Myotherapy is a massage technique to treat or prevent soft tissue pain and restricted joint movement. “Myotherapy” stands for “Myo” Muscle “Therapy” therapy. In Australia, and specifically in Melbourne, it is a practice that took over the massage market in the last few decades and is not becoming more and more popular. There is Dry Needling and Joint Mobilization along the different techniques used in a Myotherapy treatment. Is Myotherapy Safe? Yes, Myotherapy is a safe treatment. Said so, you want to ensure that the therapist treating you has their qualification up to date. Here is a link to my qualification. What about Dry Needling in a Myotherapy Treatment? Dry needling is one of the many ways a Myotherapist can treat a client, but it is unnecessary. Before using needles, the therapist always has to double-check with the clients the following: No metal allergy No bleeding disorders No needle fear or phobia The client feels comfortable with such treatment The therapist does explain how dry needling works Is Myotherapy available at Melbourne Massage and Treatment? Yes, it is. I am a fully qualified Myotherapist who completed an Advance Diploma in Myotherapy at RMIT University. On top of all, I am now enrolled in the last year of my Bachelor’s Degree in the Myotherapy Clinic at Torrens University. What’s the difference between Myotherapy Treatment and Remedial Massage? Myotherapy is similar to a Remedial Massage session. The difference is that a Myotherapist has more knowledge about the human anatomy, joints, and functionality. So before the session, the therapist would guide the patient through a specific range of motion to evaluate the body’s presentation. Done so, the therapist has an idea of what can be done to improve the body’s presentation. Furthermore, a Myotherapist is trained to use mobilization, which is a repetitive joint movement to improve the joint’s range of motion. My favourite “mobs” are along the spine. They consist of a gentle push over the transverse process of the spine. Applying this constant firm push, the transverse process gain mobility, allowing all the muscle inserts originating from that joint to be more mobile. Is a mobilization the same as what a chiro does? No is not. The Chiro makes an adjustment, which is a fast joint pull or push, to adjust its position or functionality. Along with an adjustment, the patient has no control over the fast movement. Indeed, during mobilisation, the patient can take control of the push and stop the treatment if he/she does feel uncomfortable. Book Now your Myotherapy treatment with Giovanni. Giovanni is available in Fitzroy North at 175 Holden St Monday to Saturday 9 am to 7pm.
Tag Archives: muscle pain
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Aug
Myofascial Dry Needling (MDN) treats sore muscles and trigger points. How does Dry Needling work? As discussed in another blog post, muscles are made of many individual fibres. As the fibre contract and stretches, this does give the muscle the ability to have strength and elasticity. Along with repetitive movements and lack of posture, the muscle fibres can accumulate tension that we generally call knots. Those “knots” are also known as trigger points. This is one of the many theories behind the formation of trigger points. Said so, a trigger point is a terminology used to describe a painful spot. And still, nowadays, there is no exact explanation for how trigger point forms and what exactly they are. But what we know for sure is that not everyone develops trigger points in the same spot. Now, to release the tension out of the trigger points, we can either apply external pressure, with the thumb or the elbow, in case of a Remedial Massage or even the knee or the heel of the foot with a Thai Massage, or we can break the fibres from within by using a needle. What a needle is like? The needles used in this practice have a diameter from 0.15 to 0.25mm, so really thin needles. Whereas the length can vary from 15mm to 90mm. Depending on the target muscle, the length of the needle is different. So, as we penetrate the muscle with the needle, we brake the fibre, and we recall an inflammatory response from the patient’s immune system. Which drives more blood and nutrients to the target area. As discussed further in this study published on PubMed, Dry Needling is effective for chronic non-specific neck pain 1. Is dry needling safe? Yes, it is, as long as the practitioner offering the service is qualified for it, and well knows the anatomy of the muscles. Said so, when you receive dry needling, there are a few things that you may want to consider. Firstly you better not have any metal allergy. Also, Dry Needling is not recommended if you have just done any strong physical activity or training, as the muscles would be in an acute inflammatory stage. In addition to this, other contraindications are: If the patient is on a blood thinner Diabetes type 1 The area is affected by Lymphedema The patient is unable to give the consent The patient would not be able to stay still as the needle is in the body Book now, your next Myotherapy session at Melbourne Massage and Treatment, Fitzroy North Clinic. How long the needle stays in the body? Depending on the area needing treatment, the needle may stay in the body for 3 to 10 minutes. And always based on the target muscle that needs to be treated would also depend on the type of treatment. Indeed, the needle could be placed in the muscle and left there to sit and create the physiological response needed, or it could even be partially extracted, moved around and placed back. This type of technique is called “peppering”. Peppering along a dry needling session allows the therapist to target other fibres around the muscle fibre area. 1. Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, Perez-Muñoz M, Mayoral-Del-Moral O, Lluch-Girbés E, Prieto-Valiente L, Falla D. Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016 Sep;157(9):1905-1917. DOI: 10.1097/j.pain.0000000000000591. PMID: 27537209.
Jun
Calf muscles make up the lower posterior portion of the leg. Calf Muscles are: 2 are the calf muscles, the Gastrocnemius and Soleus. Below is a table with Gastrocnemius and Soleus’s Origin, Insertion and Action. Gastrocnemius Origin The posterior surface of the lateral and medial condyle of the femurs Insertion Calcaneus via calcaneus tendon Action Flex the knee Plantar flex the ankle Soleus Origin Soleal line; the proximal posterior surface of the tibia and posterior aspect of the head of the fibula Insertion Action Plantar flex the ankle So, due to their origins and insertions, we can clearly understand how the Gastrocnemius is involved in knee flexion and how the Soleus is not. The Gastrocnemius does across the knee, as it originates from the femur itself. On the other hand, the Soleus doesn’t cross the knee, so it doesn’t play any role at the knee level. This aspect is so important to differentiate what of these 2 muscles are involved in the restrictive movement at the ankle, and or in calf pain. Calf Muscles testing Firstly the patient is lying down in a supine position (face up) doing active dorsiflexion. Secondly, we will ask the patient to lie in a prone position (face down), and we knee bend (passively), they would go in ankle dorsiflexion again. What happens there is when the knee is flexed passively, the Gastrocnemius is deactivated, and so the ankle dorsiflexion is happening by pulling the soleus only. Now, 2 are the case scenarios that could happen: Still a limited range of motion at ankle dorsiflexion with or without pain A better quality of ROM with a greater angle in dorsiflexion. In the first case, the tension muscles could still be both. In the second case, the Gastrocnemius is clearly the muscle limiting the ROM. For ankle ROM in dorsiflexion, we are looking for a minimum of 20° to up to 30°. It is not all about Muscle Pain. But can calf pain be related to something else and not just to muscle pain? The answer is YES. Calf muscle pain can be a RED FLEG for Deep Veins Thrombosis (DVT), especially after a flight. DVT Symptoms: Sharp pain; Heat at the touch; Soreness at the touch; Redness on the skin. In this case, you want to contact your GP immediately. Massages are absolute contraindications. In conclusion, for a full calf or muscle recovery, we want to look in too some exercises. Remedial Massage, Myotherapy, and Thai Massage are great ways to reduce pain and manage symptoms, but exercises are essential actually to heal a muscle. Indeed, when we talked about plantar fasciitis, those exercises are something that we can look at for calf strengthening.
May
When experiencing pain around the head, we talk about Headaches. Headache is a common condition, and for most cases, is not considered a serious illness. Migraine and headache. 4.9 million Australians experience migraine. Migraine is a specific type of headache, so consider that the number stated above is still a small figure. Headache and muscle. If you ever experience a headache, you may notice that the pain sensation does start from your cervical area. Or, by confronting yourself with who is around you, your headache pain pattern, is consistent, but it is different from the one of someone else. On the other hand, you may associate headaches to the result of a heavy drinking night, or of lack of water (which is why you get headaches after a heavy drinking night, by the way), but often headaches are there because of cervical muscle tightness. Wait, what? Yes, you did read right. How can we define then if the headaches come from muscle tension? So in order for this to happen, the muscle responsible for referring its pain up to the head must be tight or stretched out, and loaded with trigger points. As massage therapists, especially in the first consultation session, we would ask about headaches and if there are any, “where about do you feel the headache”? Indeed, the answer to this question is most luckily the giveaway to know which muscle is may responsible for your headaches. To confirm the suspicions, we would then assess your posture, looking for any muscular-skeletal unbalance, and then we would assess the Range of Motion (ROM). If the ROM show up to be limited on the muscle that we believe is responsible for the pain in the head, then most luckily we are halfway through the solution. I do say halfway through, a single massage session either Myotherapy, Remedial Massage, Thai Massage, or MLD is maybe not enough to release all the tension that is in needs to be alleviated to eradicate the headache. Said so, no journey starts, without doing the first step, isn’t it? When a headache is a Red Flag? For red flags, we refer to symptoms that may be present due to serious illness or condition. Some example includes clients who had a clinical history of stroke and or brain cancer, a recent car accident or recent head trauma, or blurred vision. If that’s the case, the next step is referring the client to a GP immediately for further investigation. What about the cervical muscle tension headaches type of presentation? As already mentioned in another blog post, the Occipital muscle can have headache type of pain in the lower section of the posterior side of the skull. If we then look into the area of the skull that seat above the ear, could be more tension from the Upper trap or Levator Scapulae. By keep moving more medially and above the head, Splenius cervis can refer to the medial superior side of the head and Splenius capitis to the middle top side of the head. Sternocleidomastoid, indeed, can refer to the frontal lobe of the skull. Now, all these muscles are sitting on the neck and throat and from above the shoulder. So, ensuring that those areas are free or not overloaded with tension can help in staying headache-free. Now, in this blog post, we are keeping the headache presentation type of pain to its simple aspects. On the other hand, the topic can be further discussed in person with Giovanni during your next massage appointment. Book now your next massage session, if you are trying to get to sort out your headache presentation. Other approaches to a headache-free life, out of massage therapy. There is a series of things that complimentary massage can help with to relieve headache pain. Exercises Keep yourself hydrated Good posture when seating and standing Good variety of food as diet intake Wearing glasses if needed. Meditation for stress management In conclusion, headache is a really common problem for all Australians, for both women and men. Don’t wait for your symptoms to get worse; you may not need to take medicine all the time if you have a headache, as the medicine will just numb the symptom but will not sort out the problem. If you are keen to learn more about where your headache may be coming from, book your next Massage Session today.
Apr
Knee pain is a common presentation for clients of any range of age and gender. Knee pain indeed is a vast topic. So in this post, we are going to go through how to identify the reason why we can experience knee pain. For doing so we are going to look at some special testing, that we use for the knee joints. Next, in a further post, we may analyse individual conditions. What about the Knee Joint? The knee is the strongest joint in the body. It takes a lot of pressure from the upper body and still has to handle the shock coming from the lower leg session, shock as walking, running and jumping. Indeed, whenever we do one of these actions, the knee plays a big role. Knee Anatomy Bond: Above: Femur Below: Medially the Tibia, laterally the Fibula. Patellar is the front “floating bond” Ligaments: Anterior Crucial Ligament Posterior Crucial Ligament Posterior Menisco-Femoral Ligament Fibular Collateral Ligament Tibial Collateral Ligament Transverse Ligament (this one is visible only from the front side of the knee, below the patella). In between the bonds we have: Medial Meniscus Lateral Meniscus If this post is talking to you, book your next massage session by clicking here. So, the knee joint can be divided into two parts: Tibiofemoral joint Connects through the collateral ligaments, cruciate ligaments and menisci; Patellofemoral joint Gives stability to the medial and lateral retinaculum and allows the extension mechanism through the tendons of the quadriceps f.. Now that we have a better idea of what the knee anatomy is, we can look into his functionality. Knee ROM are: Extension: 0° Flexion: 140° Internal Rotation: 30° External Rotation: 40° Abduction/Adduction: 15° Said so, we can see that the major movement that the knee can accomplish is, flexion. Even if the Internal and External rotation since to be a big move for the knee, in the reality, that’s not always the case. The older we get, easily this motion actively gets tighter. Indeed, one of the main reason for meniscus injury is the twisting of the knee, when the feet is holding the ground and the body rotates. But as previously mentioned in this post we would look into the knee special test. What knee functional test have to tell us? As we already mentioned in another post, a generic active, passive or resisted ROM tell us about muscle functionality. On the other hand, a special test for the knee can show us if a ligament or a meniscus is loose, in the case of ligament or injured. Furthermore, special tests, on the knee are essential to prevent further injury and reduce joint degeneration. To start with we have the drawer test: Anterior Draw test and Posterior Draw test. The Anterior one is to test the anterior crucial ligament, and the posterior, obviously, is for the crucial posterior ligament. Both these tests are done with the client lying supine on the table, with a hip and knee flexed, and foot on the table. The therapist will ensure that the foot doesn’t move and will place its hands around the knee, with the fingers (except the thumb) seating at the top of the calf and the thumbs seating on the patella. For the A.D. test, the therapist will lightly pull the knee joint away from the patient body. On the other hand, for the P.D. test, the therapist will push the knee towards the patient’s body. These tests are positive if there is a loose movement within the knee, in the direction of pull or push. If the client has a history of injuries, to the ACL or PCL the therapist wants to make sure not to push or pull with great effort, or injury could occur. Vagus and varus test. Those tests analyse the status of the medial and lateral ligaments. For the valgus test, the therapist places one hand above the knee laterally, and the other hand above the ankle on the medial side. By applying opposite pressure in the 2 directions we put the medial ligament under stress. If pain is reproduced, or there is a loose movement the test is positive. The same action is for the Varus test. In this case, the hands are placed still above the knee and ankle, but the bottom hand is placed laterally and the top one, is placed medially. Apleys Test This test is used to evaluate the state of the meniscus. The client, in this case, would be lying in a prone position, with the knee flexed. The therapist will be standing next to the client, on the side of the knee flexed and will apply pressure to the knee. If no pain is reproduced with pressure only, the therapist can gently apply a rotation movement to the flexed knee. The test is positive if the pain is reproduced. McMurray test. This is luckily the most efficient and most used knee test used by therapists in case of meniscus injury Here is how it works: The patient lies in the supine position with the knee completely flexed (heel to glute). Lateral Meniscus: the examiner then medially rotates the tibia and extends the knee. Medial Meniscus: the examiner then laterally rotates the tibia and extends the knee. McMurray is a positive test if the pain is reproduced. There are still a couple of tests that can be done for the knee, but so far we did cover the most important. About the therapy that I can offer for releasing knee pain, MLD is what I would suggest the most. Especially for acute pain and swelling or oedema reduction. Whereas, Myotherapy or Remedial Massage and Thai Massage can be used too but more to facilitate and or strengthen the muscle surrounding the area.
Apr
First Massage Appointment. At Melbourne Thai Treatment, a first massage appointment session does last a bit longer than a regular appointment. Indeed, if you go on the booking page, you may notice that the first appointment lasted 75mins. Why so?! Well, within the first appointment, as a therapist my aim is to track down your Clinical History. For doing so there is initially a form to fill in and in a second stage few subjective questions that I am going to ask. Questions are like: “What do you do for work?” “What sports activity do you do or did?” “On what side do you sleep?” “Are you Right or Left Handed?” Ext… These and other questions, relevant always to the presentation that you come in with, are for me therapist essential to understand how you end up having the pain or discomfort that I have to remove or reduce. Obviously, those questions asked during the first massage appointment can take a bit of time to be answered Occasionally an answer gives space to a new question. Said so, the more specific are the answer more I can narrow down the clinical situation. If this post is talking to you, book your next massage session by clicking here. As per result, will be easier to find a path to alleviate pain and discomfort. On the other hand, as the session last longer than a regular visit, as a therapist I charge a bit more. For a Remedial Massage and a Thai Massage a first appointment session would last 75mins. About MLD a first Massage session would last 60 minutes. Indeed, with this post, I would like to share and explain to any clients that the first appointment is not more expensive because I am greedy. Is through, the time we spend doing the massage itself is per usual the same time that we would spend during a general consultation. But, that initial time that we spend working out your Clinical History, will save time after actually treating the condition. In conclusion, I would not see the first appointment as an extra expense, but as an investment in your health. Before we find out what’s the cause of your pain, and discomfort before I can create a proper treatment for it.
Mar
Range of Motion is the movement of a joint within a 3-dimensional space. For each joint, we expect a minimum and a maximum degree of movement. When to use a range of motion evaluation. Before performing a Myotherapy, Remedial Massage, or a Thai massage session, we check for a Range of Motion, also know as ROM. Checking for ROM is to establish the functionality of the joint and the muscles that surround it. For example, when a client walks in complaining of cervical pain, the first thing we look in too after the postural assessment is the ROM. A postural assessment is an evaluation of the skeletal structure. After that, we ask the client to do specific movements with their head. Like, Rotation side to side, flexion, extension, and lateral flexion. Indeed, these are the basic range of motion for the cervical area. What this range of motion can tell us? Well, depending on the essential mobility of the person, we expect a minimum and maximum range. Let’s say that the client has average mobility; we expect the range of motion of their cervical to be: Flexion (able to flex the head forward and leave a gap of 3cm between the chin and the sternum) Extension, we look in too 70° of movement Lateral Rotation we look in too 80° of rotation (the chin is nearly in line with the shoulder) Lateral Flexion we look in too 45°. If this post talks to you, book your next massage session by clicking here. Are the range of motion movements the same for everyone? A person with a hypermobile joint range may have a 10° about less ROM than this. Indeed, a person that has a hypermobile joint range can reach 10° furthermore. That’s why every person needs his evaluation. Moving forward, if the range of motion is limited, it could be a muscle tightness or a joint mobilization issue. The best approach for improving joint mobilisation is the Myotherapy treatment or Thai Massage. Both techniques relieve muscle tension and improve muscle tone and joint mobility. The release of tension from the muscle would improve the ROM. On the other hand, when we ask a client to do a ROM, we don’t look only for the length of movement. Quality of movement. For the quality of movement, we refer to how smooth the movement is. Is the client trying to compensate for the cervical rotation by flexing the head? Is the client compensating for the flexion by shrugging the shoulder? Indeed, the movement of a joint is the key to understanding what muscle is responsible for the pain, discomfort or limited ROM. Once we individualise the key muscle/s, we can address the issue. Different types of ROM. In conclusion, the ROM can be active, passive and resisted. The client itself does active ROM. Passive are ROM done by the therapist with no assistance in controlling the movement by the client. Reisted is ROM active done by the client, with a resistance force applied by the therapist again the client’s movement. Each of this ROM can tell us something different about the joint. Active is about muscle lengthening. Passive is about joint mobility (ligament and tendon) Resisted is about the strength of the muscle. We can’t use the Resisted if Active or Passive reproduces pain. That would not be safe. Regarding the Resisted ROM, the resistance is applied in 3 different levels. When the pain gets reproduced, we stop the test. Occasionally, an orthopaedic test can be performed too. Orthopaedic tests are specific tests to evaluate in specific the muscle involved in the limited ROM.
Mar
As Massage Therapist, I often see people who come in for treatment due to pain and discomfort. Indeed, I am more than happy to be that person who, by manual therapy, can alleviate others’ agony. Exercises post-treatment. At the end of the treatment, I tend to show the client a series of corrective exercises and, most of the time, a straightforward one. Those corrective exercises must be done to help maintain the change we created in the body along the massage session. Massage treatments like Myotherapy, Remedial Massage, Thai Massage or MLD can be a good starting point to change the musculoskeletal unbalance of the body. Even though the changes we created will not last long unless there is constant work done on it. So, when the client returns to routine life, those change tends to disappear quickly. That’s why we give clients exercises. How can exercises help? Exercise can help address everyday muscle weakness, joint stiffness and or painful presentation on your own time. And yes, I understand it’s hard to find the time to do exercises, but would you rather live a life in pain or find a way to feel better about yourself? It’s part of our behaviour to want the fast, quick and immediate change we want. Isn’t it?! But nothing comes easy in life. We must learn that changes take time, and along this time, we must work hard for it. Said so, I am more than happy, and I feel honoured to treat people. I feel like Massage skill is one of the skills that can change people’s life. And when I do run a Thai Yoga class and teach people the exercises, I feel even more accomplished as a massage therapist. Book your next massage session by clicking here if this post talks to you. In conclusion, postural exercises are the key if you are willing to get rid of the body ache and pain. Then, working at the gym or doing sports activities is still as important. But those activities, if not monitored by a coach or done professionally and with full awareness, can lead to injury and pain. Indeed, when doing strengthening exercises, you want to ensure you correctly use the body biomechanics. But not only that. Indeed, you want to make sure that your joint has enough range of motion to deliver that action correctly. Following this link will give you access to the Thai Yoga Class videos.
Feb
Massage appointments, how often? How often should I come for a massage appointment? Often I got asked this question, and the answer is not as simple as. A massage, that is Remedial Massage, Thai Massage or MLD treatment, has the aim to heal a condition or alleviate the pain. Well, at least that’s the main aim of those techniques. Said so, the second, but not less important task for a massage is to induce relaxation. Therefore, if you are aiming to get some relaxation, I would suggest considering getting a massage appointment regularly. Like, every 2 weeks, every month or every 2 months. Of course, depends mostly on finance. So, a regular massage appointment, allows the body and mind to aim for something positive. It is like a reward. On the other hand, if the message is not limited to relaxation time, then, you may need it more often. That’s the case when the client comes to the appointment that is in pain (99% of the time). If this post is talking to you, book your next massage session by clicking here. The fact that you are in pain can be a sign that the body issue has been there for a while. Indeed with a massage, we can alleviate the pain, but to actually fix the issue (if it’s fixable by the way) or to make the best out of what the condition is, we need to do more than one session. In fact, one session may release the pain for a couple of days, but then, as you go back to your daily routine, the pain would come back. Therefore, a series of close massage appointments, in a short time can actually help for the best. Another important aspect of pain management is exercise. Corrective exercises are a key role in expanding the time between one session and the next one. If you actually do the exercises, you can by yourself improve your body conditions, reducing the risk of injury and pain. In conclusion, the frequency for which you should attend a massage appointment is based on your needing. For a Remedial massage or a Thai Massage, you may wanna initially see the therapist once a week for the first 3 to 4 weeks. With MLD is different. With MLD the need for seeing a therapist can be more frequent. Obviously depending on the condition that has to be treated.
Jan
MLD and Pain. As previously mentioned, MLD is a massage technique pain-free. This is one of the reasons that makes it so special. It doesn’t matter where the technique is applied, the touch has to be so light, that the patient doesn’t have to feel any pain. And believe it or not, MLD can be applied right after surgery, when you get sunburn or right after physical trauma. Indeed, what MLD does is prevent the body to feel the pain. So, in order to explain this, I may use the mosquito bite example. When a mosquito bites us, after several minutes we start to feel itchy. In fact, the first auto-reaction is to start stretching the body. What does the scratching do? Firstly, by scratching, we stimulate the mechanoreceptors of the skin. The mechanoreceptors, send a signal to the spine (to CNS) that inhibit the pain receptors, which are constantly stimulated from the mosquito bite. Indeed, the pain receptor can be stimulated once and keep reacting, whereas the touch receptors, in order to be activated need constant stimulation. Now, in MLD that’s what we do, we constantly and gently stimulate the mechanoreceptors. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. In fact, we keep inhibiting the pain receptors, reducing the pain signal frequency. Secondly, and no less important, by stimulating the lymphatic system activity, we reduce the amount of nociceptors. Per nociceptor, we refer to the actual sensory neuron that transports the pain signal to the spine and brain. Furthermore, by reducing the pain, the client can start experiencing a high state of relaxation. Indeed a high state of relaxation is another efficient way to deal with pain and eventually pour mobility, due to the injury the client is dealing with. In conclusion, this is how MLD can reduce the pain in an injured area.
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