There is no worse way to start the day than with a wry neck. Wry neck is a common term used to describe a painful neck that limits the way you can move. Medically speaking, we call the same presentation acute torticollis. At my Myotherapy clinic in Coburg, Melbourne Massage and Treatment, I get to hear clients often telling me: “This has happened on and off for years.” And this is the first piece of the clinical history that tells me we’re probably not dealing with a simple muscle spasm, and that’s where we start looking for why the neck keeps becoming irritated in the first place. Wry Neck Is Often Acute on Chronic The first misconception we need to clear away is that wry neck comes out of nowhere. The reality of the fact is that many people have developed underlying dysfunction over months or years. Therefore, the neck has been compensating until one day something relatively small, sleeping awkwardly, reaching for something, reversing the car or even sneezing, is enough to trigger the painful episode. The acute pain is simply the last straw that broke the camel’s back. So the million-dollar question is: Why did your neck become vulnerable in the first place? That’s where an initial consultation is important, and that’s why I spend my time investigating during an assessment. A Previous Whiplash Injury Could Still Be Affecting You A common overlooked cause for wry neck that I get to see here at my clinic is a previous whiplash injury. Indeed, while someone may recover fine from this type of incident, others develop subtle changes in how their neck moves and how the muscles coordinate movement. So yes, it can be either a physical strain or irritation of the ligaments, or even neurodegeneration at the muscle level. That’s why, even years later, the body may continue protecting certain joints while overloading others. Research by Woodhouse and Vasseljen (2008) has shown that people with chronic whiplash often demonstrate altered cervical motor control, reduced movement quality and persistent dysfunction long after the original injury. That’s why, if you’ve ever had a rear-end collision, even if it happened ten years ago, even if it was due to a contact sport injury, it’s worth mentioning during your assessment, as it is an important piece of information. Hypermobility Can Also Play a Role Another presentation that I come across in my clinic, for people who suffer from wry neck, is hypermobility. Indeed, being flexible isn’t always an advantage. This is because if some joints move excessively, your muscles have to work much harder to provide stability. Over time, these muscles become overworked and fatigued, especially around the neck and upper back, which is an area where muscles already work hard most of the time, as they have to ensure we can stay straight while we stand or sit. When stability can’t keep up with mobility, the body often responds by developing muscle guarding. That’s when the neck suddenly “locks.” On the other hand, the lack of stability also creates an overload of joints, which may get easily irritated, and then initiate the pain response. Your Neck Doesn’t Work Alone Another important thing to be aware of is that we should stop focusing only on where the pain is, as the source of the problem. In fact, the cervical spine is part of a much larger movement system. So, poor movement through the upper back, reduced thoracic mobility, rib restrictions, shoulder dysfunction or altered control through the lower spine can all change the workload placed on the neck. And this is a long time game, not something that happen in one night of bad sleep. A way to conceptualise this is: If one link in a chain doesn’t move well, another link has to move more than it should, and eventually that overloaded area becomes painful. That’s why my assessment as a myotherapist doesn’t stop at your neck. I look at how your entire spine works together. The goal is to improve the balance between mobility, where mobility is needed, and stability, where stability is required. And this can only be done and maintained via exercises. Can a Better Pillow Fix a Wry Neck? I did already dedicate a full blog post about the pillow topic, but it is worth it to touch base about it even here, as this is probably one of the most common questions I get when talking about wry neck. A supportive pillow can certainly help reduce stress on your neck while you sleep; however, a pillow doesn’t: Change how your joints move. Improve muscular control. Restore stability. Correct movement patterns that have developed over the years. Therefore, think of a good pillow as something that is improving the environment rather than fixing the cause. If the underlying issue is poor movement control or spinal dysfunction, changing pillows alone usually won’t stop the episodes from returning, and it can end up being an expensive search. Your Workstation Might Be Causing the Problem Another issue that I get to see mostly with office workers is for those who work with multiple screens, like two or even three computer screens. This setup becomes a problem when the main screen isn’t positioned directly in front of you, and you end up spending eight or more hours each day with your head slightly rotated toward one side or the other. Now, try to think about what that means for your joints and muscles on that side. Until you repeat that position every day for months or years. The muscles on one side of the neck become overloaded because they are constantly contracted, while the muscles on the other side are constantly stretched. One of the simplest changes you can make is ensuring your primary monitor sits directly in front of your body, or if that’s not an option, then make sure to swap your screen software-wise. So you end up having even days looking at right, and uneven days, looking to the […]
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Hip Pain in Coburg: Causes, Symptoms & Treatment
In the many presentations I get to see here at Melbourne Massage and Treatment in [...]
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Lymphatic Walking: Let Me Tell You Why It Is Another Trend
Lymphatic Walking is another trend that you really don’t need to overthink. But let me [...]
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Shoulder Pain in Coburg: Myotherapy Can Help You
Shoulder pain is a common presentation I get to see and treat here at my [...]
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Lower Back Pain in Coburg: Causes, Symptoms and Treatment Options
Lower back pain is a leading cause of disability in Australia. That said, not everyone [...]
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Myotherapy for Coburg’s Active Community
If you have been living in Coburg and the surrounding area, like the Merri Bek [...]
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Jun
Hip pain can be frustrating, and not all hip pains are the same. I personally experienced Femoroacetabular Impingement (FAI) pain myself, and it is not fun. Indeed, this type of pain can stop you from training, affect your sleep, make sitting uncomfortable, and eventually impact your quality of life. Over the years, I’ve seen many active people spend months treating the symptoms without understanding the actual cause. If you’re experiencing groin pain, hip stiffness, pinching during squats, or discomfort after prolonged sitting, FAI may be worth investigating. What Is Femoroacetabular Impingement? In simple terms, Femoroacetabular Impingement (FAI) occurs when there is abnormal contact between the femoral head (the ball) and the acetabulum (the socket) of the hip joint. As with any tissue that gets overstimulated, this can result in irritation and inflammation, leading to damage to the labrum, cartilage, and surrounding tissues over time. In some cases, if left unmanaged, it may contribute to the development of early hip osteoarthritis. The symptoms that most people come up with when experiencing FAI are: Deep groin pain Hip stiffness Clicking Catching Locking sensations Pain when sitting for extended periods. Those symptoms are typically aggravated by activities involving Deep hip flexion Squatting Running Kicking Cycling Getting in and out of a car. The Different Types of FAI As we have already seen in the antirotated and retroverted hip presentations, we are all different, and even a Femoroacetabular Impingement can present differently. Let’s have a look at the different types of Femoroacetabular Impingement. Cam Impingement Cam impingement occurs when the femoral head is not perfectly round. During hip movement, particularly flexion and internal rotation, the abnormal shape creates increased pressure against the edge of the socket. This is the most common form seen in young athletic populations. Pincer Impingement Pincer impingement occurs when the acetabulum provides excessive coverage over the femoral head. The socket effectively “overhangs,” increasing the likelihood of compression during movement. Mixed Impingement Mixed FAI is the most common presentation clinically. In this situation, both cam and pincer characteristics are present simultaneously, resulting in a combination of abnormal contact from both the femur and the acetabulum. Who Is More Likely to Develop FAI? The common ground for an FAI presentation includes young and middle-aged active individuals. A higher prevalence is seen among athletes participating in sports that involve: Repetitive hip loading during adolescence Football Hockey Soccer Martial arts Dance Running. This evidence shows that sports activities play a crucial role in FAI presentation, but it is also important to consider that genetic factors could be involved. On the other hand, as per any physical structural presentation, not all the people who present with a FAI may experience pain. Many people have structural changes visible on imaging but remain completely symptom-free. Is a Scan Worth It? This is one of the most common questions I get asked when someone presents with some sort of ongoing pain or even acute discomfort. My answer is usually: it depends on your symptoms and how long they have been lingering around. Why I don’t recommend a scan as a first thing to go for (unless I am suspicious of something that I can’t treat directly) is because a scan may find an abnormality in the body, but that doesn’t mean that what we see is actually the source of the pain. In fact, many people may have a FAI presentation and have no symptoms at all. Therefore, a scan alone should never determine treatment decisions. Sp, a diagnosis of FAI should combine: Clinical history Physical examination Symptom presentation Imaging findings So yes, a scan should support the diagnosis, not create it, or it would be really chaotic to define why someone is experiencing pain, and create a treatment plan for it. If You Need Imaging, Which Scan Is Best? Step 1: X-Ray For most people, a standard pelvic and hip X-ray is the first and most appropriate imaging investigation. X-rays are excellent for identifying the bony shapes associated with cam and pincer impingement and are considered the primary imaging modality in the assessment of FAI. The downside of X-rays is that they involve radiation, so if possible, avoid them. Step 2: MRI If symptoms are there for a prolonged period of time, and exercise therapy is failing to restore functionality, an MRI becomes extremely valuable. MRI can assess: Labral tears Cartilage damage Joint degeneration Other soft tissue causes of hip pain Many hip specialists consider MRI the cornerstone investigation when assessing intra-articular damage associated with FAI, given the high definition of the image and results. Step 3: CT Scan CT scanning is generally reserved for surgical planning or when a very detailed understanding of the hip’s bony anatomy is required. CT provides excellent visualisation of bone structure, but it is not usually necessary as an initial investigation. So, When Should You Get a Scan? In my clinical opinion, based on current evidence, imaging becomes worthwhile when: Hip or groin pain has persisted for more than 6–12 weeks Symptoms continue despite appropriate rehabilitation The range of motion is progressively decreasing Mechanical symptoms such as catching, locking or giving way are present, and are painful Surgery is being considered The diagnosis remains unclear after clinical assessment If your symptoms are mild and improving with treatment and exercise, I would not bother to get an image taken. Exercises are a great way to maintain hip pain-free and keep your body going. Exercise Protocol for FAI This is where we need to put some focus: Exercises! So, first things first, when someone presents with a FAI, we want to take away or modify the habit that we can, in order to reduce discomfort and hip pain. An example could be removing squat from an exercise program or reducing the time spent in a seated position. Next, we would start looking into your mobility capacity at the ankle level, especially if you are someone who runs as part of a sports activity. And all of this is part of a protocol […]
May
As a therapist who offers Manual Lymphatic Drainage in Melbourne, I am blown away by how many people come and seek MLD for general wellbeing, and ask me questions like: “What about tapping my body?” “Should I do guasha?” “I have been told my Lymphatic System is sluggish” Indeed, if you’ve spent any time on social media lately, you’ve probably seen endless content about the lymphatic system, and of course, the more time you spend watching them, the more you will be offered. Dry brushing. Guasha. Detox teas. Essential oils. I call those “Social Media, Lymphatic hacks.” They belong only to social media, not to reality and/or science. As someone who practises Manual Lymphatic Drainage in Melbourne (MLD), I think it’s important to explain what the lymphatic system actually does, what MLD is really useful for, and why people often overcomplicate something that the body already does naturally. And honestly, for many healthy people, one of the best things you can do for your lymphatic system is simply go for a walk. What Is the Lymphatic System? To start with, the lymphatic system is part of your body’s immune and fluid regulation system. Its job is to: Help manage fluid balance Support immune function Transport waste products Assist with inflammation and healing It consists of: Lymph vessels Lymph nodes Lymphatic organs Lymph fluid Unlike the blood circulation, the lymphatic system does not have a pump like the heart, and another difference is that the lymphatic system is capable of absorbing substances that are, molecularly speaking, bigger than what the blood stream can do, simply because the capillaries of the lymphatic system have a bigger aperture than those of the blood stream. Then, regarding how the lymphatic system pumps fluid around the body, it is based on the fact that the internal vessel contraction occurs. The more the vessel contracts, the more liquid moves. And those vessels are sensitive to their surroundings, in fact: Muscle contractions Breathing Changes in pressure Everyday movement Those are all factors that stimulate the lymphatic system to work faster. That’s why movement is so important. And consider that in the human Lymphatic System, contraction rates are typically around 1 to 2 times per minute, at rest, where when doing intense visceral activity, it can jump up to 15 contractions per minute. Why Walking Helps Your Lymphatic System Now, we can than easily understand that every time we walk, our muscles gently contract and relax, and specifically, the calf muscles are the ones that work the most, and are the ones responsible for assisting both the lymphatic and blood systems to push liquid upwards, against gravity. So, walking acts like a natural pump for lymphatic flow, and it can help with: Encourage fluid movement Support circulation Reduce stiffness Improve breathing mechanics Support general recovery and wellbeing Reduce stress Your body evolved to move lymph through normal human movement. Not through expensive “detox” products. Not through aggressive scraping tools. Not through viral wellness trends. Simple movement works remarkably well. What About Dry Brushing and Guasha? Ok, I will be honest on this one: this is where social media often exaggerates things. There is currently no strong scientific evidence showing that dry brushing or guasha creates a special lymphatic drainage effect in healthy individuals. And I want this message to be clear: we are talking about healthy individuals, who are the vast majority of us. That doesn’t mean people cannot enjoy those practices, because they still have a meaning and a use. Indeed, any skin gentle stimulation would still have a major impact on the nervous system, specifically the parasympathetic (rest and digest one), which means it can still have a relaxation effect. Therefore, dry brushing may: Exfoliate the skin Increase temporary circulation at the surface Feel relaxing Guasha may: Feel relieved of muscle tension – and again, this is a nervous system response Temporarily increase local blood flow But neither appears to “detox” the body or dramatically improve lymphatic drainage in the way social media often claims, and most importantly, none of the effects mentioned above last for a long time, nothing like or in comparison to a good walk or exercise time. So let’s be clear about what does what, and let’s remember that the human body already has highly sophisticated systems for managing waste and fluid balance: The lymphatic system The liver The kidneys The lungs The digestive system And again, most healthy people do not have a “blocked” lymphatic system. What science says about those tools? Interestingly, even some of the more positive research around guasha comes with important limitations that are often ignored on social media. Indeed, a study published by Sun‐hee A. et al (2025) that looked at facial roller massage and guasha found some short-term improvements in facial contour measurements, muscle tone, and skin elasticity. However, the researchers themselves acknowledged several limitations, including: The small sample size – only 34 participants The short 8-week duration – already longer than other studies They only looked at temporary aesthetic outcomes rather than meaningful health changes to the lymphatic system itself In fact, the study did not demonstrate that guasha “detoxifies” the body or improves lymphatic drainage in healthy individuals. In other words, while these techniques may temporarily affect appearance, circulation, tissue tension, or relaxation, that is very different from the dramatic claims often made online about “flushing toxins” or “resetting” the lymphatic system. Where Manual Lymphatic Drainage (MLD) Can Be Helpful Ok, if you got this far in the blog, it means you are actually serious about your wellbeing. Great! As a Clinical Myotherapist and Vodder MLD therapist, I am with you. Now, it is important to separate evidence-based treatment from wellness marketing. Manual Lymphatic Drainage (MLD) is a gentle, specialised treatment approach designed to support lymphatic flow and fluid movement. MLD can be beneficial for people experiencing: Lymphoedema Lipoedema Chronic venous insufficiency Post-surgical swelling Scar recovery Chronic inflammation Swelling after injury Sunburn recovery MLD may also support general well-being because it is deeply […]
Dec
Elbow tendinopathy, whether it presents as tennis elbow (lateral elbow pain) or golfer’s elbow (medial elbow pain), is one of the most common overuse injuries in active people, desk workers, and manual labourers. At Melbourne Massage and Treatment in Coburg, I frequently help patients recover from both forms of elbow tendinopathy. Elbow Tendinopathy: How Does It Manifest? “Tendinopathy” refers to irritation and degeneration within a tendon due to repeated overload. Elbow Tendinopathy, in both of its forms, tennis or golfer’s elbow, can sound like a sport-related injury, but it has little to do with the sports world. The reason why those presentations carry their name is due to the sport action, which requires that specific muscle group to work to deliver the golfer strike (medial) or tennis strike (lateral). So what can actually cause an elbow tendinopathy are: Sudden increase of tendon load – lifting heavier than usual, at the gym or at work Repetitive action – think of that constant mouse or keyboard action in the office environment Overstretching of the tendon – Poor office ergonomics can overload the elbow joint and the elbow’s tendons To be more specific, the office worker presenting with elbow tendinopathy often has repetitive mouse/keyboard use, which is often accompanied by poor ergonomic factors, such as the forearm being in a prolonged pronated position (palm facing down), which places the common extensor digitorum tendon (CEDT) under stretch. Medial and Lateral Tendinopathy of the Elbow Let’s look into the difference between the actual Tennis (lateral) and Golfer’s (medial) Elbow. Tennis Elbow (Lateral Epicondylitis) Pain in the outer elbow Irritation of the wrist extensor tendons, especially the Extensor Carpi Radialis Brevis (ECRB) Familiar with typing, lifting, racquet sports, and DIY tasks Golfer’s Elbow (Medial Epicondylitis) Pain in the inner elbow Irritation of the wrist flexor tendons Related to gripping, pulling, forearm rotation, and throwing How To Recover From a Tendinopathy? Despite different pain locations, the rehab approach is almost identical, and while rest provides temporary relief, it does not fix the underlying tendon changes. The true solution? A structured, progressive exercise rehab program that restores tendon strength and resilience. In fact, as the tendinopathy itself came to be an issue due to an overload of the elbow’s tendon, to settle the pain and discomfort, we have to: Reinforce the elbow tendon and muscle so that it can perform better. Analyse what overloaded the elbow tendons – we have to understand what can be changed in the loading process, starting from: Shoulder stability (looking up in the joint chain – Mobility and Stability) The ergonomic of your workload, that is, office or heavy repetitive work (like gardening, for example, or construction). Workout program – ensure there is a progressive load in the program that is right for your capacity. The 3-Phase Exercise Program for Elbow Tendinopathy Here at Melbourne Massage and Treatment in Coburg, as a clinical myotherapist, I get to see many patients presenting with Elbow Tendinopathy, and the rehab protocol and recovery that I used is detailed below. Phase 1: Pain Reduction & Tendon Activation (Week 1–3) In this initial phase, the goal is to calm symptoms without resting the tendon completely. Tendons respond best to gentle, controlled tension, better known as isometric exercises. Isometric is ideal because: Tendons have a low blood supply compared to muscles, so in order to receive the nutrients that allow the healing process to be delivered, they need long and steady engagements. A tenodon that is inflamed presents with disorganised collagen fibres, which are not running straight, and no longer form a compact line. And there is a need for a constant load to restore new fibres that can regain the tendon’s functionality. Wrist Extension Isometric (for Tennis Elbow) You will be sitting at a desk with your forearm comfortably supported by the desk, with your hand in a prone position (palm down) Slightly extend your wrist against resistance. Pain-free movement (it could be a bend or a lightweight) Hold 20 seconds, repeat 10 reps Wrist Flexion Isometric (for Golfer’s Elbow) You will be sitting at a desk with your forearm comfortably supported by the desk, with your hand in a supine position (palm up) Deliver a slight wrist flexion against resistance. Again, it has to be a pain-free movement. Hold 20 seconds, repeat 10 reps Time of hold, repetition and pain response are subjective to each individual. That’s where we would stop and focus on each individual clinical history and presentation, and adapt the elbow tendinopathy rehab program to your needs. Gentle Mobility & Dry Needling From a point of view of massage for elbow tendinopathy, there are a few techniques that work really well, especially in the early phase of recovery: Joint Mobilisation – passive movement applied to the wrist and elbow joint, to improve the range of motion of this joint and disengage the area. Dry Needling – The usage of a needle on muscle, to create a micro-inflammation and to drive more attention from the nervous system into the targeted area. Deep Tissue Massage – When dry needling is not an option, deep tissue massage can also help in creating this targeted central nervous system response. Phase 2: Strength & Tendon Remodelling (Week 3–8) This is the most critical phase, and the one that actually restores tendon health. Eccentric Wrist Extension (Tennis Elbow Gold Standard) How to do it: Extend the wrist of the affected side with your good hand, while in the affected side, you are holding a lightweight or resistance band. Slowly lower the weight with your injured side with a tempo that last 3–5 seconds Repeat 12–15 reps, 2–3 sets – this is an endurance setup. Between each set, rest for at least 30 seconds. Eccentric Wrist Flexion (Golfer’s Elbow Gold Standard) Same method, but applied in a flexion motion. Assist the initial movement of flexion Slowly bring the wrist back to the straight position with a 3-5 second tempo. Look always at somewhere between 12-15 reps, for endurance performance. The eccentric […]
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 […]
Aug
As a Lymphoedema therapist, I often get asked what the difference is between Lymphoedema and Lipedema. In this blog, we will explore the differences, the similarities, and what can be done for prevention, management and treatment of those presentations. Furthermore, we will look into how Lipoedema can degenerate into a Lipo-Lymphoedema, and why this is not the case for everyone. What is Lipoedema? Lipoedema is a chronic adipose tissue disorder that primarily affects women. On a global scale, we know that about 11% of women are affected by this presentation, and it often runs in families as it has a strong genetic component. The major characteristics of Lipoedema are an abnormal and symmetrical accumulation of fat around the hips, buttocks, thighs, and legs, and upper arms. On the leg area, the fat appears in abundance in the medial side of the knee, too. Where feet are completely untouched by the fat accumulation, this fat is resistant to diet and exercise and is often painful to touch. The pain is due to the cutaneous nerve entrapped in the fatty tissue, and so delivers a pain response when stimulated. Other Lipoedema key features: Often triggered or worsened by hormonal changes Symmetrical fat distribution Soft, nodular, or lumpy tissue Pain and easy bruising – as per the pain, bruising is due to blood capillary compression from the fat, and so, is easily damaged by touch No skin thickening or pitting in the early stages Nowadays, there is increasing awareness about this presentation, and more and more women find benefit from a management protocol that is not only about cardio and exercise. Part of the Lipoedema management includes: Movement Compression stocking Antiinflammatory diet Skin care Where and if needed, cosmetic surgery intervantion What is Lymphoedema? Lymphoedema, on the other hand, is a condition where lymphatic fluid builds up in the tissues due to a malfunctioning lymphatic system, causing chronic swelling. Compared to Lipoedema, Lymphoedema is strictly related to the Lymphatic system. It can be primary (congenital or hereditary) or secondary (due to trauma, surgery, radiation, or infection affecting the lymphatic system). Lymphoedema characteristics: Unilateral or asymmetrical swelling (though it can be bilateral) Pitting edema – It consists of deep indentation (pitting) left behind on the skin when pressure is applied Skin changes over time (fibrosis, hyperkeratosis, papillomatosis) Affects feet and hands as well – primary lymphedema would start from the extremity Heaviness or tightness in the affected area – can potentially be pain-free, but the limb/s may feel very heavy It does affect men and women – only primary lymphedema has a genetic component Lymphoedema Management The management of Lymphoedema is more tricky than lipoedema, as everyone may react differently to the management, it can be related to other health issue which needs to be considered, and requires the patient to be active in the management side of things. At Melbourne Massage and Treatment, I treat different types of lymphedema, as per the upper and lower body, focusing on an initial reduction of the swelling via a combination of Manual Lymphatic Drainage (MLD) and compression with Combined Decongestive Therapy (CDT). The management of this presentation can take anywhere between 3 and 5 or more appointments, depending on the severity of the presentation. The treatments are better done in close proximity, 24 to 48 hours one after the other, so that we give no time to the body to accumulate fluid back under the skin. Once the combination of treatment allows us to achieve the desired result, which is bringing the limb/s to a thinner size, you will be scheduled for a custom garment wear compression, which will guarantee to maintain the results achieved. This is usually done at other clinics, like Sigvaris or Juzo clinics. Those clinics are specialised in the making of garment wear. Custom garments wear last about 6 months, so twice a year, you will need to change them, and if needed, because the limb/s may start swelling again (especially in summer, when there is a change of atmospheric pressure, due to the heat), a short series of MLD and CDT therapy may be needed. Key Differences between Lymphoedema and Lipoedema Feature Lipedema Lymphoedema Cause Abnormal fat metabolism Lymphatic dysfunction Gender prevalence Almost exclusively women Affects both sexes Onset Often at puberty, pregnancy, or menopause Can be congenital or triggered by injury/surgery Distribution Symmetrical, lower limbs and arms Can be asymmetrical; any body part Feet/Hands Spared Usually involved Pain Tender, painful fat Often painless, heavy feeling Skin texture Soft, nodular fat Skin thickens over time (fibrosis) Pitting Rare (early) Common (early) Response to elevation Minimal improvement Often improves with elevation (if early stage) Bruising Common Not typical Common Characteristics of Lymphoedema and Lipoedema As seen above, the characteristics of Lipoedema and Lymphoedema are different, but, both conditions share chronic swelling, potential functional limitations, and a need for long-term management: Both can cause leg discomfort, heaviness, and swelling Both may lead to reduced mobility Neither condition improves with calorie restriction or exercise alone – it is more about stop the intake of inflammatory food Compression therapy is often used for both Both can have a progressive nature if not managed properly – especially lymphoedema Misdiagnosis is common, often delaying effective treatment When Lipedema Becomes Lipo-Lymphoedema If we stick to a vision of Lipoedema progression, that is possible when no management is put in place, this presentation can degenerate into secondary lymphatic impairment, resulting in a combined condition known as Lipo-Lymphoedema. How this happens: As the fat keeps accumulating under the skin, and there is an increase in inflammation, the lymphatic vessels are put under major load and potential damage Over time, this leads to fluid retention and swelling due to the lymphatic system failing to do its job As the lymphatic system becomes overwhelmed, the person may start experiencing lymphedema symptoms (Example: swelling in the extremities, feet and or hands) Patients now experience both fat deposition and fluid buildup, making treatment more complex Signs that Lipedema has progressed: Swelling starts in the feet […]
Jul
The term “inflammation” originates from the Latin word “inflammare”, meaning “to set on fire” or “to ignite”. And this is why it may sound scary, and sounds like a bad thing to go through, but in the initial phase of an injury, the inflammation is actually a necessary part of healing. Indeed, this initial step is how your body signals that something is wrong and starts the repair process. On the other hand, if the injury is not looked after, especially when we talk about major injury, the inflammatory process can become problematic. In this blog, we are going to look into what the steps are to take when going through an injury, which can be a sprained ankle, recovering from surgery, or managing chronic pain, in order to have the best recovery. The 0–72 Hour Rule: Respect the Acute Phase When going through the initial phase of an inflammation, which is the first 72 hours post-injury, the body enters the acute inflammatory phase, and this is absolutely normal and necessary for the body to start taking action towards safe healing. In this process, the immune system rushes white blood cells and inflammatory mediators to the area to begin cleanup and repair. Things to avoid: Avoid anti-inflammatories (NSAIDs or corticosteroids): As this process is needed from the body to understand what has happened and to clear up the area from eventual pathogens, taking something that suppresses the process is not ideal. Avoid ice: Ice is a vessel restrictor, which means it would slow the amount of blood that is sent to the area. Yes, it may reduce the swelling, but that swelling is innoquos compare to the consequence of not having blood rushing to the area with the nutrience and substance needed to start the healing process. Things you can do: Protect and rest the area. Avoid using the injured area and place weight on it. Rest it and where possible do really some minimal movement that may not cause pain or disconfort. Compression and elevation help reduce fluid buildup. If your goal is to reduce swelling, you can apply compression and keep the area elevated. After 72 Hours: Shift to Recovery Support Past the first 72 hours, the inflammatory response was meant to be settled. If that’s not the case, that’s when it ok to take anti-inflammatories. That would help manage the pain in the long term and allow you to start moving freely. That said, before you take any medication, always consult your GP or pharmacist. Moving forward, this second phase of the injury recovery is called remodelling and repair. In this phase, it is the time to: Introduce gentle movement and rehabilitation exercises – most often isometric hold, which we spoke about in another blog. Use anti-inflammatory agents (if needed) under professional guidance. Massage therapy and heat packs become helpful — they promote circulation, lymphatic drainage, and tissue flexibility. While the remodelling and repair phase starts past the 72h post injury, the recovery itself may last weeks or months, depends on the type of injury. For more details about the healing process of different tissues, read this blog. What Are The Symptoms of Inflammation Post-Injury You may notice that soon after an injury the body has a really specific way to respond to what just happened. This response include: Swelling – more blood is sent to the area; Skin redness Pain to touch or movement Those are some of the visible or more noticeable aspects of an inflammatory response post injury, but on the macroscopic level, there is more happening, such as the rush of white cells to the injured area, and the increase of blood clotting cells, if the skin is cracked. Food, Fats, and Chronic Inflammation: The Lymphatic Link An inflammation is not a process that comes only from an injury. The food and drinks that we intake are a significant source of chronic, low-grade inflammation, especially when they include excessive amounts of long-chain fatty acids found in ultra-processed foods, deep-fried items, and fast food. Given the chemical structure of those fats, which are made from a chain of 16 carbon atoms (therefore long-chain), they can be absorbed directly by the capillary of the bloodstream, due to the narrow passage at the capillary end. Indeed, those fats would get absorbed by the lymphatic system, which capillaries have a wider aperture. That said, once the fat is travelling along the lymphatic system, it would be recognised as an external element and attacked by immune cells such as macrophages, and this is an inflammatory response. Now, when the lymphatic system becomes overburdened with inflammatory fats, it can lead to chronic inflammation. This is also why some people feel bloated, puffy, or in pain even without any injury. This also explains why, when seeing people with Lymphoedema, we refer them to a GP to discuss an anti-inflammatory diet. Given the excess load of the lymphatic system along this presentation, it is better not aggravating it. And to loop back on the topic of this blog, even when you hurt yourself badly with a major injury, or you may be suffering from chronic pain, a balanced diet rich in veggies and fruit, grain and fresh food, is recommended over junk food and inflammatory meals. Top Pro-Inflammatory Foods to Watch Out For: Highly refined vegetable oils Fried foods High-sugar snacks and drinks Ultra-Processed meats How Massage Therapy Helps (and Why Sometimes Hurts) Many forms of massage, especially those where you may experience discomfort and pain, like Remedial Massage or Thai Massage, or even technique like Dry Needling, aim to reproduce microinflammatory response, and that’s why they are effective in helping you with recovery. Indeed, that pain response, is an alarm for your nervous system, which is pushed to send nutrience to the area affected by the pain. Now, what is important is to understand the time frame of healing, the subjective history of the patient we are working with and the level of injury they are presenting with. Massage helps by: […]
I did stop counting the number of times I hear patients say that their hamstrings are tight, and that’s why they can’t bend forward. And I did stop counting, because this happens so often that it is really hard to find someone who actually knows what tissue is limiting their movement. In fact, most of the time, what is happening is not hamstring tightness, but rather a lack of hip hinging and associated hip mobility, or neural tension (in this case, the sciatic nerve neural tension). What Is Neural Tension? When we discuss neural tension, we refer to the lack of mobility of the nervous system’s connective tissues, so the actual nerve as a fibre or tissue, when it’s put under mechanical stress (like tension, compression, or stretch). Here is an example: When we bend forward, the sciatic nerve (the largest nerve in the body) runs from the lower back (Ventral rami spinal nerve L3-S1), through the buttocks (below the piriformis muscle most of the time), and down the back of the leg (right between the hamstrings muscles). When doing such an action, the nerve needs to glide freely, and if any where along its journey, there is a compression, due to other tissue tightness or inflammation, or even a physical outer pressure (a belt from the pants) it becomes irritated, compressed, or “stuck” ending not moving well. That’s where you may experience a pull on the back of the leg. That is neural tension. More specifically, your symptoms can be: A deep pulling or burning stretch in the back of the thigh or calf. Tingling or numbness (especially if holding the stretch for a longer time) A sensation of “snapping” or “tugging” deep in the leg when stretching Limited range of motion that doesn’t improve with traditional hamstring stretches How Is Neural Tension Different from Muscle Tightness? While neural tension and muscle tightness may feel similar, they are fundamentally different in their causes and treatments. Muscle Tightness Neural Tension Origin Muscle fibres are shortened or tense Nerve or nerve sheath is restricted or irritated Sensation Broad stretch, fatigue, cramping Sharp, burning, electric, or pulling sensation Area Felt Localised to the muscle belly Along a nerve pathway (e.g., back of the leg) Improved by Stretching and massage Nerve gliding/mobilisation, reducing irritation Common in Athletes, post-exercise, poor posture Sciatica, herniated discs, hipo-mobility, and a sedentary lifestyle Now, Let’s Talk About Forward Bending When bending forward with the upper body, aiming to reach the toes or the floor with the hands, we may experience a stretch in the back of the leg. That stretch it may not be only your hamstrings but also the sciatic nerve. When this nerve lacks mobility, as expressed earlier, due to things like disc issues, facet joint irritation, piriformis syndrome, or general irritation, it can feel like your hamstrings or calf or back are tight, even when they’re not. A good way to understand if the feeling of tightness is from your nerve or not is to perform a Slump Test. How to perform a Slump Test? Below is a step-by-step guide on how to perform the slump test: Sit on a chair or table, where both feet are off the ground; Slump your body forward, while looking straight ahead, and your arms are crossing behind your back (which means your spine rounds backward, your shoulder drops forward); Now, start lifting up one leg, while the other one is bent at the knee at 90°; While you lift up the leg, start noticing if you feel any pulling sensation from the lower back going down to the back of the leg or calf (it could be anywhere along the lower back to the feet); If you manage to reach full leg extension, now, start looking down (you may notice tension arising or increasing); If nothing happens yet, then bring your toes (of the leg raised) backwards (ankle dorsiflexion); If, along any step of this process, your pulling sensation increases (more intense) or becomes longer (like from only the back of the leg, it now feels even in the back or in the calf), this is neural tension. Indeed, the tension would feel like a long rope pulled across multiple joints (lumbar, hip, knee) with a burning sensation and maybe some pins and needles. Next, to experiment further with the neural tension, start looking up with the head, go if you can in full cervical extension, and you should feel relief in the back of the leg tension. This last step is proving to you how, by releasing the central nerve (that travels in the central canal of your spine), the neural tension slows down. You are stopping the nerve’s pull from its origin, the brain. Should You Stretch a Nerve? No, not really. Nerves aren’t designed to be stretched like muscles. In fact, if you keep stretching a nerve aggressively, you may end up irritating the nerve and worsening the symptoms. Instead, use nerve gliding or joint mobilisation exercises, which are gentle, rhythmic movements that help the nerve move through its surrounding tissues without overstressing it. And to stay in the loop, let’s look at the sciatic nerve glide: Lying on your back, lift one leg while keeping the knee slightly bent. Slowly extend the knee and flex the foot back toward you, then release. Repeat in small, pain-free ranges. This can help restore nerve mobility without aggravating the nerve. If this is not the case, and you still experience pain and discomfort, then it is probably time to book an appointment (myotherapy) to ensure there is not significant entrapment along the nerve pathway, and see what can be done to relieve that compression. How Myotherapy Can Help with Neural Tension? As a Clinical Myotherapist, I specialised in assisting people with any sort of musculoskeletal issue. Neural Tension is one of those. During a Myotherapy session, we would address, via a detailed clinical history and a series of assessments, what may be the cause of the neural […]