Neck pain and or upper back pain often originates from a disbalance of mobility and stability joints along the spine, including poor scapula-thoracic joint stability and thoracic mobility. Indeed, a hypermobile scapula can lead to instability, muscular imbalances, and chronic tension in either the shoulder joints or the cervical. Therefore, assuming that neck pain is only a neck issue is a bit limiting. We need to look at the bigger picture and target the right reason why you are in pain. In this blog, we are going to look at how scapular stabilisation exercises can restore balance, enhance posture, and reduce neck pain. Understanding Scapular Stability and Hypermobility The scapula, or shoulder blade, plays a vital role in upper-body movement and stability. It acts as the foundation for arm motion, connecting the humerus to the thorax through the scapulothoracic joint. When control is compromised, which is common for those with general hypermobility or for those who have scapular hypermobility, the result can be excessive movement and discomfort. Consequences of having a hypermobile scapula are: Neck and shoulder pain Reduced athletic performance Increased injury risk Muscle fatigue and tension As is often recommended, we need to look at strengthening as a way to improve muscular control of the joint, and in this case, we would look at: rhomboids, trapezius (upper, middle and lower), and latissimus dorsi, which is essential for restoring balance and function. Mobility Comes First: The Foundation of Stability As already mentioned in so many other blogs, and as I educate my clients all the time, before introducing strengthening exercises, mobility must be addressed. A stiff thoracic spine forces the scapula to compensate for many shoulder movements, leading to muscles originating and or inserting in the scapula to be overused, leading to pain and discomfort. Essential Thoracic Mobility Exercises There are some really easy exercises that you can do to pick up on thoracic mobility. Here is a short list: Foam Roller Thoracic Extensions Open Book Rotations Thread-the-Needle Cat-Cow Mobility Drill Diaphragmatic Breathing Exercises Those exercises would help in restoring thoracic mobility, preparing the groundwork for effective scapulothoracic stability exercises. Key Muscles for Scapular Stabilisation Now we can look at the muscle that we would need to strengthen to create a better scapular stabilisation. Rhomboids Function: Scapular retraction and stabilisation. Importance: Provide postural support and control during pulling movements. Recommended Exercises: Resistance Band Rows Prone T Raises Seated Cable Rows All those exercises can be easily delivered at home, with some decent resistance bands, or with light weights. But don’t let the simplicity of these rhomboid exercises fool you, as prone T raises, to start with, are enough even with no weights, as the weight of your arm is already enough. Trapezius (Upper, Middle, and Lower) Function: Elevation, retraction, and upward rotation of the scapula. Each fibre group has a different role regarding the scapula movement.Importance: The lower trapezius is essential for shoulder stability and posture. Recommended Exercises: Prone Y Raises Wall Angels Face Pulls Shoulder Shrugs Again, those exercises don’t require a full gym set-up, but some strong resistance bands and light weights would do. Latissimus Dorsi Function: Shoulder extension, adduction, and thoracic stability.Importance: Connects the upper limbs to the trunk and supports efficient movement. Recommended Exercises: Straight-Arm Pulldowns Lat Pulldowns Assisted Pull-Ups Resistance Band Pulldowns Scapular Stabilisation Exercises for a Hypermobile Scapula Now that we have looked at which exercises are ideal for what muscle or muscle group, we can look at a combination of those based on generic fitness levels. Those exercise lists are obviously a generic recommendation, and unless we have already done some work and assessment, I would not suggest picking and choosing an exercise routine and trying your best to sort out your pain. Beginner Level Scapular Setting Exercises Wall Slides Isometric Holds Against a Wall Serratus Anterior Punches Intermediate Level Prone Y and T Raises Resistance Band Pull-Aparts Face Pulls Incline Dumbbell Rows Advanced Level Landmine Presses Farmer’s Carries Overhead Carries Pull-Ups with Controlled Scapular Movement Furthermore, these exercises for scapular stability enhance neuromuscular coordination and are particularly beneficial for individuals with hypermobility. How Scapular Stability Reduces Neck Pain While we can’t directly associate hypermobility of the scapula with neck pain, we also know that poor scapular control often leads to overactivation of the upper trapezius and cervical muscles, contributing to neck pain. By strengthening the stabilisers of the scapulothoracic joint, mechanical stress on the neck is reduced. Therefore, here is a list of the benefits of scapular stabilisation exercises: Improved posture Reduced neck and shoulder pain Enhanced thoracic control Increased muscular endurance Better movement efficiency Lower risk of injury How We Support Scapular Stabilisation at Melbourne Massage and Treatment At Melbourne Massage and Treatment, in Fitzroy North, the treatment of scapular stabilisation starts from a tailored assessment of your presentation, looking at: Overall hypermobility Your clinical history Past and present sports activities Site of pain Pain time frame That and more information are essential to understand what your experience is, and what we can do about it. Hands-on treatment, like remedial massage or myotherapy, would be the first step to relax the body and allow you to feel and move better. The next step from that would be guiding you throughout exercises that you can deliver at home or at the gym, at your own time, so that you can take control of your pain and your presentation. All of this can be easily delivered along a treatment plan. And to simplify the whole process, I also offer a FREE 15-minute Online Consultation, where we can start looking into your presentation and understand what has been done till now and what needs to be done at this stage.
Tag Archives: myotherapy
If you have been at the clinic most recently, you may have heard me talk about LLLT (Low-Level Laser Therapy). LLLT is one of those tools that quietly adds a lot of value to any treatment modalities I get to offer, without making a big fuss, and without increasing the service fees. So yes, in this blog, we are going to look into why I use it, what the science says, and, most importantly, what it can do for you. First Things First: What Is Low-Level Laser Therapy? The simplest explanation I can share is that LLLT (also called photobiomodulation) uses specific wavelengths of light to stimulate your body at a cellular level. Indeed, LLLT is not a hot or burning type of laser, but it is a low-intensity, non-invasive light that interacts with your tissues to encourage healing and reduce pain. This is possible because LLLT stimulates the cell in producing more ATP energy (cell energy) which than can be used for the cell to replicate. Simply, it helps your body do what it’s already trying to do, just more efficiently. What Does the Science Say About Low-Level Laser Therapy? As a practitioner who offers his service based on scientific recommendations, I’m very particular about what I bring into the clinic. If it’s not backed by solid research, it doesn’t stay. Therefore, here’s what recent PubMed evidence tells us: Pain Reduction In a systematic review by Diaz et al. (2025), they looked at 44 randomised clinical trials and found that LLLT can reduce pain by 60–70% in certain musculoskeletal conditions (in this case, TMJ) while also improving function. When a systematic review shows such results, it is considered strong evidence. Supports Injury Recovery & Reduces Inflammation When looking at Lawrence J. Sorra K., (2024) review, that did focus on Low-Level Laser Therapy (LLLT) for Acute Tissue Injury or Sport Performance Recovery the highlighted facts about LLLT are: Modulate inflammation Improve tissue repair Support recovery after injury All with minimal risk or side effects. That said, in this review, it is also highlighted how, in acute injury, there is a lack of evidence for LLLT effectiveness. In conclusion, than, is shown how no side effects are present and how LLLT is a safe therapy to be add to other modalities, especially fitness classes. Works Best as an Add-On (Not a Replacement) About this last statement, that LLLT is not a substitute for other modalities, we have a meta-analysis by Awotidebe A. et al. (2019), which shows how LLLT can provide additional short-term pain relief when combined with exercise or therapy, even if it doesn’t always change long-term function on its own. And this is the key point most people miss. LLT is not magic; It’s a multiplier. Exercises are the medicine. Why I Use LLLT at Melbourne Massage and Treatment? I decided to invest in the usage of Low-Level Laser Therapy SymbyxBiome DuoCare 904, which operates in a wavelength range consistent with what research suggests is effective (typically around 800–900nm), as it can be an effective treatment modality to help my patient feel better, reduce their inflammation and pain, so that they can move better and be able to deliver exercises without bein in too much pain. And here is another important part: I don’t charge extra for it. Why? The answer is simpler than you may think. LLLT is not a “standalone service” in my philosophy; it’s a value-add. If it can: Reduce your pain faster Help your tissues recover better Improve your overall outcome Then, as with any other therapy, it belongs inside your session, not on top of your invoice. What LLLT Does Feel Like? When telling people what LLLT feels like, I respond with: “Drop your expectation”. In fact, you will feel: No heat No discomfort No downtime And yet, underneath the surface, your cells are being stimulated to: Produce more energy (ATP) Improve circulation Reduce inflammatory markers That’s where the real magic happens. It is a way to make your body do what it does normally, only faster. And there is no side effect. What Condition Can Benefit Best From LLLT? Conditions where LLLT is recommended for are: Persistent muscle pain Tendinopathies Jaw pain (TMJ) Post-injury recovery Fibrosis Scar tissue Any presentation would need treatment that lasts 10 to 20 minutes, and the frequency of treatment can be 2 to 5 times a week, with results of pain relief after 3 to 6 weeks. Those numbers vary depending on the type and location of the injury. What we know is that for the early stage, it is better to have more frequent treatment, and after week 1, the treatment can drop from 4 to 5 times a week to 3 times a week, till once a week for major injury if the treatment has to go on for 5 to 6 weeks. Why Frequency Matters As mentioned above, LLLT works by stimulating your cells, particularly the mitochondria, to produce more energy (ATP), which helps with: Tissue repair Reducing inflammation Pain modulation But that effect doesn’t last forever; cells need a more frequent stimulation to obtain the best results. Therefore, if sessions are too far apart, you lose momentum, but if they’re too close without reason, you’re not adding extra benefit. So that’s why, in the initial phase of an injury, we work more often to boost the recovery, and once the recovery is nearly optimal, and you are doing your exercises and structural strength, then the LLLT session can be placed further apart. What Is The Bottom Line Regarding Low-Level Laser Therapy? After so many years in the massage industry, and after all the research and studies of different modalities, there is one thing that I have learned. There’s no single “miracle treatment.” But, on the other hand, there are combinations that work extremely well together. Hands-on therapy + movement + the right adjunct tools, that’s where results happen. And LLLT is one of those tools. So drop your expectation of magic and no effort […]
Neck pain is such a common presentation, and often I have to hear from my clients that it is due to them storing stress in their neck or shoulder. I can’t think of how many times I heard this, and how many times I than have to ask questions like: “When was the last time you did some neck-strengthening exercises or movement for your neck?” “If you work in an office, how many screens do you have in front of you, and which one do you look at more often?” “Have you ever had a whiplash? And if yes, have you done anything about it?” As you would imagine, the answers are anticipated by a moment of silence, thinking and then in order of question: “I never do neck strengthening exercises, at best I do some stretching”. “2 or 3 screens and I look at the one on one side most of the time”. “Yes, but it was xx years ago, and I haven’t done anything about it, as I was too young to care about it”. Now, I believe that those answers are already going to give you an idea of where that pain may come from. In fact, the neck isn’t just tight, it’s often weak and poorly controlled. To fix that, we need to understand how the neck actually works and how we can strengthen it. Why Neck Strengthening Matters (Mobility vs Stability) Each cervical spine is unique, and we can all present with different needs and capacities for movement. Indeed, a hypermobile person may find their neck to be really mobile and easy to twist and turn. Hypermobility, as discussed many times, is an advantage for flexibility, but it comes with the cons of joint weakness and a higher risk of joint injuries. So, when looking at the cervical area, we may notice that it sits at the top of the joint chain, meaning everything from your shoulders to your lower back influences it. Specifically, the cervical is made of 2 joint sessions: The upper neck (C1-C2) is built for mobility (turning, nodding) The lower neck (C2-C3) is built for stability (supporting your head) When that balance is off, you’ll often notice: Neck stiffness Headaches “Poor posture” (forward head position) Ongoing discomfort Fortunately, those statements are backed up by recent research that shows how strengthening deep neck muscles improves pain, posture, and neuromuscular control, especially when mobility and stability training are combined. Chin Tucks (Deep Neck Flexor Strengthening) Chin Tucks are simple and effective neck strengthening exercises that I often prescribe for neck pain. Let’s then look at a series of progressions for this type of exercise: Chin-Tuck in all four: Position yourself in all four, with hands under the shoulder, and knees under the hips You will be looking at the floor where you have placed an object, right between your hands. Now retract the chin, while you keep looking at the object between your hands. Release the chin and repeat. This version of chin tuck is ideal for: Early rehab. People with pain or poor control. Learning correct movement without compensation. Chin-Tuck in sitting or standing position: Sit or stand upright (standing is the ultimate progression). Gently pull your chin straight back (like making a double chin). Keep your eyes level. Anyhow, you are going to do these exercises, ensure to do them slowly, and take your time doing them. 4 to 5 second tempo. Why Chin Tuck Works for Your Neck Strengthening This exercise activates your deep cervical flexors, which are the stabilising muscles that support your neck. Those muscles can be defined as stabilisers as they go from the thoracic vertebrae to the upper cervical vertebrae, for the longus capitis, which originates in the lower portion of the cervical (C3-C6) and inserts at the basilar portion of the occipital bone. When these muscles are weak: Your head shifts forward Larger muscles overcompensate (SCM) Pain builds over time Isometric Neck Exercises (Build Stability in All Directions) Isometric exercises are an optimal exercise that places major focus on tendons and ligaments, and are ideal for acute symptoms and warm-up pre-training. How to do it: Place your hand on your forehead and gently push into it (no movement) Repeat on: Back of your head Left side Right side Hold each for 5–10 seconds Perform 5 reps per direction This form of exercise can be applied in any direction of movement, such as flexion, extension, lateral flexion, rotation and mixed movement, like flexion on the diagonal side. Why it works: Isometric exercises are applied to pain-free range of motions, so while you move and contract the tissues, you are not experiencing pain, your brain gets triggered to be safe while the body moves, and your musculoskeletal tissues get looked after as they get activated and contract. This would help in improving joint stability and control. Shoulder Shrugs – Let’s Make Those Muscles Work Shoulder shrugs are a simple but effective way to build neck stability through the upper trapezius, which plays a key role in supporting the cervical spine as part of the broader joint chain. How to do it: Take in your hands a pair of weights, or an elastic band, which would you make pass under your feet. Gently lift your shoulders up toward your ears, pause briefly, then lower them with control. Why it works: Shoulder shrugs exercise does work by placing shared-load capacity between the neck and shoulders, reducing the strain on the cervical spine. On the other hand, when working on the cervical joints, it is ideal to intervene also on joints that are muscle-connected to the cervical itself, by adding global muscular support, which is essential for everyday loads. How These Exercises Fit Into the Joint Chain Your neck doesn’t work alone. As mentioned in many other blogs, all the body’s joints are part of a bigger system, the joint chain of mobility and stability. Therefore, if you present with: Tight shoulders A stiff thoracic spine Lack of movement […]
While I guide my client during a 1:1 fitness class at Melbourne Massage and Treatment, a Myotherapy clinic in Fitzroy North, on how to learn using bands or a single-column pulley machine to practice KLT (Kinetic Link Training), I often get asked how someone should or shouldn’t do a lunge. “Should my knee go ahead of my toes?” “Should my knee stay on top of my ankle?” “What about my back? Should I hinge or stay straight?” The answer to those questions lies in a simple fact: what part of the body are you trying to train? Are you aiming to build more glut (posterior chain) or quads (anterior chain)? No, because there is no perfect lunge, as either right or wrong. As per the squat, there is the lunge that works for you, for your presentation and for your goal. The Two Main Lunge Strategies (And Why They Matter) So, when we talk about lunges, most people are really debating between two variations: Knee Travels Forward (Past the Ankle Line) When going for this variation, we have to conceptualise that the knee is going into a deep flexion, right? Now, if the knee has to come out of flexion, the quads are the muscle that needs to be engaged. (Quads are the knee extensors). The deeper the knee flexion, the more quads fibres are engaged to do the reverse to get the extension done. In fact, what this type of lunge does is: Increases knee flexion Increases quadriceps demand Places more load through the patellar tendon Furthermore, research shows that when the knee moves forward, quadriceps force and knee joint stress increase significantly. In a super summary: This is a quad-dominant lunge. Vertical Shin (Knee Stays Over the Ankle) On the other hand, when delivering a lunge movement and the knee stays on top of the ankle, within a vertical shin line, there is a max of 90° knee flexion; therefore, the amount of fibre engaged for the quads is less, and what is than the primary mover for the ascending action, is the gluteus maximum, the biggest glut, which is going to help with the hip extension. So, in this variation, what we are going to achieve is: Shifting the load away from the knee Increases contribution from the hip extensors Encourages more posterior chain involvement Therefore, this will be a glute-focused lunge. What Biomechanics Actually Tell Us About The Lunge Exercise While we look at this movement, we may get triggered into thinking that the lunge exercise is knee-dominant because the knee does a lot of movement, right? Well, if we break it down a bit more, as Riemann et al. (2012) did, we find that yes, the knee moves a lot, but what really takes the load during the lunge movement is the hip. So this is how we can break it down: The knee moves more (kinematics). But the hip produces more force (kinetics). Why this is a thing, then(?) you may ask. Well is tru that the knee move a lot, it can flex up to 90° and still this can be a hip dominant exercises, but, we have to think that the knee, while it is moving that far, is not placing much load on the lower fibers of the quads, and the joint that has to push against gravity, in the ascending phase, are indeed the hip. That’s where all the load actually is. The weight of the upper body. The Lunge Game-Changer: Add a Hip Hinge And here is where we can add a twist to the lunge, by going into hip hinging. What happens if we do so? The glutes are placed under greater stretch at their origin. This increases mechanical tension. You get better glute recruitment and carryover in strength. In fact, this is not just theory, but it’s basic muscle physiology: Muscles produce more force when stretched under load. Therefore, by hinging at the hip, you are not only going to feel more burning sensation in the glutes, but you are going to train them even more effectively. Why Toe Mobility Is the Missing Piece Now let’s talk about something almost no one considers: Your toes. As often happens, the toes and feet are not taken into consideration when looking at functional movement. Even though every leg movement starts from there. In a proper lunge, especially for the rear leg, your toes need enough mobility (extension) to: Accept vertical load Stabilise the movement Prevent your body from shifting forward Indeed, if you lack toe mobility: The movement gets projected forward Load shifts into the front knee and quads You lose posterior chain contribution To support those statements, a study by Harato et al. (2019) examined how foot and toe positioning directly affects knee mechanics and load distribution. So to clarify, the mobility-stability joint chain must always be taken into consideration when we look at functional movement. In this case, your toes aren’t just along for the ride; they’re controlling where the force goes. So… Which Lunge Is Best? I hope that by now, you have an idea of what answer is coming up: Neither. There is no best lunge, as there is no best squat. The forward knee lunge is not “bad”; it’s a tool for quads. The vertical shin lunge is not “safer”; it’s a tool for glutes. The mistakes are thinking that: One can replace the other one. Having an injury in the knee, and thinking that lunges are not your thing anymore. That’s why, at my clinic, Melbourne Massage and Treatment, here in Fitzroy North, I always emphasise to my clients to understand that: “Don’t chase perfect technique — chase the right stimulus.” And to get to a better technique, better than what your body can deliver for now, is a step-by-step journey. And when there is an injury, we have to be confident in the tissue’s healing timeline, and exercises with load are the best tools to help with that. How I Use This With My […]
At Melbourne Massage and Treatment in Fitzroy North, as a clinical Myotherapist, I am enthusiastic to offer 1:1 fitness class that aim to improve your wellbeing and body strength. And one thing that I will never stop surprising my clients with is that it is never too late to start working on their strengths, no matter their age, gender, and capacity. Whether you’re recovering from injury, managing persistent pain, navigating age-related changes, or simply want more energy and confidence, personalised fitness is transformative. Why Starting Now A 1:1 Fitness Class Matters? Strength Training Improves Physical Health at Any Age Have you ever heard an older person wishing to be weaker? No, don’t you? That’s why strength and resistance training aren’t just for elite athletes or bodybuilders; they’re essential for everyone. As we age, our body’s natural capacity to regenerate, including regenerating muscle mass and strength, bone density, and other body tissues, naturally declines, which can affect balance, mobility, fall risk, and independence. Resistance training reverses this decline and improves functional outcomes. A systematic review by Kashi K. S. et al. (2023) found that resistance training significantly improved muscle strength, physical function, and reduced symptoms of depression in older adults. Exercise Matters for Mental Health Too Exercises are not only the best way to maintain physical health but also have an immense impact on our mental health. And that is a 1:1 fitness class or a group class, regular exercises can really change how you feel within your head. Infact, we have plenty of evidence from Recent Research that looks into this: A review by Ayaz A. et al. (2026) highlights how aerobic, resistance, and mind-body exercise modalities have psychological benefits, from improved mood to reduced stress and anxiety. Study by Ma Y. and Mumtaz S. (2025) finds that structured exercise programs improve mental well-being by activating neurobiological and psychosocial pathways. Meta-analysis by Rossi E. (2024) showed that strength training has moderate and significant antidepressant effects in adults with depressive symptoms. So yes, your workouts aren’t just changing your body, but they’re changing your brain. Why 1:1 Fitness Classes Are Especially Effective While training is beneficial for everyone, for physical and mental health, personalised training, like a 1:1 fitness class, makes a huge difference, and here’s why: Training Tailored to You Everyone has different goals when starting a fitness journey, or while they are training, and everyone has different needs and capacities, on which the goal is shaped. Therefore, a 1:1 fitness class session allows for customised programming that matches your goals, health history, injury status, and movement patterns, which generic videos or crowded group classes rarely provide. Expert Guidance Prevents Injury At Melbourne Massage and Treatment, I am proud of the studies I done (a Bachelor in health science clinical myotherapy, and following courses like the KLT training) and the effort I put in place to improve my fitness and communication skills, which led me to offer a tailored program for any of my clients. For people with pain, past injuries, or chronic conditions, this is crucial. Motivation and Accountability I often come across clients who don’t feel confident enough in themselves, who don’t like the gym and think that strength training for them is not a thing. And that’s when I can’t stop thinking about how powerful it is to change their mind by showing them how a few minutes of well-done movement, either with or without load, can change everything. That’s when I get them in for Fitness Class here in Fitzroy North, and I help them achieve their goals. Personalised Follow-up On top of a tailored 1:1 fitness class in person, what makes the difference in terms of service here at Melbourne Massage and Treatment, when I show some exercises, I will send you a PDF file with the picture and the description of the exercises, to ensure you will be bale to replicate those exercises anywhere you are ay your own time and comfort. Fitness Class Comes With An Added Bonus — Better Bone and Cardiovascular Health The action of lifting weights and lifting heavy is seen from your body as a positive stress, which creates a concatenation of benefits. Along those we find: Bone regeneration – increase of bone density Maintaining metabolic health Improving markers related to heart disease and diabetes Improve or maintain optimal equilibrium – poor equilibrium is the major cause of falls. And more… All the benefits a fitness class can deliver are crucial as we age. No one, as they age, wishes that their health gets more and more compromised, isn’t it? Start Where You Are — It’s Not About Perfection Whether you’ve never stepped foot in a gym before, you’re returning after an injury, or you’re trying to break a cycle of inactivity, the best time to start was yesterday. The next best time is now. It is never too late to start working on your strength, and this is the most important message I find myself passing on to my clients. The body can always adapt to load. And no matter if you have just started or you are a pro, you will always have to face some challenges. Therefore, start working on your mobility, improve the way your body can move, let’s than load it a little at the time, and build your own journey into wellbeing day by day, fitness class after fitness class. Final Thoughts You don’t need to be “fit enough” to start a 1:1 fitness class, and it’s absolutely never too late. Here’s the truth I’ve seen in across many clients: People in their 40s, 50s, 60s, and beyond see meaningful gains, both physically and mentally. Individualised guidance accelerates progress safely. Strength and structured exercise improve both quality of life and mental well-being. If you’ve been thinking about starting a fitness journey, come and talk to us at Melbourne Massage and Treatment, Fitzroy North. For those who decide to commit to a change, a positive change, for their well-being, there are 5 or […]
Here in Fitzroy North, at my Myotherapy Clinic and 1:1 fitness class studio, I get to work with a wide range of clients, and what I notice is that there is a lack of knowledge and awareness on how to deliver a Glutes Strengthening. And why I believe that a squat is important is simply because squatting is an action that we do so often throughout the day that we all should be good at it, and it is the best functional movement that allows you to reinforce the full body structure. Therefore, when I come across those presentations, I ensure to educate my patients about the basic mechanics of a squat, including mobility, stability, and glutes strengthing. Are You Looking Into Glutes Strengthening? Let’s Check Your Joint Mobility and Stability First In order to deliver effective training for your glutes, including delivering an efficient squat, you will look at: Adequate ankle mobility A well-coordinated hip hinge Stability in fee tarsals and knee joints Those are regular things I would look at during a myotherapy treatment and 1:1 fitness class in Fitzroy North, to improve glute activation, movement efficiency, and injury resilience. Ankle Mobility Exercise to Improve Squat Depth and Lower Limb Mechanics As discussed in greater depth in the mobility and stability blog, before we start looking at strength and start working on functional movement, like the squat, we want to ensure that the mobile joints are mobile enough to deliver the right mechanics. In fact, limited ankle mobility often results in compensatory strategies such as: Excessive forward trunk lean during squats Early heel lift Increased stress on the knees or lumbar spine Clinical Importance of Ankle Mobility Adequate ankle dorsiflexion allows improved tibial progression during squatting movements, enabling more effective hip and glute loading. Exercise: Knee-to-Wall Ankle Dorsiflexion Drill Position the foot flat on the ground, facing a wall Aim for a 10 cm distance between the big toes and the wall Maintain heel contact with the floor Drive the knee forward toward the wall under control Perform slow, controlled repetitions Your aim is to teach the wall with the kneem, with a big toe-wall distance of min. 10 to 12 cm Clinical application:This exercise is commonly prescribed in myotherapy sessions to improve squat mechanics, reduce compensatory loading, and support long-term joint health. Hip Hinge Drill for Posterior Chain Activation and Spinal Control The hip hinge is a fundamental movement pattern required for safe and effective loading of the gluteal muscles, but not only that, indeed, poor hip hinge mechanics often present as excessive lumbar flexion or extension during deadlift-based movements. Why Hip Hinge Mechanics Matter Efficient hip hinging can help with: Increases glute and hamstring activation Reduces lumbar spine strain Improves RDL and deadlift performance Exercise: Wall-Assisted Hip Hinge Drill Stand approximately 20–30 cm from a wall Push the hips posteriorly to make contact with the wall Maintain a neutral spine and rib position Return to standing using glute contraction (squeeze those glutes) Clinical focus:This drill is a key component of both rehabilitation and performance-based programming at Melbourne Massage and Treatment. It is also a fundamental movement pattern taught in my glute-focused fitness classes, ensuring clients build strength safely and efficiently. Stability Starts From Your Feet Foot stability is a crucial part of delivering a good squat, especially during a low-bar squat, when feet are flat on the ground. Imagine your feet unable to give a stable direction to whatever is above, like the ankle, knee and hip. This would lead to knee shaking during squatting, and once the squat load increases, the risk of injury rises. So for foot stability, we look at: Even weight distribution of your load along the plantar of the feet, not only on your toes or on the heel. All toes, grabbing the floor, throughout the squat performance Lower-bar squat, feet flat on the floor (be barefoot or use gambaletto type of shoes) and feet wider than hip, stand in slight external rotation High-bar squat, feet open wide as hip stand (so a narrow stand) and heel well elevated. In both my clinical work and my strength-based fitness classes, foot stability is always assessed first. On the other hand, more about the high and low bar squat is available from this blog. Squats for Functional Glutes Strengthening In my glute-strengthening fitness class sessions, the squat is one of the primary movements we refine. Keep in mind that when we talk about squat for glut strength, we always refer to the lower-bar squat. Therefore, when performed with appropriate technique, this exercise is the most effective exercise for developing functional glutes strenghtening and improving lower-limb coordination. Below, you will find the most common Clinical Faults in Squatting Limited ankle mobility restricting depth Poor hip control resulting in lumbar compensation Reduced gluteus contribution due to motor control deficits So this is what you need to focus on to for a Optimal Glute Engagement while squatting: Maintain even foot pressure throughout the movement Maintain spinal alignment and controlled descent Drive upward through the heels and mid-foot Clinical note:Squat depth should be dictated by movement quality rather than arbitrary range targets. Romanian Deadlifts (RDLs) Another Glutes strengthening Exercise The Romanian deadlift, in comparison to the conventional deadlift, is a partial movement, where the load never touch the ground throughout the exercise (once it gets picked off the ground). This type of lift is ideal for exercising the posterior chain, particularly in the gluteal and hamstring musculature. Benefits of RDLs in Myotherapy and Strength Training Enhances glute and hamstring load tolerance Improves hip-dominant movement capacity Reduces injury risk through controlled eccentric loading RDL Execution Guidelines Maintain close bar or weight proximity to the body Initiate movement via hip hinge, not knee flexion Maintain spinal neutrality throughout the range Terminate the movement when pelvic control is lost Clinical relevance:RDLs are regularly integrated into rehabilitation and strength programs for clients with lower back pain or who are returning to lifting after injury. But are also ideal to build […]
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.
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 […]
ACL stands for anterior cruciate ligament, and is the strongest ligament in the knee. ACL injuries can be time-consuming, depending on the severity. At Melbourne Massage and Treatment in Fitzroy North, I offer an ACL rehab program that aims to help you recover based on your clinical history, daily activities, including your sports, if any, and consider that the healing time can’t be boosted, but assisted. ACL – What It Is? ACL is the strongest ligament in your knee, and connects the femur to the tibia. Its role is to keep the knee stable, especially during activities that involve sudden stops, changes in direction, or jumping. You can then understand why so many athletes or sports lovers end up with an ACL-type injury. As with all ligaments in our body, the ACL doesn’t have an excellent blood supply, which makes its recovery longer, compared to what can be a muscle injury. What is Myotherapy and How Can It Help with ACL Rehab? Myotherapy is a hands-on treatment method that targets muscular pain, improves joint mobility, and addresses the root causes of musculoskeletal injuries. For ACL rehab, this approach is essential because an ACL injury affects not just the knee but the surrounding muscles, joints and movement patterns. Hands-on treatment can indeed be a good start for rehab and injury, as it not only creates a trust between the patient and the therapist, but can help in creating better awareness of the muscles, which in a second phase of the myotherapy appointment are going to be used for delivering tailored and injury-specific exercises. The goal is to support your ACL recovery and knee rehabilitation holistically. ACL Injury: Scan and Manual Test There are several methods of diagnosing an ACL injury. Scans: Arthroscopy – A keyhole surgery, where a camera is inserted in the knee to check the level of injury. Partial or complete ACL tear. Magnetic Resonance Imaging (MRI) – Less invasive than an Arthroscopy, but still expensive to run. Indeed, it is rare nowadays; in Australia, you can get an MRI prescribed for this presentation. More information is available here. Manual Test Lachman test Lateral Pivot Shift Test Anterior Draw Test Those together with an attemptive clinical history, range of motion and functional test would help to tailor a conclusion on a possible ACL injury. ACL and Surgery – Is Surgery Still a Thing? Surgery techniques and technologies have come a long way from what we could expect, and yes, ACL surgery is still a thing. That said, before going for surgery, you will be asked to try and recover from your injury with conservative treatment, like a rehab program. The reason behind this is: Suregey cost and pressure on the public health system Rehab gives as good results as surgery most of the time Surgery also goes by the severity of your injury – is any other knee tissue/structure injured, or is it only the ACL? Post surgery, you still have to go for rehab, and it would still take 6 to 12 months for a full recovery. Athletes may benefit the most from ACL surgery, given its longer-lasting effects on knee stability. More information about ACL rehab vs ACL surgery is available from the systematic review by Papaleontiou et al (2024). The ACL Rehab Phases: Strengthen Beyond the Knee To recover from an ACL injury, we need to look behind the mechanics of your lower limb, and set a starting and and ending point of recovery. Acute Phase In the acute phase, which is the first one to two weeks after injury, we may focus on isometric holds, gentle movement, and spend more time on hands-on treatment. In this phase, the aids of crutches is mandatory. Strength Phase Past the acute phase of the injury, you will notice how it would be easier to engage the knee joint, as the swelling would be eased, and therefore, you can achieve greater movement. There, we will start incorporating eccentric and concentric loads, with some light-weight or light-resistance bends. This phase can last somewhere between 10 and 12 weeks. All of these would be a step-by-step process. So the loads would be progressed weekly, based on the strength and mobility outcome. Sometimes, you will have to push through some mild pain, but the most important thing is that you keep that joint moving, and have good rest, good food too, to enhance the recovery at its best. Return to daily activity – RDA In the final stage, the focus would shift to plyometrics, an essential part of ligament rehab. That’s where we would re-train your knee to act pre-injury time. This can take another 12 to 24 weeks. It all depends on the severity of the injury and what your needs, in terms of sport or daily activities, are. So, the combination of myotherapy treatment with targeted rehabilitation exercises and fitness classes for recovery is what makes Melbourne Massage and Treatment service stand out. In my rehab-focused classes, we work on: Strengthening the muscles that support the ACL Improving balance and stability to prevent re-injury Gradual conditioning to safely return to sports, running, or everyday activities My Personal Approach At Melbourne Massage and Treatment, I work one-on-one with each client. I assess your movement, identify areas of weakness or tension, and design a personalised ACL rehab program. To be even more specific to your individual presentation, I do use THE MAT as an aid. A measurement tool that allows me to test your mobility and stability, giving us objective numbers and data to work on, too. Recovery from an ACL injury takes time, but with the right approach, you can regain full function and return to the activities you love. I’m here to guide you through every step of your ACL rehabilitation journey. If you’re ready to start your ACL rehabilitation in Fitzroy North or want to see how myotherapy can help, book a session with me at Melbourne Massage and Treatment today. Let’s get you moving stronger and safer than […]
As a Myotherapist and Lymphoedema Therapist here in Fitzroy North, I’ve always believed that movement is one of the most powerful tools for health. Exercise isn’t just about getting fit; it’s about feeling stronger, moving with ease, and living life without pain. Recently, I completed professional training in Kinetic Link Training (KLT), and it gave me the opportunity to see fitness classes and rehabilitation programs under a new light. I’m now offering KLT sessions in Fitzroy North as part of my fitness class at Melbourne Massage and Treatment, in order to help clients move better, recover well, and build long-term strength. Why Exercise Is Good for Everyone The benefits of regular exercise are many, including: Improves muscle tone; Boosts energy Supports joint health; Improves posture; Reduces stress So it doesn’t matter what your goal is, whether you are recovering from an injury, working a desk job, or simply wanting to feel stronger, functional movement training is one of the best investments you can make in your health. That’s why we said that movement is medicine. And Kinetic Link Training is ideal for any fitness level, given the simplified structure of its exercises, and the fact that its setup can be easily replicated at home with some resistance bands and some light dumbbells. How Kinetic Link Training Is Different from Conventional Training More traditional gym workouts often aim to work one group of muscles at a time, with a primary focus on agonist muscles, agonist to a certain movement, such as bicep curls, leg presses, and shoulder raises. Nothing wrong with those exercises, they definitely help you build strength, yes, but not always functional strength. That’s where Kinetic Link Training is different, as KLT is built around integrated, full-body movement patterns that connect the upper and lower body through controlled, coordinated actions. Instead of training one movement at a time, you train the body as a connected system. This style of training improves: Core stability and posture Joint mobility and balance Real-world strength and coordination To simplify it, KLT helps you move better, not just lift more. Therefore, having a goal in mind when choosing to start training can help you define the type of training you may need and want to go for. Kinetic Link Training Is Also Ideal for Post-Surgery and Injury Recovery Rehab KLT is an excellent option for rehabilitation and post-surgery recovery. A few keys component that makes KLT so safe are: Low-impact exercises Controlled movement Entirely adjustable for your needs You can train easily at home What then makes KLT effective for rehabilitation is the fact that you will be asked to do natural movement patterns that can help in regaining body strength safely. In fact, KTL is ideal for anyone looking to rebuild function, improve range of motion, and return to daily activity with confidence. Perfect for Beginners and Those New to Strength Training If you’ve never done strength training before, KLT is a gentle and intelligent place to start. “Why so?” you may ask. Well, the beauty of KLT is that it allows you to perform any exercise to your capacity, and from there, you can not only increase the load or resistance, but you can also increase the degree of movement. Let’s take, for example, a posterior pull with a double leg squat: In this exercise, you are going to start in a squat position (max depth is quads parallel to the ground), facing the machine or the cable direction, while your arms are fully extended. To deliver the exercises, you will be asked to stand while pulling the cable towards yourself, with the elbows running alongside the ribcage. Now, let’s consider a person who may have difficulty squatting. They are not required to go as deep to start with, but still, they can apply a full upper body range of motion, which is basically like a lat. raw exercise. The depth of the squat would come with time and practice. This is only an example of how exercises can be adapted You don’t need to be strong, flexible, or experienced. The movements are easy to learn and can be scaled to any fitness level. Kinetic Link Training: A Balanced Full-Body Workout Now, another great advantage of KLT is the engagement of the upper and lower body in all its exercises. As explained in the example above, along with the KLT exercises, you are required to engage in: Upper body movement: Push Pull Arch Double or Single arm. Different directions, “from where” and “to where” the cable may run: Very Low Low Mid High Very High With or without crossover. Lower body movement between: Squat – Double Leg, Single Leg, Wide Stand Lunge – Anterior, Posterior, Lateral Calf Raises (as a progression of the end/start of squat movement) Which can also be subcategorised as alternated, Split, Reciprocal, and Partial Standing direction: 0° – Facing the cable 45° – To the cable 60° – To the cable 90° – Your L/R side is facing the cable direction 180° – You are giving your back to the cable direction Now, combine all of those options, and you easily end up with thousands of exercises that engage the upper and lower body with an incredible variety of regression and progression. Indeed, this is why every KLT session integrates upper and lower body movements, creating balanced, total-body strength. This ensures you don’t overwork one area while neglecting another. KLT and Lymphoedema Lymphoedema is a chronic condition characterised by severe swelling of the limb due to failure of the Lymphatic System. It can occur due to a congenital presentation (primary Lymphoedema) or post-surgery (secondary Lymphoedema), as often happens after cancer surgery. To manage a Lymphoedema presentation, exercises are essential, as the lymphatic system is stimulated by muscle contraction. Based on the severity of your lymphedema, we can use KLT to help you boost lymphatic fluid circulation and build resistance in the joints and limbs affected by lymphedema. Functional Fitness Fitzroy North Bringing Kinetic Link Training into my practice […]





