Tag Archives: therapy

Lymphoedema Therapy: Effective Management Strategies

Lymphoedema therapy is crucial for those dealing with this chronic condition characterized by swelling due to lymph fluid buildup. Effective management can significantly improve quality of life, making it essential to understand various approaches.  The Importance of Prevention in Lymphoedema Therapy Prevention is critical in lymphoedema therapy. Early intervention is vital for those at risk, such as cancer survivors or those with this presentation running in the family genetics. Regular exercise, maintaining a healthy weight, and avoiding tight clothing, including underwear and bras, can help support lymphatic health. Other things to be aware of include being vigilant about skincare and promptly addressing any injuries, which can further prevent lymphoedema’s development or worsening. Degeneration and Fibrosis Without proper lymphoedema therapy, the condition can lead to degeneration and fibrosis, where excess fibrous tissue develops in the affected area. Thdis can cause stiffness and discomfort, making it harder for lymphatic fluid to drain. Regular therapy, including manual lymphatic drainage, can help maintain tissue health and prevent these complications. Fibrosis is the body’s response to the constant inflammation created by the accumulation of lymph liquid. Once the fibrosis hardens and starts building up, no lymph capillary can be generated through that. Still, eventually, capillaries and nerves would, making the surgical removal of this type of tissue difficult. Skin Care and Anti-inflammatory Diet as part of Lymphoedema Therapy Proper skin care is essential in lymphoedema therapy. Keeping the skin clean and moisturized helps prevent infections, which can worsen symptoms. As the lymph fluid which is accumulates under the skin is reach in protein, it is important to maintain the skin intact, or the risk of infetioncs would hires exponentially, leading to ulcers and usage of antibiotic for a prolonged period of time. On top of that, to maintain the lymphedema presentation at ease, an anti-inflammatory diet rich in fruits, vegetables, and healthy fats can also support lymphatic function and reduce swelling. Foods like turmeric and omega-3 fatty acids are particularly beneficial. More specifically about the diet, avoiding long-chain fatty acids and processed food (which most often is rich in long-chain fatty acids) is essential, too. This is because those types of fat are absorbed via the lymphatic system, as they are too big (long chain) to be absorbed by the bloodstream directly. So, once those fats are loaded in the lymphatic system, it would be extra work for this already damaged system to get rid of those components. Compression Garment Wear Wearing compression garments is a fundamental aspect of lymphoedema therapy. These specially designed garments help maintain pressure on the affected areas, promoting lymphatic drainage and reducing swelling. It’s crucial to have garments that fit properly, as the right fit maximizes their effectiveness. Indeed, Giovanni would reccomedn to get your garments wear from clinics where the do measurements, and not from the pharmacy, as those last one, they may not follow at best your presentation or limbs. Melbourne Massage and Treatment and Lymphoedema Therapy At Melbourne Massage and Treatment, Giovanni offers Lymphoedema Therapy via services like Manual Lymphatic Drainage (MLD) and Combined Decongestive Therapy. The combination of those treatments allows the reduction of severe swelling within a series of treatments. There is also to say that each presentation is unique and based on other factors, such as diet, skincare and other presentations that may coexist with Lymphoedema, someone may need more time to achieve greater results. However, MLD consists of manual therapy that stimulates the lymphatic system. CDT involves applying compression to the swollen limb, maintaining pressure and making the liquid move. To know more about Giovanni Lymphoedema Clinic services, you can now book your free 15-minute initial consultation. Based on this initial chat, would be easier to evaluate a management plan for your presentation. Conclusion about Lymphoedema Therapy Lymphoedema therapy encompasses strategies that focus on prevention, skin care, dietary choices, garment wear, and infection management. By following these guidelines, individuals can effectively manage their condition and enhance their overall quality of life. Awareness and proactive care are key in navigating the challenges of lymphoedema.

Lymphoedema After Mastectomy | Key Facts You Should Know

Lymphoedema is a condition that can affect many individuals following a mastectomy, particularly those who have undergone lymph node removal as part of their breast cancer treatment. Understanding lymphoedema, its causes, symptoms, and management can help those affected navigate this challenging aspect of recovery. What is Lymphoedema? Lymphoedema is a chronic condition characterized by tissue swelling, usually in the arms or legs, due to an accumulation of lymphatic fluid. It often occurs when lymph nodes are removed or damaged, disrupting the normal flow of lymph fluid through the body. Another reason why someone could end up going through Lymphoedema is severe skin infections that damage the lymphatic system, radiation therapy, or invasive surgeries. Why Does Lymphoedema Occur After Mastectomy? During a mastectomy, when lymph nodes are removed (as in axillary lymph node dissection), the pathway for lymph fluid drainage from the hand and the arm can be compromised as the fluid has nowhere to be discharged at the surgery area. This disruption can lead to a buildup of fluid, resulting in swelling that, if left untreated, can create severe discomfort. While not everyone who has a mastectomy will develop lymphoedema, certain risk factors may increase the likelihood, including: The extent of surgery Radiation therapy Infection Obesity Lack of physical activity Previous or current other injuries to limb/shoulder Surgery was on the side of the dominant hand Be a smoker Symptoms of Lymphoedema post mastectomy The symptoms of lymphoedema can vary in severity and may develop gradually. Common signs include: Swelling in the arm, hand, or breast area A feeling of heaviness or tightness in the affected area Restricted range of motion in the shoulder or arm Skin changes, such as thickening or hardening Swelling doesn’t reduce just by holding the arm elevated Early Detection and Diagnosis Recognizing the early signs of lymphoedema is crucial for effective management. This would help prevent degeneration of the condition and reduce the chance of fibrosis building under the skin, which would lead to longer treatment and possible complications. If you notice swelling or other symptoms, Giovanni is here to help, so don’t hesitate to get in touch. To simplify the diagnosis process, Giovanni offers a 15-minute free phone consultation appointment. During this phone call, we can evaluate whether no pathologies need to be addressed by a GP or other medical staff or if the Lymphoedema management plan can be initiated. Managing Lymphoedema While there is currently no cure for lymphoedema, various management strategies can help reduce symptoms and improve quality of life: Manual Lymphatic Drainage (MLD) is a specialized massage technique that stimulates the lymphatic system and encourages fluid movement.At Melbourne Massage and Treatment in Fitzroy North, Giovanni specialises in the management of Lymphoedema with MLD. Combined Decongestive Therapy (CDT): CDT refers to the application of bandaging that Giovanni would do after the initial MLD treatment. Garments Wear: Wearing compression garments, such as sleeves or bandages, can help prevent fluid buildup and promote lymphatic drainage. Exercise: Gentle, targeted exercises can improve circulation and lymphatic flow. Giovanni at the end of the appointment would show a series of simple exercises that can help you in managing the Lymphoedema swelling. Skin Care: Maintaining skin hygiene and moisturization can prevent infections, which may exacerbate lymphoedema. Diet and Lifestyle: Maintaining a healthy weight and staying active can reduce the risk of developing or worsening lymphoedema. Surgery: In some cases, surgical options may be considered, such as lymphovenous bypass or vascularized lymph node transfer. Support and Resources Coping with lymphoedema can be emotionally and physically challenging. Support groups and counselling can provide valuable resources and community connections. Organizations like the Lymphatic Education & Research Network (LE&RN) and local cancer support services can offer information and support tailored to your needs. Conclusion Navigating lymphoedema after a mastectomy can be daunting, but understanding the condition and implementing effective management strategies can make a significant difference. Early intervention, education, and support are key components in minimizing its impact on daily life. If you or a loved one is facing this challenge, remember you are not alone—reach out to Giovanni and ask how Melbourne Massage and Treatment services can help. FAQ   Q: What is lymphoedema? A: Lymphoedema is a chronic condition characterized by swelling in the arms or legs due to an accumulation of lymphatic fluid. It often occurs when lymph nodes are removed or damaged, disrupting the normal flow of lymph fluid. Q: Why does lymphoedema occur after a mastectomy? A: Lymphoedema can occur after a mastectomy when lymph nodes are removed, compromising the pathway for lymph fluid drainage. This disruption can lead to fluid buildup and swelling, particularly in the arm and hand. Q: What are the risk factors for developing lymphoedema after surgery? A: Risk factors include the extent of surgery, radiation therapy, infections, obesity, lack of physical activity, previous injuries to the limb or shoulder, surgery on the dominant hand side, and smoking. Q: What are the common symptoms of lymphoedema? A: Common symptoms include swelling in the arm, hand, or breast area; a feeling of heaviness or tightness; restricted shoulder or arm movement; skin changes (thickening or hardening); and swelling that doesn’t reduce when the arm is elevated. Q: How can lymphoedema be diagnosed early? A: Early detection is crucial for effective management. If you notice symptoms like swelling, it’s important to seek help. Giovanni offers a free 15-minute phone consultation to evaluate symptoms and determine a management plan. Q: What management strategies are available for lymphoedema? A: Management strategies include Manual Lymphatic Drainage (MLD), Combined Decongestive Therapy (CDT), wearing compression garments, gentle exercises, maintaining skin hygiene, a healthy diet and lifestyle, and possibly surgical options. Q: How can Manual Lymphatic Drainage help? A: Manual Lymphatic Drainage (MLD) is a specialized massage technique that stimulates the lymphatic system and encourages fluid movement, helping to reduce swelling. Q: What role do compression garments play in managing lymphoedema? A: Compression garments, such as sleeves or bandages, help prevent fluid buildup and promote lymphatic drainage, which can alleviate symptoms […]

MLD and Surgery

Wound of a knee post surgery

A surgery, even the most minor cut, is a big deal for the body. And a robust Lymphatic System can help you recover faster from this type of intervention. The lymphatic system is a body system that collects, moves and cleans the excess water and substances, like bacteria, viruses, dirt, tattoos, ink and more, from below the skin and then passes it to the bloodstream. Lymphatic System and Surgery. 80% of the Lymphatic System seats below the skin, and 20% sits with the deep fascia. When going for surgery and the skin gets cut, the superficial layer of the lymphatic system gets interrupted and so damaged. Unless we intervene, the lymphatic system will have a hard time regenerating. Indeed the lymphatic system can regenerate if stimulated. The stimulation of the lymphatic system happens through the touch, like with MLD or through the movement of the body, like exercises, even as simple as muscle contraction. How MLD can help the pre and post-surgery. Indeed, before or after surgery, it is recommended to stay active. This would allow the Lymphatic System to stay active and robust and regenerate quickly. On the other hand, being active post-surgery is not always an option. In fact, during the post-surgery, being active in the area that got stitches can be a contraindication, as the stitches could brake. A cast may be present in other cases, and the muscle near the surgery can’t be moved. That’s where MLD can help the lymphatic system to be stimulated. By doing so, we can guarantee the circulation of liquids in the body. But not only that. Reducing the swell around the cutting area or below the area affected by the operation would guarantee a fast recovery. This is because the oxygen released from the blood capillary, which would initially be too far from the swollen skin, can now reach the wound and help recover the skin cut. But if the area is puffed or swollen, that oxygen can’t travel as far, and the healing will not be as fast. So MLD, by boosting the lymphatic system, reduces the swelling and allows the body’s natural healing process. What to do if I have to go for surgery then? If you are up for surgery soon and you have no contraindication to MLD, what you can do to guarantee a faster recovery is, keep moving as much as you can, stay active, and book yourself in for a few MLD treatments just for the days before your surgery is due. That would help with the Lymphatic System recovery, as a more robust and healthier Lymphatic System would recover faster. And as the risk of infection and post-surgery are under control, and your blood pressure is within the acceptable range (this depends on what type of surgery you did), get moving as possible and come back for a few more sessions of MLD. Whit, what type of intervention can MLD help with? C-section (preeclampsia) bone fracture liposuction carpal tunnel knee reconstruction hip replacement day hospital intervention I went for surgery, and I got Lymph Nodes removed. As often can happen for cancer surgery, lymph nodes get removed if they are contaminated by the cancerogenic cells. Lymph node removal prevents the cancer cell from spreading along the rest of the body. If that’s the case, I may not be the practitioner that does this for you, as my qualification for MLD are up to a level where I can work with a patient who has an entire lymphatic system. Said so, I can still refer you to a practitioner who would be able to look after yourself. Do you have any questions about this topic? Or would you like to book in now your next session? Get in touch now through the contact page or place a booking by clicking here.

Nervous System

nervous system components

The Nervous System (NS) controls the voluntary and automatic functions of the body. It is made up of: brain spinal cord nerves Subdivision of the Nervous System The nervous system, initially, can be divided into the Central Nervous system (CNS), which is made of the Brain and Spinal Cord and the Perhiperic Nervous System (PNS), which consists of nerves that connect the CNS to the rest of the body. In more detail, the PNS can be divided into Sensory Neurons and Motor Neurons, the Motor Neurons can be divided into Somatic Neurons and Autonomic Neurons, and finally, this last is divided into the Sympathetic and Parasympathetic Nervous Systems. The function of the Nervous System The nervous system can also be defined by its functionality. For this subdivision, we have three categories: Sensory Affarent function Integrative function Motor Efferent Function The afferent function is characterised by a signal that travels to the brain from the PNS. The integrative part analyses the sensory information, stores some aspects, and makes decisions regarding appropriate behaviours. The Motor does respond to the stimulus by initiating an action. The Nervous System is made of Neurons. Neurons carry messages to and from different parts of the body. To be functional, neurons need three components: Oxygen Stimulation Food Neurons can start within the brain and travel down to the spine or can begin with the peripheric portion of the body and travel to the spine and brain next. Either way, the information can travel in one direction only. For afferent neurons, the direction is from the peripheric body portion to the brain, and the efferent is from the CNS or Brain to the peripheric part. Synapses connect neurons. The Synapse is the space where information is exchanged between two neurons. For a signal to be transmitted along a neuron, a chemical reaction has to happen within the neuron cell. This chemical reaction is better known as Action Potential. Once an Action Potential is started, an electric signal, within the order of mV would be transmitted from the Neuron cell to the opposite end, called Axon Terminal. At The Axon Terminal, the neurotransmitter would be passed and sent to the next neuron, receiving those substances through the receptors on its cell membrane. This is just a simplification of how communication between two neurons happens. In reality, there are variations to this communication methodology, and not always does the communication succeed. The NS is responsible for the following: memory, learning and intelligence movement controls the organs’ functions: – heart beating – breathing – digestion – sweating the senses: – sight – hear – taste – touch – smell The Sympathetic and Para-Sympathetic NS. The  Autonomic NS controls the body parts we don’t have to think about it, like breathing, sweating or shivering, indeed the main organs. The SNS controls how we respond to emergencies. It makes our heart beat faster and causes the release of adrenaline. Where the parasympathetic nervous system prepares the body for rest (for example, when we go to sleep). The PSNS and the SNS work together to manage the body’s responses to our changing environment and needs. Massage and Nervous System As massage or manual therapy is a direct stimulus of the body, it plays a role in the response of the NS. What can happen is due to genetic factors, muscle tensions, and bulge disk nerves can get trapped along the way. Using the different testing approaches, such as Myotome and Dermatome, Giovanni can guide you through understanding where the nerve got entrapped or pinched. But this type of work is mainly for conditions where physically the nerve is involved in pour functionality. An example can be when someone has poor strength, on one hand, compared to the other, or when the sensitivity of a patch of skin is not so accurate. MLD and Nervous System Another technique, such as MLD (Manual Lymphatic Drainage), plays a role in the Parasympathetic Nervous System. An MLD treatment is profoundly relaxing, as it calms the nervous system, reduces pain and restores balance. This happens because of the mechanic repetitive movement used during the technique. There for, no pain has to be replicated during the treatment, or the SNS gets activated, as per pain response, and the body goes into “alarm” mode. Physical or mental pathologies can play a crucial role in the functionality of the nervous system, and techniques like MLD or Massage therapy generally can help in reducing symptoms and assisting in overcoming pain and body dysfunctions. Along the mental conditions, we find Anxiety or Depression too. In conclusion, any Massage Therapy or Manual Therapy, including Thai Massage, Remedial Massage, MLD and or Myotherapy, are great tools to release the tension in the body and improve the status of the nervous system. On the other hand, breathing, as per already disgust in the breathing wave blogs (Blog 1, Blog 2) plays a vital role in the well-being of the body, mind and nervous system. Feel stressed and need to release some tension? Book now your next massage at Melbourne Massage and Treatment.        

Mobility Joint, Stability Joint, Strenghening

Joint Mobility

Mobility is the degree to which a joint can move before being restricted by surrounding tissues. Not all the joints taught are considered mobility joints. The Mobility and Motility Joints Theory Starting from the big toes joint and moving up the body to the upper cervical joints, we can count one by one a mobility joint alternating with a stability joint. So this would be like this: Big toes – M. Metatarsal – S Ankle -M Knee – S Hip – M Lumbar -S Toracic – M Lower Cervical – S Upper Cervical – M Shoulder – M Elbow – S Wrist – M Tarsal – S Fingers – M The major differences are: A Muscular structure surrounds mobility joints Stability joints are surrounded by ligaments and tendons Mobility joints move in more planes than stable ones. The stability joints, indeed are essential to the body mechanics to ensure that gravity and force applied to the body by its own weight are well distributed. First thing first. Now, if we plan to strengthen our body, like by going to the gym, running or doing any sports activity, ideally we would like to ensure that the mobile joints can deliver the minimum required of ROM. Why? Well, if the mobility joints are stiff or not mobile enough, the priority of moving would not diminish and the stability joints, are going to do their best to compensate. But let’s see this with an example. Mark (name of fantasy) who is an office worker, spends about 40 hours a week at his desk, and to reduce the work and life stress decided to start a routine run 3 to 4 times a week for 1 hour per time. Mark thinks that to go for a run, you don’t need training and has no clue about the mobility, stability and strengthening chain. After a few weeks that is enjoying his new routine, Mark start experiencing knee pain. Mark also didn’t realise that due to the long hours of sitting at the office, his hips joint are tight, and his external rotators, such as the gluteus max and piriformis, are tight. As per consequence, when Mark stands up, the angle of the gate (AOG), which refers to the rotation of the foot in a standing position, is up to 4 toes per side. (3 toes is the max AOG we expect in the foot). Now, what happens next is that when Mark goes running, his ankle mobility and hip mobility are visibly restricted. So, he will lean forward with the upper body, by having tight hips, and strike the floor with the feet externally rotated, so all the body weight will be loaded in the middle of the foot. As a result, the Stability Joint that sits between the ankle and hip, so the knee, will compensate for the other two joint dysfunctions. In this case, the knees would take extra pressure medially and stretch out laterally. So, what should Mark do?! Well, initially, to stop the pain from happening, stopping running would be a good idea. Said so, that would not fix the problem. What Mark should do, is: Massage to boost the change within the tight joints and reduce the knee pain Start a mobility program to improve the Hip and Ankle functionality Exercises that aim to reduce tension in the external rotator reinforce the internal rotator (Gluteus Med and Min) Train on how to run These are the basic steps to implement a model of Mobility, Stability, and Strengthening. Does this model apply to other sports activities? Of course, it does. Visualise your body as a giant mechanical machine made of rope and hinges. The mechanical result will not be ideal if the hinges are stiff and the ropes are tight. To improve the result, each component needs to be looked after. So what message would be the most recommended? Along with Melbourne Massage and Treatment services, Thai Massage, Remedial Massage, and Myotherapy are soon the most recommended services Giovanni offers to improve the body’s mobility. Regarding mobility training, Thai Yoga is also an effective way to improve joint mobility, as these exercises focus primarily on improving joint mobility. What there is to consider is the patient’s presentation, medical history and pre-existent injuries. If there are no significant concerns, I suggest Thai Massage as the best approach.  For people who have presentations such as Diabetes n1 or hypertension, Myotherapy treatment or Remedial Massage is mainly recommended.    

Myotherapy

A Hand inserting needle in to a forearm for a dry needling session

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.  

Carpal Tunnel

Carpal Tunnel median nerve impingmenet

The carpal tunnel is a narrow passageway in the wrist that opens into the hand. The median nerve runs through the carpal tunnel and gives feeling to the 2nd through the 4th finger (the medial half of it). Carpal tunnel is a condition that affects any gender, and the prevalent of people affected by this condition, are people who do repetitive movements with their hands and arm. Carpal tunnel Symptoms Numbness Pins and needles in the hand Pain, particularly at night Darting pains from the wrist Radiated or referred pain in the arm and shoulder Weakness of the hand The little finger and half of the ring finger are unaffected. Causes of Carpal Tunnel Presentation Occasionally there is no clear cause for Carpal Tunnel. Said so, sometimes there is a combination of factors such as: Arthritis – C.T. is a consequence of inflammation and swelling Pregnancy – During the pregnancy period, given the increase of hormones, the body tends to retain more fluid, which can compress the median nerve and replicate CT symptoms. Genetics – some people can have smaller carpal tunnel Overuse injury – as previously mentioned, repetitive movement and overload of the wrist can lead to CT syndrome Treatment options Along with different treatment options, massage is the first non-invasive approach someone can try for carpal tunnel. As soon as the symptoms show up, it would be wise to go and see a massage therapist. Techniques such as Remedial Massage, Myotherapy can easily address the problem and alleviate the pain. Depending on the presentation and the cause of the carpobual tunnel, even Applied MLD (manual lymphatic drainage) can be an ideal treatment option. Along the physical therapy, rest is highly recommended, and exercises, as often happen, play the main role. To prevent pain from wrist movement, a splint can help. Other treatment options. Surgery is a standard alternative option for Carpal Tunnel. It is a common intervention and can be done on both hands simultaneously. The patient can choose to go for local or general anaesthesia. Surgery for Carpal Tunnel involves a cut along the palm and the wrist. The surgeon then cuts the ligament to reduce pressure on the underlying median nerve. Once the skin gets stitched back, the ligaments heal themselves, and the new scar would not put so much pressure on the median nerve. Even though the surgery is easy, it can have some complications, like swelling and damage to the median or ulnar nerve. Also, if the ligament was not cut completely, it would still apply pressure on the Median Nerve, and a second surgery would be needed.      

Lymph Nodes

lymph node

Lymph nodes (or lymph glands) are small lumps of tissue containing white blood cells that fight infection. They are part of the body’s immune system and filter lymph fluid, composed of water and waste products from body tissues. Introduction to Lymph Nodes Lymph nodes are located in different body areas. On average, we have approx 600 LN. In the neck area only, we find 160 LN itself. LN can vary in size and go from 2 to 30 mm. Lymph Nodes are connected by vessels, better known as afferent and efferent vessels. The afferent vessels carry the lymph to the lymph node, and the efferent vessels take the lymph away from the lymph nodes. So, the lymph nodes are also connected directly to the blood system, veins, and arteria. What is a lymph node made of? Despite the structures that enter and leave the lymph node, these cleaning stations are made of: Connective tissue capsule Supporting strands of connective tissue inside Below the marginal sinus, there are clusters of lymphocytes lymphoid follicles Artery, vein and nerve As for the filtering station, the lymph node is essential to ensure that no bacteria, viruses or dirt can access the blood system. Where we find no lymph nodes in the brain. Indeed, the lymph fluid around this area gets drained by the Optic and Olfactory nerve. Following then the position of the lymph nodes, we can define the watershed. MLD and Lymph Nodes. Lymph Nodes can occasionally be swollen, which happens when the body fights an infection. In my practitioner experience, I often have to refer to the lymph node concept to introduce the client to MLD treatment. Not many clients know about this technique; they are more familiar with Myotherapy or Thai Massage and Remedial Massage. Said so, the client who tried MLD are all well impressed with its benefit. During an MLD session, what happens is that with a gentle stretch and recoil of the skin, I help your lymphatic system to work faster. Consequently, that’s how swollen area gets reduced. In pushing your lymphatic system to work harder, the lymph node would receive more liquid to process. On the other hand, knowing where the lymph nodes are, is essential to ensure we push the lymph liquid in the right direction. If you haven’t booked your appointment yet and wish to set a goal for MLD, please follow this link.

Knee Pain

Knee Anatomy Frontal View

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.  

First Massage Appointment

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

First Massage Appointment. At Melbourne Thai Treatment, a first massage appointment session does last a bit longer than a regular appointment. Indeed, if you go on the booking page, you may notice that the first appointment lasted 75mins. Why so?! Well, within the first appointment, as a therapist my aim is to track down your Clinical History. For doing so there is initially a form to fill in and in a second stage few subjective questions that I am going to ask. Questions are like: “What do you do for work?” “What sports activity do you do or did?” “On what side do you sleep?” “Are you Right or Left Handed?” Ext… These and other questions, relevant always to the presentation that you come in with, are for me therapist essential to understand how you end up having the pain or discomfort that I have to remove or reduce. Obviously, those questions asked during the first massage appointment can take a bit of time to be answered Occasionally an answer gives space to a new question. Said so, the more specific are the answer more I can narrow down the clinical situation. If this post is talking to you, book your next massage session by clicking here. As per result, will be easier to find a path to alleviate pain and discomfort. On the other hand, as the session last longer than a regular visit, as a therapist I charge a bit more. For a Remedial Massage and a Thai Massage a first appointment session would last 75mins. About MLD a first Massage session would last 60 minutes. Indeed, with this post, I would like to share and explain to any clients that the first appointment is not more expensive because I am greedy. Is through, the time we spend doing the massage itself is per usual the same time that we would spend during a general consultation. But, that initial time that we spend working out your Clinical History, will save time after actually treating the condition. In conclusion, I would not see the first appointment as an extra expense, but as an investment in your health. Before we find out what’s the cause of your pain, and discomfort before I can create a proper treatment for it.


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