residence in Australia. But I knew that hospitality life was not what I wanted to do for the rest of my life. So, in Jan 2016, I did enrol in a Certificate IV in Massage Therapy at the SSNT (Southern School of Natural Therapies) in Fitzroy. After that, as soon as I finished the course, I decided to go travelling and experience more of the outback life. It was not till February 2018 that I returned to studying massage practice. Thai Massage Qualification. That was in Chiang Mai, Thailand, with Pichest Boonthumme. I ended up in Chiang Mai, thanks to a friend who understood what I was looking for. And what was I looking for? Well, I was searching for someone to teach me more than a massage sequence or stroke. So I was not looking for just a random massage qualification. Someone that could show me how to improve myself as a massage therapist and person in the first place. Pichest is the right teacher. Anyway, I passed the first round of training in 2018 with Pichest, I then kept travelling, and before heading back to Australia, I did a second stopover in Chiang Mai, and that was in Jan 2019. But still, before starting the Diploma in Remedial Massage at the RMIT in July 2020, I did go to study with Pichest for another couple of weeks (November 2019). Do you feel like you need help with your neck pain? Book now your next appointment. Back to school. As already mentioned in 2020, in the full Covid-19 pandemic, I decided to completely abandon the hospitality industry and dive more into the massage practice. That’s why I did decide to go for a Remedial Massage course. Once the Remedial Massage course was over, in December 2021, I decided to step into the advance Diploma of Myotherapy, which would last one year more. Between those courses, I also found the time to take a class for MLD (Manual Lymphatic Drainage) with the Vodder Academy here in Australia. But, it was not till the latest training with Pichest Boonthumme (November 2022) that I understood how all those modalities are interconnected with the other one. Where am I now, along the massage qualifications journey? I just enrolled in the last year of my Bachelor of Health Science in Clinical Myotherapy at Torrens University. I did decide to enrol in this course for several reasons: Personal challenge. Learn more and more about body and massage practice. I am possibly going for a master’s after it (a master’s in acupuncture).  

Sitting on the floor, and easy way to improve mobility

Seating on the floor, squatting

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.          

Back to Chiang Mai, Thailand back to Thai Massage Training

On the occasion of my 4th time in Chiang Mai, since 2018, I am dedicating this post to Thai Massage in Pichest Boonthumme Style. When and where did it all start? In March 2018, I started studying and practising Thai Massage. I came here to Chiang Mai, to see Pichest Boonthumme, after a friend’s recommendation. I was looking into finding someone, that could teach and share a massage technique, not only based on sequence and repetitive movement. As often happens, as long as you ask, what you are looking for will show up. And now, after 3 long years of the Covid pandemic and limitations on travelling, I am back in Chiang Mai. This is my first trip out of Australia since 2019, so it was an excellent way to celebrate the freedom of travelling, once again. Being back at Pichest Thai Massage School is always challenging. Even though I spent the last three years training for Remedial Massage, Myotherapy and MLD, when I came here, there was always something new to learn. Along with that new practice, there is always the Thai/Buddhist philosophy aspect of how to see things. I did really like the way Pichest, with his limited English, can explain the complex way life can present and shape, and how simple it is to learn how to deal with it. Just observe the breath. Well, no surprise, as this is the principle of Vipassana Meditation itself. That said, what most often happens is that people who come here to study with Pichest ask to learn how to breathe, even before they can receive a massage. Many people come here because they heard of how good Pichest is at giving massages. And they all come with the expectation to get fixed. And it is just hilarious to see how Pichest, every time, turn these people away from treatment and asks them to learn how to breathe. We are used to thinking of Thai Massage as a painful approach, a strong technique, and it is. But not because we are physically suffering means we are getting better. If we can’t deal with the pain if we stop breathing as we perceive that pain, we keep creating tension in the body and will not let the healing process happen. Breathing during a massage comes with a  series of benefits: helps the blood to be pushed around Oxygenation of the muscle tissues Improve relaxation It helps in dealing with the pain reproduced by the touch of a tense area Stimulates the Vagus Nerve, which controls the parasympathetic nervous system On the other hand, before we start doing deep work on the body, the patient does better take 5 minutes to practice breathing, and the first area to work would be around the posterior portion of the shoulder and the hip or Tibia area, to stimulates the blood flow within the body. In conclusion, Thai Massage as we know it in the West is a bit of a distortion of the real thing. Thai Massage, as with any deep tissue massage, can replicate pain, but the pain must be good, not sharp. The pain must help to release tensions and not increase them. And to be a Thai Massage therapist, you better know your anatomy well. Are you curious to find out what a traditional Thai Massage is like? Bookings are open for Traditional Thai Massage at Melbourne Massage and Treatment Fitzroy North studio.  

Joint Mobilisation

Feet Metatarsal Mobilisation

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.

Ice Pack

Ice pack

In a previous blog, we did talk about heat packs, now it is time to talk about the Ice Pack. Ice pack application, in the last few years, is a practice that got reviewed. What Ice Pack is about? An Ice pack, as the name says, is a cold (icy) bag. As better explained in this study an ice pack is something that can be applied to an acute injury, to prevent swelling and reduce pain, but it can’t be used for too long. As per the heat pack, an Ice Pack burn the skin, and that’s one reason why its usage has to be short (10 to 15mins at a time). In addition, extended exposure to icy temperatures, would reduce the blood flow around the injured tissue and can also damage nerves. Ice Pack usage recommendation: You have a new injury or aggravation of an existing condition, and the pain is above 7 out of 10. Where you want to minimize swelling to keep you mobile later. There are different types of Ice packs: Home-made one, ice from the freezer wrapped in a towel. Gel pack Ice Bag (as per the photo) Instant one – most of the time found in the first aid kit. Snap it and a chemical reaction would occur in the bag and freeze the bag. Those last ones are efficient as you can store them anywhere safely and use them as you need them. The cold lasts for about 20 minutes. Not to be used if they are broken. On the other hand, if you running out of ideas of what to use as a Cold pack, you can even use a bag of frozen food. Still would do the work. We have the ice bath and the cold show related to this topic. I did experience cold showers myself, most of the time not of my choice, but because of a limited supply of hot water, and I have to say that even on this topic, there are a series of debates on how that works and if it’s beneficial. So far, a cold shower, compared to a hot shower, is better for dry skin. This is because the heat of the water combined with soap can wash away the good oils of the skin. Then the benefit of an Ice bath can be more of a placebo effect. But again, I haven’t done much digging about myself, so I would stay out of any comment regarding it. Ice pack after a Massage? Well, as mentioned above, the usage of Ice Pack is suggested after an acute injury. So, either after a Remedial Massage or a Thai Massage, firstly there should be no acute injury, secondly, you want the blood flow along the worked area to stay active and not restricted. That’s why a heat pack would be more recommended. If you find this helpful information and need a massage, book your next session here.

Muscle Tear

Muscle Tear

A muscle tear is an acute injury caused by a laceration of the muscle cells/fibres and or tendon to which the muscle is attached to. How can happen a muscle tear? A muscle tear happens when a muscle is weak and don’t activate at the right time. Weak muscles are common in repetitive movement or when a muscle overcompensates due to a fragile pattern.  For example, tearing a hamstring is expected when the Gluteal Firing pattern is incorrect. This type of injury is common in sports activities. Still, it can also happen within a home environment by lifting a box incorrectly or during garden activities. The three grades of muscle tear. Grade 1 muscle tear is the mildest one. As per this case, only a few muscle cells have been torn. Symptoms are like: mild pain,  moderate swelling, none or light bruising. In grade 2, a moderate amount of muscle cells have been damaged. Symptoms are like: Bruising is now more evident as per the swelling You must luckily hear a sound as the tear happens More severe pain, especially when trying to use that muscle. Grade 3 is the worst-case scenario. In grade 3 muscle tear, the muscle has fully torn.  Still, a pop or a sound would happen as the tear happens. On the opposite side of where the muscle did lacerate, you will notice a bulge as the muscle coiled up after tearing.  Weakness in using the limb where the muscle got torn. In case of a Grade 3 muscle tear, surgery is needed to reattach the muscle. How to treat a muscle tear? The immediate appliance of heat or cold packs is highly debated. A cold pack would numb the area and help with the pain symptoms. As mentioned in the “Ice Pack” blog post, that is actually recommended. On the other hand, a heat pack would help stimulate blood circulation in the affected area, reduce swelling, and boost recovery. It’s important to note that applying a heat pack too soon after an injury can actually make things worse. It’s best to wait until the acute phase has passed, which typically takes around 48 hours. At that point, heat therapy can be a helpful way to alleviate pain and promote healing. Regarding massage treatments, MLD can be the only technique used as soon as the tear happens. Indeed MLD would be highly recommended for boosting the recovery, especially in case of a tear in 3rd grade, where operation is needed. In case of a 3rd-grade muscle tear, the first thing to do is see a doctor. Other massage techniques, such as Myotherapy, Remedial Massage and Thai Massage, are still valuable for muscle tears. On the other hand, either Myotherapy, Remedial or Thai Massage can only be practised after 48 hours of rest are passed after the incidents. Indeed that 48 h is considered the acute phase of the muscle tear. How to prevent a muscle tear? More the body moves, the less the chance of injury.  Making sure to do simple exercises involving basic body movement can help in muscle tear prevention. but not only. Keeping the joint moving is another essential aspect of injury prevention. How can massage help? Along with a massage treatment, the area of focus will be the torn muscle and surrounding area. Initially, the technique used with a massage treatment, especially for the injured area, would be MFTT and passive movement/mobilisation.  That would help muscle recovery and facilitate joint mobility, reducing the muscle’s load. Going ahead with the treatments, techniques such as MET, a resisted muscle force technique, can be used. This would allow the muscle to gain elasticity. Book your next session by clicking here if you are suspicious of a muscle tear and need treatment.

First Massage Appointment

Giovanni giving a Thai Massage as part of treatment plan to a client

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.

Corrective Exercises VS Massage

corrective exercises fore arm

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.    

How Often Should I Get a Massage Appointment?

Upper Trap Remedial Massage

Massage appointments, how often? How often should I come for a massage appointment? Often I got asked this question, and the answer is not as simple as. A massage, that is Remedial Massage, Thai Massage or MLD treatment, has the aim to heal a condition or alleviate the pain. Well, at least that’s the main aim of those techniques. Said so, the second, but not less important task for a massage is to induce relaxation. Therefore, if you are aiming to get some relaxation, I would suggest considering getting a massage appointment regularly. Like, every 2 weeks, every month or every 2 months. Of course, depends mostly on finance. So, a regular massage appointment, allows the body and mind to aim for something positive. It is like a reward. On the other hand, if the message is not limited to relaxation time, then, you may need it more often. That’s the case when the client comes to the appointment that is in pain (99% of the time). If this post is talking to you, book your next massage session by clicking here. The fact that you are in pain can be a sign that the body issue has been there for a while. Indeed with a massage, we can alleviate the pain, but to actually fix the issue (if it’s fixable by the way) or to make the best out of what the condition is, we need to do more than one session. In fact, one session may release the pain for a couple of days, but then, as you go back to your daily routine, the pain would come back. Therefore, a series of close massage appointments, in a short time can actually help for the best. Another important aspect of pain management is exercise. Corrective exercises are a key role in expanding the time between one session and the next one. If you actually do the exercises, you can by yourself improve your body conditions, reducing the risk of injury and pain. In conclusion, the frequency for which you should attend a massage appointment is based on your needing. For a Remedial massage or a Thai Massage, you may wanna initially see the therapist once a week for the first 3 to 4 weeks. With MLD is different. With MLD the need for seeing a therapist can be more frequent. Obviously depending on the condition that has to be treated.    


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