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By Ethan Farr, Sports Myotherapist & Exercise Scientist According to the Australian Institute of Health and Welfare an estimated 594,000 Australians over the age of 15 played netball throughout 2020–21. During this year there were 1,500 injury hospitalisations attributed to netball—1,380 female and 120 male. Just over half of these hospitalizations were due to soft tissue injuries and a little over a third were for fractures. According to Netball Australia “knees and ankles are the most commonly injured body parts for netballers” and they are most commonly injured during the landing phase when jumping or stopping.  A few of the most common soft tissue injuries that occur within netball include: ankle sprains, shin splints, achilles tendinopathy, patella tendinopathy and ACL tears.
Now ankle sprains often dismissed as minor injuries, can prove far more nefarious than most believe. Beyond the immediate discomfort and inconvenience, untreated or improperly rehabilitated ankle sprains can lead to chronic instability, recurrent injuries, and even long-term joint damage not to mention decrease in sports performance and changes in walking and/or running mechanics increasing risk of many other injuries. The initial pain and swelling may subside, lulling individuals into a false sense of recovery, yet lurking beneath the surface are weakened ligaments and compromised proprioception, leaving the ankle vulnerable to further trauma. Myotherapy can play a crucial role in the treatment of ankle sprains by reducing pain and inflammation, improving blood circulation, and promoting tissue healing. Through targeted techniques, such as deep tissue massage and lymphatic drainage, we can help restore mobility, flexibility, and function to the injured ankle, facilitating a speedier and more complete recovery. Patellar tendinopathies and ACL tears are some of the other more common and more sinister injuries that occur in netballers. These injuries can decrease general stability around the knee and cause a lot of pain in all movements of the knee. Patellar tendonitis or “Jumper’s knee” is an inflammation of the patella tendon or the tendon just below the knee cap, it is an overuse injury caused by running or jumping especially on hard surfaces much like a netball court. It is associated with pain around the knee cap that gets worse with activity such as walking, running or jumping, and it can get worse with walking up stairs or uphill. Massage can help through improving circulation improving the healing process and by reducing tightness of muscles around or connecting to the patellar tendon reducing the pulling on the tendon. ACL tears are an injury I’m sure most have heard of but you may not know what it actually entails, The ACL or the anterior cruciate ligament is one of 4 ligaments in the knee holding and supporting the femur (thighbone), tibia (shin bone) and the patella (kneecap) creating stability in knee movements. The ACL runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur and provides rotational stability within the knee (if you would like to know more on this check in with some of our other blogs). Tears of the ACL are graded on a severity scale being graded 1-3: Grade 1: The injury stretched your ACL enough to damage it, but it’s still in one piece and holding your knee bones together. Grade 2: The injury stretched your ACL so much that it was partially torn and loosened. Grade 3: A complete tear through your ACL meaning the ACL is now in two pieces. So how can treatment help with ACL tears, in cases where surgery was required massage can help control swelling and improve circulation around the site as well as reduce tightness of muscles around the knee reducing perceived pain on your rehabilitation pathway for lower graded sprains and tears of the ACL massage can help reduce some guarding around the knees that can reduce mobility and cause pain but through the use of some exercise prescription we can help strengthen the muscles around the knee to improve stability and reduce risk of further injury of the ACL. Should netballers be receiving myotherapy? Absolutely! Prevention and "prehab" of injuries is a much better option then getting seriously injured in sport! Netballers, it's time to prioritise your well-being on and off the court. Don't let injuries sideline your passion for the game. Whether you're a seasoned player or just starting out, understanding the risks and knowing how to address them is key to staying in top form. Don't wait until it's too late. Invest in your health, invest in your game. Schedule a treatment with me on a Tuesday, Thursday or Sunday so I can help assess and plan a course of treatment for your knee issues, so you can keep playing strong. Your body will thank you for it! Simple Wellness Myotherapy is located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178. Additionally, you can contact us on (03) 8204 0970 to arrange an appointment today. By Duke Autret, Myotherapist Chronic pain is a complex and persistent condition that significantly impacts an individual's quality of life. Managing it often requires a multi-pronged approach. Myotherapy, a specialised form of physical therapy, offers effective interventions for chronic pain, particularly ‘nociplastic’ pain, which lacks clear structural or inflammatory causes. This blog explores the management of chronic pain with myotherapy, including key interventions and techniques.  Understanding Nociplastic Pain
Nociplastic pain is characterised by pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage or sometimes disproportionate to the level of tissue damage that may be there. This type of pain can be challenging to manage as it often involves central sensitization. Central sensitisation is where the central nervous system becomes hypersensitive to pain signals, which is in effect like the malfunctioning of the sensory system rather than the tissues themselves, perhaps like when your car has a sensor problem rather than actual part problem it is monitoring. Causes of Nociplastic Pain The exact causes of nociplastic pain are not well understood, but factors may include:
Symptoms of Nociplastic Pain Common symptoms can include:
Myotherapy offers a range of physical and educational interventions to manage nociplastic pain effectively. Physical Interventions: Movement and Exercise Therapy: Movement and exercise therapy, including graded activity and graded exposure, helps retrain the nervous system and reduce pain sensitivity. Adjunct Tools/Modalities: Techniques such as heat, cold, or electrical stimulation can alleviate symptoms by reducing muscle tension and pain. Manual Therapy: Manual therapy, including joint mobilisation and soft tissue techniques, can be beneficial when integrated with other treatments. Educational Interventions: Pain Neuroscience Education (PNE): Pain Neuroscience Education (PNE) helps you understand the nature of pain and how to manage it better. Here are some key principles to keep in mind: 1. Pain is an Output from the Brain: Pain is not just a signal from damaged tissue. Your brain processes information from all over your body and creates the sensation of pain. This means pain is not only a physical sensation but also involves cognitive and emotional experiences. 2. Pain Does Not Always Indicate Harm: Understanding that pain is not always a sign of serious damage can help reduce fear and anxiety. Many factors, such as stress, emotions, and past experiences, can influence pain. 3. Changing Your Perspective on Pain: By seeing pain as a signal that your brain is sending to make you pay attention to your body, you can take steps to manage it more effectively. This can help reduce the intensity and frequency of pain. 4. Techniques to Manage Pain: Relaxation and stress reduction techniques like deep breathing and progressive muscle relaxation can help manage pain by reducing muscle tension and anxiety. Regular practice of these techniques can make a significant difference in your pain levels. 5. Listen to Your Body: It's important to listen to your body and take care of yourself in ways that feel safe and comfortable. This includes practising good posture, engaging in regular exercise, and maintaining a healthy lifestyle. Progressive Muscle Relaxation (PMR): PMR is a technique used to reduce muscle tension and anxiety, promoting relaxation and pain relief. Steps for Progressive Muscle Relaxation:
Graded Exposure Therapy: Graded exposure helps individuals gradually confront and overcome activities or movements they avoid due to fear or pain, reducing pain and improving function. Protocol for Graded Exposure:
Graded exposure gradually helps people confront their fears or anxieties. By slowly exposing you to things that make you anxious, your brain learns these things are not as dangerous as initially thought. This builds tolerance and reduces anxiety over time, helping you regain control over your life. Comprehensive Pain Management When structural or biomechanical explanations fall short, pain often results from central sensitisation, neuroplastic changes, psychological factors, lifestyle influences, and environmental factors. Effective management involves a multidisciplinary approach, combining physical and cognitive interventions tailored to individual needs. Common Explanations in the Pain Process:
Chronic pain, particularly nociplastic pain, requires a comprehensive approach to management. Myotherapy offers effective interventions, including physical techniques and educational strategies, to manage pain and improve quality of life. By integrating myotherapy into your treatment plan, you can address the multifactorial nature of chronic pain and take proactive steps toward relief and improved well-being. You can book online to start the process now! Simple Wellness Myotherapy is located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178. Additionally, you can contact us on (03) 8204 0970 to arrange an appointment today. By Megan Cornish, Pre/Post Natal Myotherapist I would like to first and foremost start this blog by talking about the idea of pregnancy related musculoskeletal aches and pains being “a normal and common part of pregnancy”. And while that may be so for the majority of pregnant women, my biggest pet peeve is when prenatal ladies are told that their back and/or hip pain is “normal” and to basically deal with it til the baby comes out. No further pain management strategies or options are discussed, and mama's are left concerned and in pain without a plan, and that in my opinion is a disservice to all women! I am writing this blog to solidify that just because these types of muscular aches and pains are frequent occurrences during pregnancy, you absolutely do not have to just ‘put up’ with the pain. Pain management strategies are definitely out there if needed - myotherapy being one of them - and I want ALL women to feel empowered to utilise these strategies as needed to feel the absolute best they can for the duration of their pregnancy. Please never feel that you need to just power on through pain.  For the purpose of this blog we will learn why muscle and joint pain is common during pregnancy particularly in the lower back and hip regions. We will also look into how myotherapy works to reduce and manage pain as well as other alternatives and options available to you.
So why is it that the soft tissues of the lower back and hips get so sore? The most common regions to get affected by musculoskeletal aches during pregnancy are hip joints and surrounding muscles and the lower back. An element of the reason why this happens is going to be due to the growth of your baby throughout pregnancy and the pressure/added weight that this brings to the joints themselves. Wherever there is excess strain or pressure on our joints our muscles automatically guard to protect that joint - this will be the source of the pain. Another element to why you might experience pain in these regions is going to be because muscle relaxant hormones become involved, these hormones - relaxin and progesterone - cause a softening of tendons and ligaments surrounding the pelvis/lower back to prepare your body for the physical act of giving birth. As a result of the increasing laxity of these joint stabilisers muscles again begin to guard to compensate and protect the joints. How does myotherapy help to reduce and manage my pain? If you’ve had a massage or myotherapy treatment before you probably already know how amazing your body feels during and after the treatment. Its a very safe and effective way to manage and treat pain during pregnancy and works in a few ways to ease your discomfort. Massage releases muscular tension During your massage a few biomechanic functions are stimulated which is what is going to make the physical change to the musculoskeletal tissue as well as rewire the way your brain is processing the pain you are experiencing . Massage will release muscular tension by stimulating blood flow and increasing circulation to the muscle tissue. Endogenous opioids which are your “feel good” hormones also get released and therefore interrupt the pain cycle. The inflammatory response is our body’s healing response which is also triggered during the massage. Advanced Pain Relief Techniques Advanced techniques like dry needling and cupping are mighty helpful during pregnancy, and when they are used by a Myotherapists who are well educated on pre natal care they can provide a great amount of relief. We can use techniques like dry needling for reaching deeper into your glute muscles without needing to be heavy handed, and this can be incredible when you have sciatic pain or that build up of pressure around your pelvis and sacrum. Calm the CNS (Central Nervous System) Our central nervous system consists of our brain and spinal cord, this is how our body receives, responds and processes sensory information. During the massage sensory receptors carrying messages of sensation to the brain are calmed and therefore relaxing muscle tissue and reducing pain. Safely lay on your tummy! We have excellent pregnancy therapy cushions that allow you to safely lay on your tummy and protect your growing bump and sensitive breasts. All our mama’s simply love to be able to spend some time supported and face down, plus its a great position for us to really effectively manage back, neck, shoulder and hip pain. Taping your pelvis Pressure and instability in the joints of the pelvis are some of the most common complaints, especially when baby is becoming big! Taping can help to offload some of the pressure around your pelvis, or to support it if you’re starting to feel a bit wobbly, pinchy or unstable. Are there any other available strategies that I can utilise? There are also other ways that pain in pregnancy can be managed as well, this could be any or a combination of the following. Yoga and Exercise Recent studies of the benefits of movement throughout pregnancy show positive effects on reducing and managing pain while pregnant as well as improved general overall health and wellbeing. Yoga and gentle stretching are great ways to ease muscular discomfort and exercise will work to increase blood flow and support healthy muscle tissue. Thermotherapy (Heat Therapy) This is an easy and accessible way to get relief from pain at home, warm baths and warm wheat bags are able to be utilised to address muscle pain as this allows for opening of blood vessels to increase blood flow to the soft tissues. However with this management strategy please note we want WARM but not HOT. It can be potentially dangerous for bubs if a mothers internal body raises too much which is why hot tubs and spas are not advised. If you are ever unsure about this strategy consult your treating practitioner before use. Mindfulness and Meditation Mindfulness and Meditation exercises along with breath work are great techniques and strategies to use to manage pain. The body and mind are intertwined, especially when it comes to experiencing pain and discomfort. Studies have shown that a heightened nervous system can influence a person's overall experience of pain. By practising mindfulness and/or meditation your nervous system will relax and muscle tissue will follow, therefore decreasing pain. Pain management strategies are out there and available to be used to treat and manage pain experienced during pregnancy. Ladies! Please NEVER feel ashamed or hesitate when seeking these out. As I mentioned earlier the biggest thing I would like you to take away from this blog is just because pain is a common and usual part of pregnancy, this does not mean you have to just power on through! Do you need help from a Myotherapist who has a great understanding about pre and post natal bodies? Thats me!! Book a time to see me for pregnancy care, I'm here 5 days a week. Simple Wellness Myotherapy is located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178. Additionally, you can contact us on (03) 8204 0970 to arrange an appointment today. By Megan Cornish, Pre/Post Natal Myotherapist Calling all my pregnant ladies! Have you found yourself at some point during your pregnancy rubbing your hand over sore muscles and/or joints? Or maybe you find yourself asking your partner for a back rub? Anything to get some relief, right!? Have you ever longed for a relaxing pregnancy massage but then right after caught yourself wondering if it's even safe for you and bubba? In my experience this is the biggest concern holding women back from experiencing rest and relief from musculoskeletal symptoms associated with pregnancy. And that’s what this blog aims to change! My goal is to educate expecting mama's on pregnancy massage and the industry secrets so that by the end of this blog any worry or anxieties about whether or not pregnancy massage is right for you are gone. So let's dive in!  When is pregnancy massage safe and when is it not safe? Pregnancy massage is a relaxing and safe way to effectively loosen muscles and ease discomfort that may present itself at some point throughout your pregnancy. And it is safe for the majority of pregnant women. In saying that, there are certain conditions your treating practitioner must be aware of and take the appropriate precautions to ensure your safety. What conditions would need to be treated with caution? ‘High risk pregnancies’ are definitely treated with caution and would usually require a medical clearance from your obstetrician or GP before commencing hands on treatment. For example, if you are pregnant and have diabetes or high blood pressure, if you have a heart condition, if you’re pregnant with twins or triplets or if you are in a certain age bracket (over 35 or younger than 17) ect you may fall into the criteria for a high risk pregnancy which just means that there could be a higher than normal chance of encountering potential complications. There may also be medical conditions or pregnancy symptoms unrelated to high risk pregnancies that your therapist will discuss with you prior to your treatment or massage to clear you for safe treatment. This could be morning sickness through to fatigue which are generally considered “normal” pregnancy experiences and it would be considered a precautionary “yellow flag” and safe to proceed with treatment. If you were pregnant and already had a medical condition such as Asthma or IBS this would also be considered a yellow flag and treatment would again be able to continue safely. Is there ever a situation where it would be unsafe to proceed with treatment? There are not many cases where treatment would be completely unsafe to go ahead, but in saying that there are certain concerning symptoms that your therapist may consider a complete contraindication and treatment would not be safe to proceed with. This could be if you were experiencing abdominal pain or bleeding this would be a “red flag” and treatment would not be safe until you have been medically cleared and immediate medical attention is advised. What precautions will my practitioner take to ensure Mumma and Bubs stay safe throughout the treatment? Are there certain regions my therapist can’t treat while I'm pregnant? All regions are safe to be treated while pregnant however there are certain regions your therapist must treat carefully. Although your abdomen and legs are able to be treated, deep pressure is avoided around these regions so your therapist would use light massage techniques to ensure you stay safe and comfortable throughout the treatment. There are also certain pressure points on the feet that your therapist will avoid using deep pressure on or around - this is due to an eastern medicine theory (reflexology) that these points can potentially induce labor however there are actually no definitive studies to prove this theory as of yet. Regardless, your therapist will keep this in mind to make sure that you and bubs stay as safe as possible! What about positions throughout the treatment? Are there certain ways I shouldn't be lying? Please do not worry about crushing bubba! Pregnancy pillows are fantastic at allowing you to safely lie on your front whilst making sure that baby is also comfortable! Obviously as you progress through your pregnancy and as the baby grows bigger the pregnancy pillow may not be able to provide optimal comfort anymore so this is when we like to treat you on your side. Being on your side is very safe at any stage of pregnancy. We understand that its often recommended by doctors to lay primarily on the left side for optimal bloodflow, but want to reassure you that spending time on your right side throughout your treatment is safe. It may even be possible to have you lay for a short time on your back, if that is needed to treat the areas that you're experiencing pain. We will always safely position you to make sure we can target those painful spots without making you or bub uncomfortable. I’m 38 weeks +, Is it too late to get treated? It's never too late! It is generally still safe to treat you even if you are past your due date or above that 38 week mark. If you are overdue or above 38 weeks and are considered a high risk pregnancy your therapist might ask you for medical clearance prior to treatment however as long as your therapist is looking out for those red flags/ yellow flags as mentioned above and is taking into account any medical conditions then you are in good hands! And once you reach that 38+ week mark, we know you're going to be feeling in need of some TLC! Pregnancy massage is a low risk and safe way to effectively manage those pesky muscle aches and joint pains that come with creating a life. But just because musculoskeletal aches and pains are considered a ‘normal’ experience of many women throughout their pregnancy doesn't mean you have to just ‘put up with it’. I hope that this blog clears up a few things and you are now armed with the information you need to make an informed decision about whether or not pregnancy massage is safe for you. If you are still unsure or have any doubts you can always check in with your doctor or OBGYN to get that confidence you need to book in for a massage and start receiving that pain relief that you deserve! Simple Wellness Myotherapy is located at Shop 12B/150 Kelletts Rd, Rowville VIC 3178. Additionally, you can contact us on (03) 8204 0970 to arrange an appointment today. |
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