Once you have been diagnosed with lymphoedema (also known as lymphedema), you will soon learn that compression therapy plays a vital role in long-term management of this chronic condition, and one of the most common questions I hear in my clinic is: “What’s the difference between circular knit and flat knit lymphoedema compression garments?” In this blog, I will explain the difference between these two types of lymphoedema compression knit, so that it may help you understand better how your lymphoedema can be managed in the long term. Why Is Lymphoedema Compression Essential? As discussed in many more blogs, lymphoedema is a chronic condition caused by an impaired lymphatic system, which leads to the accumulation of lymph fluid and persistent swelling in one or more body parts. If not correctly managed, lymphoedema can progress and cause: Increased limb size – elephant leg Tissue fibrosis (hardening) Skin changes – including numbness Higher risk of infections – cellulitis is a common one Compression therapy is a cornerstone of CDT (Complete Decongestive Therapy), alongside: Manual Lymphatic Drainage (MLD) – ideal to boost your lymphatic system drainage capacity Skin care is essential to avoid skin cracks and infections Exercise and movement – especially if wearing circular knit compression Long-term compression – So in short, lymphedema compression supports lymphatic flow, helps maintain limb volume reduction, and prevents the worsening of lymphoedema. What Is Circular Knit Lymphoedema Compression? Circular knit compression refers to the method by which garments or bandages are made. In this case, the knit is made using a continuous circular weaving method, creating a seamless and highly elastic fabric. Benefits of circular knit compression: Lightweight and smooth texture Greater elasticity and stretch Often available off-the-shelf More discreet under clothing Circular knits are ideal for those lymphoedema patients who can and should move with the limb affected by lymphoedema. Indeed, the circular knits are designed to allow the lymphedema patient to move; therefore, while the limb is compressed, the lymphatic system is simultaneously boosted by compression and movement. When circular knitting may be suitable: Mild lymphoedema Early-stage lymphedema Limbs with minimal shape distortion Well-controlled swelling However, due to their elasticity, circular knit garments often lack the containment needed for more advanced lymphoedema, especially when fibrosis or limb shape changes are present. What Is Flat Knit Lymphoedema Compression? So, even in the case of Flat-knit compression, the name refers to the way the fabric is produced, like flat fabric and stitched together with a seam. This allows for higher stiffness and customised shaping. Benefits of flat knit compression: Firmer, more supportive structure Superior containment of swelling Custom-made to individual limb measurements Better control of irregular limb shapes Flat knit is usually recommended for: Moderate to severe lymphoedema Long-standing or progressive lymphedema Skin folds or lobes Fibrotic tissue Swelling that rebounds quickly A lymphoedema patient is unable to move much Therefore, based on the severity and lymphoedema stage, we would suggest using flat knit compression for more severe presentations or for someone who is unable to move the limb(s) affected. Compression Garments and Complete Decongestive Therapy (CDT) At Melbourne Massage and Treatment, in Fitzroy North, I offer Complete Decongestive Therapy (CDT) as part of lymphoedema management, which is internationally recognised as the most effective approach to lymphoedema treatment. Here is a list of things that I would offer during a lymphoedema management appointment: Comprehensive lymphedema assessment Manual Lymphatic Drainage Swelling reduction during the intensive phase of CDT Preparing limbs for compression garments Education on long-term self-management To simplify the process of lymphoedema management, at Melbourne Massage and Treatment, I do offer a free 15-minute online consultation, where I can answer your questions and go through an initial assessment about your clinical history. Compression After CDT After we manage to reduce the swelling in the limb(s) affected by lymphoedema, via MLD and CDT, which can take 3 to 5 appointments, or more, depending on your presentation, we can then look into getting garment wear that can fit your limb(s), so that the swelling can be managed for a longer time. While I do not supply compression garments directly, I refer patients to Sigvaris in West Melbourne, specialists in medical compression for lymphoedema, ensuring accurate fitting and high-quality garments. Circular Knit vs Flat Knit: Which Is Right for You? The correct compression garment depends on several factors, including: Stage and severity of lymphoedema Limb shape and tissue texture Presence of fibrosis Skin health Lifestyle and daily activity This is why coming for an appointment and getting your lymphoedema assessed and treated, where needed, is essential before selecting compression. Lymphoedema Treatment in Fitzroy North Living with lymphoedema can be challenging, but with the proper care, education, and treatment plan, it can be effectively managed. At Melbourne Massage and Treatment in Fitzroy North, I focus on: Evidence-based CDT Individualised lymphedema management Clear guidance around compression therapy Collaborative care with trusted garment providers Therefore, if you are in need of professional lymphoedema treatment in Melbourne or need clarity around compression options, I’m here to support you. About myself: a Myotherapist specialised in Lymphoedema Management My name is Giovanni, and I run Melbourne Massage and Treatment, a Myotherapy and Lymphoedema clinic in Fitzroy North. I trained with the Vodder Academy in lymphoedema management, and I provide Complete Decongestive Therapy (CDT), the gold standard for lymphedema treatment. My approach is tailored to each individual patient, to achieve objective results, and to help you enjoy more your life while dealing with Lymphoedema management.
Tag Archives: MLD
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Lymphoedema Compressions: Circular Knit vs Flat Knit
Once you have been diagnosed with lymphoedema (also known as lymphedema), you will soon learn that [...]
Continue readingJan
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Face Swelling After Rhinoplasty: What You Should Know
Along with many types of post-cosmetic surgery presentations I get to work with, Rhinoplasty can [...]
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Elbow Tendinopathy Rehab: What You Should Know About It?
Elbow tendinopathy, whether it presents as tennis elbow (lateral elbow pain) or golfer’s elbow (medial [...]
Continue readingDec
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Brazilian Lymphatic Drainage vs Vodder MLD
As a therapist who works with Lymphatic Massage in Fitzroy North and post-cosmetic-surgery patients, I [...]
Continue readingDec
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Myotherapy for ACL Rehab in Fitzroy North
ACL stands for anterior cruciate ligament, and is the strongest ligament in the knee. ACL [...]
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Jan
Along with many types of post-cosmetic surgery presentations I get to work with, Rhinoplasty can also present with facial swelling, which is one of the most common (and often most frustrating) parts of post-surgery recovery. While you may find many therapists claiming to work with lymphatic massage, as a therapist trained in Manual Lymphatic Drainage (MLD) through the Vodder Academy, I can help you achieve great results post surgery and help your body deal with excessive swelling, bruising, and, where it happens, even fibrosis. I So in this article, I want to explain why swelling can last longer than expected after rhinoplasty, what the science tells us, and how MLD may help reduce swelling and limit the development of fibrosis during the healing process. Why Does Swelling Persist After Rhinoplasty? Rhinoplasty is a surgery that can be done for cosmetic or functional reasons, like improving nasal breathing, and is a surgical procedure that involves deliberate trauma to bone, cartilage, and soft tissue. This trauma triggers inflammation and a temporary disruption of the lymphatic system, the network responsible for clearing excess fluid from tissues. Scientific research published in the Plastic and Reconstructive Surgery Journal shows that: Approximately two-thirds of post-rhinoplasty swelling resolves within the first month Up to 95% resolves by 6 months Residual swelling can still be present 12 months or longer, particularly in the nasal tip. Now, two things about those data: Those numbers are the results of a study done on 40 patients, so still, even if they are quite promising, more evidence is welcome for further comparison. On the other hand, this prolonged swelling is a normal physiological response, but it can be uncomfortable and visually concerning. The Role of the Lymphatic System in Facial Swelling The swelling that you may present with post-rhynoplasty surgery is due to a temporary impairment of the lymphatic system, which acts as the body’s drainage mechanism. After surgery, lymphatic vessels can become overloaded or temporarily impaired, leading to fluid stagnation in facial tissues. In another paper by Meade R et al. (2012), published in the Oxford Academic Journal, it is shown that postoperative facial surgery disrupts lymphatic flow, leading to prolonged edema in the head and neck region. In more chronic cases, where lymphatic fluid stagnates for prolonged periods, patients may also experience tissue hardening and early fibrosis. What Is Manual Lymphatic Drainage (MLD)? Manual Lymphatic Drainage is a gentle, non-invasive manual therapy designed to stimulate lymphatic vessels and redirect fluid toward functioning lymph nodes. Unlike remedial massage or deep tissue techniques, MLD is a post-surgical lymphatic massage characterised by: Light Pressure Slow and rhythmic Movements MLD aims to stimulate superficial and deep lymph vessels, not muscle tissue MLD is internationally recognised as part of Complete Decongestive Therapy (CDT), the gold-standard conservative treatment for lymphatic swelling. Lasinski B.B. et al. (2012). How MLD May Help Reduce Swelling After Rhinoplasty As mentioned above, the number of patients who undergone clinical trials for post-rhinoplasty swelling treatment is limited, but along with other studies available on PubMed, the physiological principles of MLD are well supported, and here is a breakdown of what you can come across while doing some research: Supporting Fluid Reabsorption By stimulating lymphatic flow, MLD helps the body clear excess interstitial fluid more efficiently, which may assist in reducing facial puffiness and pressure. Marxen T. et al. (2023). Improving Tissue Mobility Reduced fluid stagnation helps tissues remain softer and more pliable during healing, an essential factor for aesthetic outcomes. Masson I. et al. (2014). Encouraging Symmetrical Healing MLD techniques can be adapted to address asymmetrical swelling, which is very common after rhinoplasty. Ulu M. et al. (2025) MLD and the Prevention of Fibrosis When the body goes through severe trauma, like a surgery, as part of its natural reaction, it may build tissue under the skin. This tissue is called: Fibrosis. Fibrosis may feel firm to the touch and leave you with a feeling of tightness under the skin. When swelling is unattended, can leads to fibrotic formation and changes. In this clinical study by Masson I. et al. (2014), they looked into post-liposuction and body contouring surgery, and how Manual Lymphatic Drainage, particularly when combined with other conservative therapies, can reduce both swelling and tissue fibrosis. While facial tissues differ, the underlying biological mechanism is shared: improved lymph flow supports healthier tissue remodelling. When Can MLD Begin After Rhinoplasty? Timing is crucial, but MLD post- rhinoplasty should only begin: With surgeon approval Once acute inflammation has stabilised Using facial lymphatic drainage massage protocols appropriate for post-surgical tissue Once the antibiotic cycle is finished, and the risk of infections is no longer there anymore At Melbourne Massage and Treatment in Fitzroy North, I tailor each session based on: Surgical date Healing stage Tissue sensitivity Presence of swelling or firmness MLD is not a painful treatment, and it doesn’t matter how sensitive your skin is, or how good you are at tolerating pain, still, throughout the treatment, pain should not be experienced, as this would lead to increased inflammation, which is not what we need, when clearing off exceed lymph liquid to reduce oedema post-surgery. My Approach With MLD at Melbourne Massage and Treatment – Fitzroy North As a Vodder-trained MLD therapist, my focus is on precision, safety, and evidence-informed care. Each session is: Gentle and non-invasive Individualised to your healing phase Focused on supporting natural lymphatic recovery Most clients benefit from a short series of treatments over several weeks or months, depending on swelling persistence. Nothing can boost your healing, whether you went through a cosmetic surgery or just had a severe incident, but there are certain practices, like MLD or exercises, and even good food and plenty of rest, that can help in assisting your healing process and not make it worse or longer. <div class=”faq-accordion”> FAQs: </div>
Dec
As a therapist who works with Lymphatic Massage in Fitzroy North and 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, as Vodder MLD, would allow: Reduce the swelling with a pain-free approach Take away 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 the 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, either […]
Dec
Liposuction interventions are on the rise, driven by the enormous influence of social media on how we look and by the abundance of cheap clinics worldwide. While liposuction surgery removes stubborn fat deposits, the recovery period from this type of intervention is often underestimated. As a clinical myotherapist specialised in Manual Lymphatic Drainage (MLD) Vodder style, I regularly work with clients who are navigating the post-operative process, and I often get to hear clients who haven’t been fully informed about the post-surgery care needed, and the timeframe of recovery. Indeed, many patients who have undergone Liposuction surgery are surprised to learn that MLD plays a supportive role in the recovery process, and not by “boosting” healing, but by complementing your body’s natural ability to manage swelling, fluid congestion, and fibrosis. Below, I explain what liposuction involves, why MLD is recommended before and after surgery, and what you can expect during the healing timeline. What Exactly Is Liposuction? Liposuction is a surgical procedure that aims to remove excess fat from targeted areas of the body. There are different ways in which liposuction can be delivered, but what they all have in common is the usage of a cannula to break down and suction fat from beneath the skin. Once the surgery is delivered, and the fat is removed, the body experiences trauma in the form of: Swelling Fluid accumulation Tissue inflammation Disruption to lymphatic pathways Development of fibrosis (hardened or rope-like scar tissue) Superficial blood cloth Manual Lymphatic Drainage (MLD) is a manual therapy that can make a significant difference for all those presentations. How Manual Lymphatic Drainage Supports the Healing Process MLD is a non-invasive, gentle manual technique that stimulates the movement of lymphatic fluid toward functioning lymph nodes. Compared to a regular massage (Remedial Massage, Deep Tissue, Thai Massage…), it does involve the usage of oil or creams and does not aim to reproduce any pain or inflammatory response. In fact, it is the opposite; it aims at taking away excessive inflammation, as this is one of the many roles of the lymphatic system, and the technique I used is Vodder style, which is clinically recognised for its rhythmic, directional, and methodical application. Here’s how MLD supports recovery after liposuction: Reducing Post-operative Swelling As with any surgery, even Liposuction leads to significant swelling as the body implements an inflammatory response post-trauma (the physical damage of cutting the skin open and removing body tissue). MLD helps guide the fluid that builds up due to the inflammatory response back into the lymphatic circulation, easing pressure and discomfort. Minimising the Formation of Fibrosis Fibrosis is the body’s natural response to invasive body intervention and to sudden skin dilatation; indeed, it is a common presentation in Lymphoedema too. The fibrotic tissue is a common concern after liposuction, and without proper care, tissue can become firm and lumpy, affecting the final aesthetic result.Here is how MLD supports the breakdown and prevention of fibrosis: Increasing lymph flow Softening congested areas In the fibrotic area, we apply strong pressure (still pain-free) to break fibrosis down Encouraging natural tissue remodelling That’s where more frequent treatment is most helpful. To break and manage fibrosis at its best. Preparing the Body Before Surgery The reason why MLD should be considered as a pre-operative intervention too, lies in the fact that a stimulated Lymphatic System place you in an advantageous position along the recovery process, by improving lymphatic circulation, creating better conditions for tissue recovery after surgery. When Should You Start MLD After Liposuction? Once the surgery has been delivered, the ideal time to begin MLD is as soon as you have finished your course of antibiotics, as long as: All open wounds are closed, and No infection is present. The above are essential precautions to prevent the spread of infections. Also, the early start of MLD practice would ensure the best outcome post-surgery. What To Expect from MLD Treatment Post-Liposuction While many patients find out about MLD only after they receive the surgery, and this often happens when they have their surgery overseas, in countries like Turkey, Thailand, Bali, they are still not sure till the time they meet me, what MLD treatment would be about for their post-surgery recovery. In this case, I always explain in detail what the treatment is going to be about, starting with and overview of: What is the lymphatic system How we stimulated What you should expect post-treatment, and what to do and not to do Healing time frame Other topics I had to share and reassure my patients about are: MLD is not painful There is no body fluid extraction I am not going to push liquid out of your incision Yes, you need to drink plenty of water post-treatment I found that patients who undergo liposuction, especially in Turkey, come back with tough stories about acute post-surgery care, where they get their incision reopened, and liquid milked out from there. THIS IS A DANGEROUS PRACTICE AND IS NOT MLD AND IS NOT WHAT I OFFER ANYWHERE UNDER ANY CIRCUMSTANCES. How Should You Prepare Yourself for and MLD Treatment? Here is a list of things to be aware of before you go for and MLD treatment: Food and water – You can eat a light meal a few hours before your treatment and ensure you drink only water before and after the treatment. Strictly avoid alcohol – Avoid any form of intoxication before and after treatment, as this can make you really sick and unwell Medication and Clinical History – In the initial consultation form, you must declare any medication you are taking or have taken and your clinical history, to ensure no contraindications for MLD are present. Avoid cream or lotion – Application of cream or lotion on the skin would make the skin slippery and more difficult to stretch, impairing then the stimulation of the lymphatic system Post Treatment – MLD is extremely relaxing. Ensure to have some time off after your session, in case you feel like a nap or not doing […]
Oct
Experiencing a vertebral fracture can be an overwhelming and challenging experience to recover from, but this doesn’t mean there is no safe protocol and successful treatment pathway out there. At Melbourne Massage and Treatment, I am here to assist you in this complex journey, which could be by offering MLD treatment, Myotherapy or Fitness Class. But let’s first understand what fractured vertebrae mean, and what we have to be aware of when working with this type of injury. Spinal Damage vs. No Spinal Damage Let’s start to look into what difference makes to have a spinal fracture where the spinal cord was injured and where it was not. With spinal cord damage, a fracture may injure the spinal cord or nerves, leading to severe symptoms such as numbness, weakness, or paralysis. These cases are medical emergencies requiring hospital care. The rehabilitation process for someone who encounters spinal damage varies based on the severity of the injury. Surgery may be necessary to repair the nerve, but there is also the fact to consider that there may not be a recovery option and life paralysis (quadriplegic or paraplegic) as an outcome. Without spinal cord damage, it is a result of a bone fracture only, without affecting the cord. These are painful but often managed with an initial period of rest and bracing and gradual rehabilitation. At our Fitzroy North clinic, Giovanni carefully assesses your needs and works alongside your medical team to provide safe and effective rehabilitation. Cervical, Thoracic, and Lumbar Vertebrae Your spine has three main regions, and fractures behave differently depending on location: Cervical (neck): Mobile but delicate; fractures here can have severe consequences. Thoracic (mid-back): Stabilised by the rib cage, but injuries here often come from higher-energy impacts. Lumbar (lower back): These vertebrae carry the body’s weight, so fractures here cause significant pain and restricted movement. Based on where the fracture is, the treatment and recovery options and plans differ. Scans for Diagnosis To properly understand the type of fracture and the severity of the fracture itself, scans are essential. Here is a short list of what diagnostic scans are available and which are most commonly used, and why: X-ray: The first step to confirm a fracture. This type of test is good to see the fracture at the bond level; it is quick, but as a downside, it exposes you to radiation. CT scan: Provides detailed 3D imaging to assess the fracture’s stability. The downside of a CT scan is that, as it is based on X-Ray technology, it can still expose you to radiation, and it can take longer to be delivered, and it is essential to be lying down while receiving the scan. MRI scan: Compared to X-Ray technology, MRI scan would not expose you to radiation, and is used to detect any involvement of nerves, discs, or the spinal cord along the fracture, as this type of scan is used for water-based tissue in the body, and not bones. These scans help guide safe rehabilitation, ensuring the right treatment approach from day one. Something else to keep in mind from the result of the scan is that not everything that a scan shows must impact your life. Indeed, a building disk may show in your scan, but that doesn’t mean that that specific pathology is something related to your spine fracture (it may have been there already before), and that doesn’t mean the body would not look after it while you are recovering from the spine injury. Types of Vertebral Fracture Common fracture types include: Compression fracture – vertebra collapses, often linked to osteoporosis (also called a wedging fracture). Burst fracture – bone shatters outward, sometimes threatening the spinal cord. Flexion-distraction fracture – usually from high-speed accidents where the spine bends suddenly. Fracture-dislocation – bone and soft tissues are displaced, often requiring surgery. Avulsion – It is a type of stress fracture, characterised by a small piece of bone pulled away from the main bone by a muscle or ligament (typical along the transverse process). Mechanism of Injury Fractures can occur from: High-energy trauma – car accidents, falls, sports collisions. Low-energy stress – in osteoporosis, even coughing or bending can trigger a fracture. Scheuermann’s disease – in this specific condition, the vertebrae may grow at different heights compared to the sagittal plane. A meticulous clinical history intake can help in figuring out he chance of you suffering from a vertebral fracture. Healing Time and Recovery As per all non-complex bone fractures, most vertebral fractures take 8–12 weeks to heal, even if recovery varies depending on age, bone health, and whether surgery was required. What we know is that nothing can actually boost the healing, but different therapies, active and passive, can help in assisting the healing process, ensuring a positive outcome. What then can be done during the recovery time is: Early phase: Pain management and protection of the fracture. Rehabilitation phase: Gentle guided movement, strengthening, and improving mobility. With myotherapy support, clients can return to safe daily activities while minimising the risk of re-injury. What to Avoid in the Early Stages of a Vertebral Fracture As mentioned earlier, in the early stage of vertebral fracture, it is important to prevent further damage to the spine and wear a corset that helps in stabilising the spine, while the body is starting the calcification of the bone. Even though you may wear a support, you will want to avoid: Heavy lifting, twisting, or bending movements. Prolonged sitting without support. High-impact exercise or activities. Movement is still recommended, as it can still promote fluid movement and relaxation. Therefore, it is possible to go for walks, move your arms, and move your legs even if in a seated position. Manual Lymphatic Drainage Massage in the Early Phase of a Vertebral Fracture At Melbourne Massage and Treatment, I got to offer MLD as a form of treatment for relaxation, which can have a positive impact on pain perception and tension relief from the spine area. MLD is a gentle […]
Sep
Within the last few years, cosmetic surgeries have been on the rise in Australia. These types of interventions can be helpful for quick body changes. Still, the recovery process post-surgery is often under-estimated and misinterpreted, especially when, past a couple of days or just a few weeks, the body’s response to surgery leaves behind hard lumps, thick skin, and reduced sensitivity. The thought skin and lumps are simply fibrosis, and the reduced sensitivity results from damaged nervous system endings. At Melbourne Massage and Treatment in Fitzroy North, I specialise in Manual Lymphatic Drainage (MLD) using the Vodder technique, helping clients reduce swelling, assisting the recovery, and breaking down fibrosis post cosmetic surgery, safely and effectively. If you’re looking for post-surgery care in Fitzroy North or Melbourne, here’s how MLD can support your recovery and improve your results. What is Fibrosis After Cosmetic Surgery? Fibrosis formation post cosmetic surgery is the result of tissue damage that occurred during the surgery. When going for an intervention like liposuction, where fat is removed from the body (either at the abdominal level, arms or legs or elsewhere), the body, to replace the void left by the fat removal, builds up fibrotic tissue. The fibrotic tissue is mainly made of collagen. While this reaction is natural, it can often cause: Hard lumps or nodules under the skin; Uneven skin contour or texture; Tightness or restricted mobility; Tenderness or discomfort. There is no real way around those types of side effects post-liposuction, at least in the short term, and the body would take weeks to recover fully (up to 3 months). That said, everybody reacts differently to this type of intervention, and based on the type of intervention received, the recovery process can vary. Who Benefits Most From Lymphatic Drainage Massage After Cosmetic Surgery? Here is a short list of cosmetic surgery interventions that are going to leave you with fibrosis in the post-surgery time, and that would benefit from Lymphatic Drainage Massage intervention: Liposuction (abdomen, thighs, arms, chin) – This includes liposuction for Lipoedema management too. Tummy tuck – Either due to post-liposuction or from severe weight loss. Breast surgery (augmentation, reduction, reconstruction) – If this is due to breast cancer, one should be aware of any risk of Lymphoedema development. Facelifts and neck lifts Brazilian Butt Lift (BBL) – This type of intervention requires fat to be removed from other body parts, as the abdomen, and that’s where fibrosis would build up. How MLD Helps Reduce Fibrosis Manual Lymphatic Drainage (MLD) is a gentle, specialised technique that stimulates the lymphatic system to clear excess fluid, reduce swelling, and assist with the healing process. After surgery, your lymphatic system could be damaged and can struggle to keep up with its work, and that’s where MLD makes a big difference. Indeed, the stimulation of the Lymphatic System, via MLD therapy, can help in assisting your recovery and ensure that the fibrotic tissue gets absorbed and dismissed, restoring freedom of movement and leaving you soon after treatment in a deep relaxation state. I trained in the MLD with the Vodder style, therefore I can provide precise, tailored treatments that are safe for sensitive post-operative tissue. Book your post-surgery lymphatic drainage in Fitzroy North today to safely reduce fibrosis. When Can I Start MLD Treatment Post Cosmetic Surgery? Generally, MLD is safe to start as soon as the antibiotic cycle is ended post-cosmetic surgery. Given the light touch of this type of therapy, we aim to produce no pain during the treatment, so we can work close to the surgical side, without affecting the recovery process. On the other hand, I found myself occasionally referring patients to the local nurse or GP here at Fitzroy North Doctors, as their recovery immediately post-surgery was compromised by misleading suggestions and procedures offered by overseas cosmetic clinic surgery. If you are not sure about what’s going on with your recovery, please, before placing a booking for an MLD treatment, talk to your GP about your recovery state, and if you have any questions regarding MLD treatment, you can always reach out to me via the contact page. How Many MLD Sessions Do I Need To Reduce The Fibrosis? As mentioned earlier, everyone responds differently to cosmetic surgery, but in my experience, it would take at least 4 to 6 weeks to start seeing a significant difference in fibrous tissue presence. That said, the number of sessions and the time length of the sessions can vary, based on the area where you received the surgery. Abdominal surgery only: I will recommend 2 to 3 treatment per week, for the first 3 weeks. Within the first week, we may spend 1 hour per session, and from the 2nd week onwards, we reduce the treatment to 45 minutes. Multiple liposuction sites: as there are multiple areas where you received a surgery, we may need to extend the time of treatment up to 1 and a half hours initially, or go for multiple sessions, each for a different area. The first few treatment may take longer as we want to spend some extra time trying to break down the fibrosis with a gentler touch, due to the high sensitivity of the body, which is high due to post-surgery. As the sensitivity decreases, and we can apply further pressure, we can achieve the same result in fibrosis reduction with less time. If you are not sure what works best for you, you can book a 15-minute free online consultation, so we can discuss your needs and work out a treatment plan in accordance with them. MLD Prices in Fitzroy North All my services are offered at the same rate and are as follows: 90 mins – $175 1 hour – $125 45 mins – $ 115 30 mins – $90 All those prices are inclusive of GST. The 90-minute option is available only if required, and not via the booking system. Why Choose MLD at Melbourne Massage and Treatment in Fitzroy North? Not all lymphatic […]
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
When the space between the collarbone and first rib gets tight, during movement or even at complete rest, it can lead to Thoracic Outlet Syndrome (TOS). Between the two structures mentioned above, we have the passage of the thoracic plexus (nerves) and blood vessels. The compression of those structure, can result in pain, weakness and numbness radiating down the shoulder, arm, and hand. Because TOS has multiple causes and presentations, effective treatment depends heavily on accurate assessment and an individualised approach, and that’s where myotherapy can play a crucial role. What Causes Thoracic Outlet Syndrome? As there are different tissues passing by this space, the nature of TOS can be broadly categorised into three types: Neurogenic TOS: Compression of the brachial plexus (nerves). Venous TOS: Compression of the subclavian vein. Arterial TOS: Compression of the subclavian artery. But not only can different tissues be compressed, but different structures can be responsible for the compression. Indeed, the compression can be due to the scalene muscle, pectoralis minor or bone. And here are some common causes: Muscle imbalances that lead to poor posture (forward head/rounded shoulders); Repetitive overhead activities (which lead to constant compression of the tissues); Trauma (e.g. whiplash or clavicle fracture); Anatomical variations (such as a cervical rib). The Role of Myotherapy in TOS Assessment As a myotherapist, when treating someone with suspicious TOS, we go for a series of assessments that we compare to the clinical history and symptoms. The test itself would aim to reproduce the patient’s symptoms and guide us on what potential structure is compressed. If we are suspicious of TOS, we can aim to reduce tension in soft tissue and give exercises that can reinforce those structures to alleviate any compression in the area. Orthopedic Testing & Myotome Assessment Some common assessments include: Adson’s Test (for scalene involvement) – It consists of reproducing a drop of heart bit in the wrist (affected side) by asking the patient to abduct and extend the arm while rotating (same side) and extending the neck. This would add extra compression on the suspected structures. Roos/Elevated Arm Stress Test (to reproduce vascular or neural symptoms) – It is about asking the patient to lift the arm at 90°/90° and start closing and opening their hands repetitively for 30 seconds to 1 minute. A drop of strength or symptom reproduction would lead to a positive test. Costoclavicular Maneuver (to assess space between clavicle and first rib) – It is delivered by having the patient with depressed and retracted shoulders. The positivity of this test is given by the reproduction of symptoms or a reduction in the distal wrist. Wright’s Hyperabduction Test (for pectoralis minor tightness) – The patients get asked to lift their arm (affected side) above their head while the therapist stands behind and keeps count of the wrist heartbeat. Any symptoms, reproduction, or drop in bit is considered positive. In addition to those tests, we would use: Myotome testing: which assesses the motor function of specific spinal nerve roots; Clinical history: Any history of previous injury, surgeries, work and sport loads; Type and timing of symptoms: When and how those symptoms are reproduced on daily life. All this said, we always have to consider that as therapists, myo or physio as per osteo exc… we can assume that the positivity of many of those test leads to a positive or negative conclusion regarding TOS. Hands-on treatment and exercises in combination can be the easy steps to take to treat the presentation, but can not always guarantee the best outcome, due to each individual’s unique presentation. Hands-On Treatment and Exercise Prescription Once we have more understanding of what is potentially happening in terms of compression, a myotherapy treatment focuses on addressing the underlying causes: Manual Therapy Myofascial release of the scalene, pectoralis minor, and upper trapezius muscles. Trigger point therapy to reduce local and referred pain patterns. Joint mobilisation to improve scapular movement and rib mechanics. Neural gliding techniques to encourage nerve mobility and reduce irritation. Exercise Rehabilitation Postural re-education, particularly strengthening the deep neck flexors and lower trapezius. Scapular stabilisation exercises to improve shoulder mechanics. Breathing retraining is necessary if dysfunctional patterns (like apical breathing) are contributing to compression. Neurodynamic stretches are appropriate for nerve mobility. Together, these interventions help reduce symptoms, improve function, and support long-term recovery. The time frame for improvement, if not complete reduction of the symptoms, can be different per individual, but we can estimate a period of time that goes between 12 and 16 weeks. If no changes are reproduced within this time frame, that’s where we would refer the patient elsewhere for further investigations, like a scan. When Is Surgery Needed for Thoracic Outlet Syndrome? Surgical intervention is typically reserved for cases where conservative care fails or in cases of vascular TOS, where there’s a risk of thrombosis or embolism, but also where anatomical variations, like a cervical rib is present. Surgical procedures may include: Scalenectomy (removal of the scalene muscles) First rib resection Clavicle decompression or repair if there’s previous trauma These operations aim to create more space in the thoracic outlet, thus relieving the compression. Post-Surgical Recovery and the Role of Myotherapy In case of surgery, as a myotherapist, we can still help and ensure a correct recovery post-intervention. Treatment like MLD can help in flushing excess liquid out of the surgery area, but again, we would look into exercises as a form of recovery and rehabilitation of the area affected by the surgery and or affected by the lack of strength that is a consequence of a prolonged period of muscle weakness. More broadly, myotherapy treatment can help with: Pain management Scar tissue Muscle guarding or weakness Neurological symptoms that may persist or reappear Do You Need a Scan if we’re suspicious of TOS? Imaging, as discussed in other blogs, may be recommended when we are suspicious of other presentations, or if standard method are not creating any difference. For example: To rule out cervical disc herniation, tumours, or other causes of neurovascular symptoms. When […]
Jun
Cosmetic surgeries have become increasingly common, with procedures such as liposuction, tummy tucks, facelifts, and breast augmentations helping people achieve their desired aesthetic goals. However, while the surgical aspect gets most of the attention, what often goes under-discussed is the importance of post-operative care, especially Manual Lymphatic Drainage (MLD) in promoting faster, smoother recovery and reducing the risk of ending with fibrosis tissue build up underneath the skin. What Is Manual Lymphatic Drainage (MLD)? MLD is a gentle, rhythmic massage technique designed to stimulate the lymphatic system and encourage the natural drainage of lymph fluid. The lymphatic system plays a crucial role in immune function and fluid balance. After cosmetic surgery, lymphatic flow can become disrupted due to inflammation, surgical trauma, or temporary damage to lymph vessels. While the first few days post-surgery are dedicated to acute recovery and the taking of Antibiotic to reduce the risk of infection post-surgery, as soon as this risk is passed, that’s when you want to start your MLD journey. Why Is MLD Important After Cosmetic Procedures? Cosmetic surgeries often cause swelling, bruising, and fluid accumulation (known as seroma or edema). This is due to the body reacting to an invasive procedure and removing tissue beneath the skin. MLD helps: ✅ Reduce post-surgical swelling ✅ Accelerate the removal of metabolic waste and excess fluid ✅ Improve skin texture and reduce fibrosis (hardened tissue) ✅ Speed up visible results by enhancing contour definition ✅ Decrease discomfort by reducing pressure from trapped fluids As with any surgery, when lymphatic drainage massage is applied, no pain is to be experienced. While I treat someone with MLD I always pass this information up front, to ensure that if they experience any type of pain, I get told about it, so that I can go lighter with pressure. Which Procedures Benefit Most from Lymphatic Drainage? MLD is commonly recommended after: Liposuction (including 360 lipo or Brazilian Butt Lift – BBL) Tummy tucks (abdominoplasty) Facial surgeries (rhinoplasty, facelifts, blepharoplasty) Breast augmentation or reduction Body contouring procedures As a Lymphoedema therapist, I do get surgeons referring me patients to assist them with post-op management, especially when swelling or fibrosis is a concern. When Should You Start Lymphatic Drainage? As briefly explained above, the ideal time to begin MLD is as soon as you stop your antibiotic cycle, and is your surgeon or GP call to when you are safe to do so. On the other hand: Typically, MLD is started 3 to 5 days post-surgery, once acute inflammation has settled and the incision sites are closed or protected. A full course may include 6–10 sessions spaced out over a few weeks for optimal results. Always follow the advise of the surgeon about post surgery, but, when you safe to do, the more movement we add to Lymphatic Draiange, the better the recovery would go. Is MLD Safe post-cosmetic surgery? When performed by a qualified lymphatic therapist, lymphatic drainage is non-invasive, safe, and effective. It’s gentle enough for delicate post-op tissue and can significantly improve comfort and healing time. My qualification in Lymphatic Drainage was done with the Vodder Academy whicg holds the gold standards for MLD practice, and is worldwide well known for the quality of their practice. On the other hand, I also hold a qualification in Clinical Myotherapy, which allows me to help people recover from injury and stick to their fitness goals via training and exercises. When Can I Book My Appointment for Post-Cosmetic Surgery Recovery? My studio, Melbourne Massage and Treatment, is located in Fitzroy North, on the corner of St George Rd and Holden St. I work Monday to Saturday, and to book an appointment, you can just head online to the booking page and choose the best time/days that work for you. Given the number of session needed for this type of work, I always suggest to book a series of session in a raw, from to 3 session per week for the first 2 weeks. Session by session we do evaluate together the progress, and chose together what’s the next step. If you have any questions, please do not hesitate to contact me. FAQs – Cosmetic Surgery & Lymphatic Drainage
May
Pregnancy brings many wonderful changes, but it can also bring some discomfort as the body adapts to a growing baby. Swelling, heaviness in the legs, water retention, and aching joints are all common. One treatment that is safe, gentle, and highly effective in reducing these symptoms is Manual Lymphatic Drainage (MLD). At Melbourne Massage and Treatment, Fitzroy North, I provide customised pregnancy lymphatic drainage treatments designed to reduce swelling, support circulation, and help you feel your best during each stage of pregnancy. In this blog, we’ll explore the benefits, safety considerations, positioning, and when lymphatic drainage may or may not be recommended. What Is Manual Lymphatic Drainage for Pregnancy? Lymphatic drainage is a gentle, rhythmic technique designed to stimulate the lymphatic system. This improves the movement of lymph fluid, helping the body eliminate unwanted substances, reduce fluid retention, and improve overall well-being. Manual lymphatic drainage is beneficial for pregnant individuals (Cataldo Oportus et al., 2013), particularly for managing swelling, improving circulation, and supporting relaxation. Benefits of Lymphatic Drainage During Pregnancy 1. Reduction of Swelling (Oedema) Swelling in the legs, ankles, and feet is extremely common in pregnancy due to increased pressure on the lymphatic and circulatory systems. Lymphatic drainage helps move fluid away from congested areas, relieving discomfort and heaviness. 2. Relief from Pregnancy-Related Back Pain During pregnancy, the increasing weight can affect posture and strain the back. Lymphatic drainage, performed in a comfortable side-lying position, helps reduce tension through its profound relaxation effect. 3. Improved Circulation Changes in blood volume and circulation during pregnancy can cause fluid retention and fatigue. Lymphatic drainage promotes healthy blood and lymph flow, improving oxygen and nutrient delivery to both mother and baby. 4. Mental and Emotional Well-being One of the most underestimated benefits of lymphatic drainage is how deeply relaxing it is. Better sleep, reduced stress, and a sense of lightness are very common outcomes. At Melbourne Massage and Treatment, I usually deliver pregnancy lymphatic drainage in a seated or semi-reclined position using a hydraulic table, which allows maximum comfort and safety throughout the treatment. FAQ – Pregnancy Lymphatic Drainage Massage in Melbourne Reference Cataldo Oportus, S., de Paiva Rodrigues, L., Pereira de Godoy, J. M., & Guerreiro Godoy, M. de F. (2013). Lymph Drainage in Pregnant Women. Nursing Research and Practice, 2013, 1–3.