Let’s start with the fundamental root cause of all structural problems from the physical standpoint, which is to say Overload. From here we'll look at the myriad of ways this comes into play.
When we break it down further, there can be two distinct categories of overload.

​Acute Injury vs Chronic Overuse
The obvious one is of course an injury, an acute trauma to some part of the body and the details of that event will determine what structure/s may have been damaged. 
Then there is the Overuse side of things. The main difference between acute injuries and chronic overuse is the timing and underlying causes of the pain. Again, Acute injuries often occur suddenly as a result of a traumatic event, such as a fall, an impact, a sudden or over-reactive movement, or sports-related incident, causing immediate pain, swelling, and limited mobility. On the other hand, chronic overuse injuries develop gradually over time due to repetitive movements or prolonged stress, resulting in persistent pain, localised tenderness, and perhaps stiffness. First course of  management for acute injuries will usually involve rest, ice, compression, and elevation, while chronic overuse injuries require a multifaceted approach addressing underlying causes, modifying activities, and implementing rehabilitation strategies to restore function and reduce pain.
So to sum up, while they are both still forms of Overload, one is from a sudden or Acute load, and the other from repetitive and/or prolonged Chronic loads.

Furthermore there are two main divisions when it comes to the tissues or structures of the body that may be overloaded. 1) Passive structures such as ligaments, cartilage, joint capsules, discs, bones etc. And 2) Active structures which are the muscles.   
And how does overload of the active and passive structures/tissues of the body occur?
Here are the main reasons. 

Weakness 
Weak muscles are themselves more easy to overload, and more quick to fatigue which not only can lead to muscle stress and resulting tightness, soreness and referral pain (pain which travels/radiates out to other places), but therefore can also can put additional stress on our joints and lead to pain and discomfort. Another phenomenon that can happen due to muscle weakness somewhere is that other muscles may have to work harder to compensate for it and thus then those muscles will be overworked/used/loaded.
Whether it's due to a sedentary lifestyle, lack of exercise, or specific muscle imbalances, weakness can contribute to musculoskeletal issues. Strengthening exercises targeted at the weak muscles can improve their capacity for load tolerance, overall function, resilience, and can help alleviate pain.

Mobility (hypo or hyper)
Restricted joint mobility and limited muscle flexibility can contribute to pain and discomfort. When adjacent regions to an area of complaint lack mobility, it can result in overloading that specific area. For example, a sore knee with normal range of motion may experience overload due to limited mobility in the joints above and/or below, such as the hip or ankle. On the other hand, excessive joint mobility, known as hypermobility, caused by weak muscles, stretched ligaments, or a fairly common genetic conditions (known as generalised hypermobility and/or Ehlers Danlos syndrome) can all lead to joint instability (and are susceptible to poor positioning and frequent subluxation or even dislocation when severe), muscle tightness, and subsequent pain or discomfort. Balancing joint mobility and stability is crucial in maintaining optimal musculoskeletal health. 
Other factors such as poor posture, prolonged sitting, and lack of stretching or movement can lead to stiffness and reduced flexibility and/or pulling an overstretching of passive structures. 
Incorporating regular mobility exercises, and mindful movement can enhance joint mobility, and alleviate pain. As can stability, strength, muscle endurance programs.

Movement patterns 
The way we move and perform daily activities can have a significant impact on our physical well-being. Dysfunctional movement patterns are ones that once again load up our structures more than necessary. Things such as poor technique when lifting, twisting, or repetitive motions. All of which can strain our muscles and joints and lead to pain. 
Different from strength, Movement patterns are more to do with muscle control, or how you use and regulate any muscle power, and can also be thought of as a repertoire of skills, many ways and techniques or patterns you could move to achieve an action or task. If your repertoire becomes limited then you end up having to use the same few patterns over and over again, leading once again to overload.
Mindful movement practices like pilates, taichi, feldenkrais and yoga, functional training, and ergonomic adjustments can help optimise motor control and movement patterns and reduce the risk of pain and injury.

Alignment & Posture 
Poor posture is basically a repeated and prolonged overuse of body parts and positions and can place excessive loads at certain areas and therefore stress on our joints, muscles, and connective tissues, leading to pain and dysfunction. Factors such as prolonged sitting, improper lifting techniques, and repetitive movements can contribute to postural imbalances.
Joint mechanics also requires good alignment when moving through ranges of motion, when a well centred joint has to move it can glide without any friction at its pivot point, and so whether in static positions or dynamic movement practising good posture and incorporating exercises that promote good alignment can help alleviate pain and improve overall function by better distributing the loads across the body rather than having it overly concentrated in certain places.

Muscle imbalances
Muscle imbalance refers mainly to relationships of length and stiffness between muscles and can occur for example when certain muscles become overactive or tight, while others become weak or underactive. It’s a kind of shorthand way of conceptualising the result of any of the above combinations, and then feeds back onto itself. So for example, poor movement patterns or long standing postural patterns can turn into muscle imbalances, which then in turn becomes more likely to reinforce poor movement and posture as well as joint positioning (joint centration), new compensations etc., and thus increased stress on areas of the body. Corrective exercises with an aim of restoring balance to opposing muscle groups via targeted stretching and strengthening to help rebalance muscles and joints and offload the irritated tissues.

Sedentarism 
Sedentarism, or a sedentary lifestyle (characterised by a lack of physical activity), is (perhaps the) one factor that contributes to all the ones above simultaneously. It leads to atrophy (reduced muscle size/fibres) of muscles within just days, which in turn means that weaker muscles are more prone to fatigue and overload, which can result in muscle stress, tightness, and referral pain. Additionally, weak muscles may cause joints to become hypermobile, and/or other muscles to compensate, and all to become overworked. A loss of mobility can often be caused by prolonged sitting and lack of movement, can lead to restricted joint mobility, reduced muscle flexibility, and limited range of motion through adaptive tissue length and pliability loss. This can contribute to pain and discomfort, especially in adjacent regions of the body or vice-versa. Dysfunctional movement patterns, such as poor lifting techniques and repetitive motions, can strain muscles and joints, while limited movement repertoires can lead to overload and pain. Additionally, muscle imbalances, characterised by overactive or tight muscles and weak or underactive muscles, along with malpositioning of joints, can alter joint mechanics and movement patterns, resulting in increased stress on specific areas. Poor alignment and posture, often influenced by factors like prolonged sitting and improper lifting, can further exacerbate tissue stress. To address these issues comprehensively and reduce pain while improving overall physical well-being, including metabolic and mental health, it is crucial to incorporate regular strength and mobility exercises, mindful movement practices, and promote good posture.


To recap and distil all of this, one final important distinction commonly made is simply whether a condition is a Movement issue or a Workload Management issue. After considering all the information we have looked at, it becomes evident that both of these are essentially 'load' issues, but with different underlying causes. 
​
The first, a Workload Management issue, arises from overloading tissues beyond their normal capacity, either through excessive force/weight or prolonged duration/volume. On the other hand, a Movement issue stems from a lack of control and alignment in muscles and joint structures, reducing their capacity and tolerance to handle usually acceptable loads.

Although when simplified, load is at the base of all the physical determinants, it’s important to recognise also that there can be combinations of each and any of these various factors mentioned where the effects of overload can be compounded. For example a suboptimal movement pattern which has become repetitive, and then might be performed with extra load than usual (say a heavier item this time), and maybe even working harder to compensate for a currently stiff neighbouring joint, possibly throw in some muscle imbalances and/or joint instability and voila.. All these can obviously add up to a bit of a sore spot! Recognising these differences means we can tweak the way we might approach remedying the situation.

By addressing the physical determinants of pain, including weakness, insufficient mobility, muscle imbalances, alignment and posture, and movement patterns, we can take proactive steps towards reducing pain and improving our physical health. It's essential to work with healthcare professionals, such as physical therapists or exercise specialists, who can provide guidance and develop tailored strategies to address these factors. Embracing regular exercise, maintaining proper posture, incorporating mobility work, and adopting mindful movement practices can contribute to a pain-free and active lifestyle. Remember, each person's experience with pain is unique, so it's important to consult with a healthcare professional for a comprehensive assessment and personalised recommendations.

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:

• Prolonged exposure to pain
• Stress and psychological factors
• Genetic predisposition
• Neuroplastic changes in the nervous system (which means the wiring of the brain that changes)

Symptoms of Nociplastic Pain
Common symptoms can  include:

• Persistent pain without clear structural cause
• Sensitivity to pain
• Fatigue and sleep disturbances
• Cognitive and emotional impacts
  
  
  

Myotherapy Interventions for Nociplastic Pain
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:

1. Find a quiet, comfortable place to sit or lie down.
2. Take a few deep breaths to relax your mind.
3. Start with one muscle group, such as your feet, and tense the muscles tightly for about 5 seconds.
4. Release the tension and notice how the muscles feel as they relax.
5. Relax for 10-15 seconds before moving to the next muscle group.
6. Progressively tense and relax each muscle group, including calves, thighs, abdomen, shoulders, arms, and face.
7. Focus on the sensations in your muscles, letting go of other thoughts.
8. After completing the exercise, take deep breaths and continue to relax.

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:

1. Assessment: Identify pain and functional limitations.
2. Goal-setting: Set achievable, measurable goals.
3. Education: Explain chronic pain and the rationale for graded exposure.
4. Exposure Hierarchy: Develop a list of activities arranged by difficulty.
5. Exposure Sessions: Start with the least difficult activity, guiding the patient through it.
6. Gradual Progress: Increase activity difficulty as the patient becomes more comfortable.
7. Maintenance: Regularly practise activities to maintain progress.

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:

• Central Sensitisation: Hypersensitivity of the central nervous system to pain signals.
• Altered Pain Processing: Inappropriate processing of pain signals by the nervous system.
• Psychological Factors: Anxiety, depression, and stress exacerbating pain perception.
• Lifestyle Factors: Poor posture, lack of exercise, and unhealthy diet contributing to pain.
• Environmental Factors: Physical or emotional stress, social support, and cultural beliefs influencing pain perception.

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 Rachael Bird, Myotherapist

The time it takes for your body to start feeling better after seeing a myotherapist can vary depending on several factors, including the nature and severity of your condition or discomfort, the specific techniques used by the myotherapist, and your individual response to treatment. Here are some general considerations:

1. Immediate Relief: Some people experience immediate relief and feel better right after a myotherapy session. This can be especially true for pain caused by muscle tension because we can use techniques that relieve the tension quickly and make an immediate change to the sensation. Something to be mindful of is that this type of muscle discomfort can be from habitual behaviours like sitting in one position for too long, repetitive movements, training hard in the gym, frequent use of things that strain those areas like carrying a bag over one shoulder or carrying a baby on your hip. Although you might walk out feeling great immediately, know that if your pain builds up due to your daily activities and routines, you may tense up again quickly if you’re not doing anything to regularly unwind that tension.
2. Gradual Improvement: For ongoing pain conditions or fresh injuries, we generally expect to see a gradual progression as you follow your treatment plan. Pain that has been with you for a long time is likely to need a series of treatments as well as commitment to your home care plan. Similarly, fresh injuries like a rolled ankle or sprained facet joint are going to feel painful while your body is healing the acute tissue damage, but your Myotherapist will be creating you a treatment plan that aims to reduce discomfort and guide you through the steps you need to take to strengthen and recover.
3. Post-Treatment Effects: It's common to experience some soreness or discomfort in the hours or days following a myotherapy session, especially if deep tissue work was performed. This is typically a normal part of the healing process and should subside within a few days. We often see people feeling a little tender the following day, but then feeling the benefits the day after that!
4. Individual Variation: Each person's body responds differently to myotherapy. Some individuals may respond quickly and feel better within a day or two, while others may require more time. Some people have excellent responses to specific treatment techniques, like dry needling, cupping or MET, and other people can find those same techniques either don’t work for them or are less effective than other techniques. Our therapists aim to find the most effective treatment type for your body to give you the best outcomes possible!
5. Home Care: Your myotherapist will create a treatment plan that includes things for you to do at home to recover quicker - this includes exercises, stretches, or lifestyle changes to complement the treatment. Adhering to these recommendations can help speed up your recovery and maintain the benefits of the therapy, especially if you are being treated for an injury that involves damage.
6. Follow-Up Sessions: Consistency in attending follow-up sessions as recommended by your myotherapist can contribute to more sustained improvements in your overall well-being and returning to your full strength, stability and level of physical comfort.

Ultimately, it's essential to communicate openly with your myotherapist about your progress and any concerns you may have. If you’ve tried a new treatment technique but you don’t feel like its worked as well for you, let us know so we can give you other options. If you haven’t been as diligent with your home exercises, also let us know - not so we can grumble at you, but so we can help you understand why its important to do the home care prescriptions we give you, and so we can alter the program if you’re not doing it because its too hard (or not hard enough and you’re bored!)

Getting a Remedial Massage or Myotherapy appointment is becoming even easier now that we have two new therapists joining our Rowville team! Join us in welcoming our two great new practitioners to the Simple Wellness clinic!

Kel Levi will be joining us from Wednesday July 27th. Kel is an experienced Myotherapist who is currently working alongside AFL Premiers Melbourne Football Club helping their players during and after their matches. She's also a qualified personal trainer, and has a wealth of knowledge in the health and fitness realm. She has a great firm massage style, loves to use dry needling to help reduce pain and improve movement, and can use her extensive background in fitness and exercise to help you find ways to stretch and strengthen your trouble areas with ease. Myotherapy and Remedial Massage with Kel can be claimed through our HICAPS machine with private health insurers like BUPA, Medibank, HCF and all other health insurers.

Kel will be available: Mondays and Wednesdays 9-12, and occasional Fridays (when Melbourne Footy Club don't need her expertise in the club rooms!)

Colette Corr is our new student Myotherapist, who is starting with us on Tuesday August 2nd. Colette is a final year Bachelor of Health Science Myotherapy student, which means she's completed the vast majority of the 3 year Bachelor degree program and is down to the last few subjects, including student clinical hours. We'll be offering discounted treatments with Colette while she's finishing up her degree. In addition to Myotherapy, Colette is also a yoga instructor with over 5 years experience, and loves to work with people with chronic pain and hypermobility/Ehlers Danlos Syndrome. As Colette is a student, private health claims can't be made for treatments with her.

Colette will be available: Tuesdays 2-7 and Saturdays (alternating between morning and afternoon shifts)

As always, bookings with our team of fantastic therapists can be made instantly online or by phoning us on 03 8204 0970.

Predicting how long your body will take to recover from injury or pain can be difficult, because each individual person will have many different factors that can influence their pain.
Your recovery time will depend if your pain is from an acute or chronic issue. We use the terms "acute" and "chronic" to describe your injury or pain type - acute being a new, fresh injury, usually where tissue damage has occurred; and chronic being a longer term condition or pain that continues well after expected tissue healing should have occurred.

Acute injuries can include things like ankle sprains, hamstring tears, shoulder dislocations. Usually they happen quickly and are immediately obvious that something is wrong. Maybe you've lifted something too heavy in your gym routine and felt a twinge of pain in your back as a muscle has strained, or you've missed the last step and felt a sharp shock of pain in your hip or knee. High impact blows can also cause acute injuries, like if you have a fall, get in a car accident, or get kicked from a horse.

Chronic pain can stem from an originally acute injury. Its common for people to have ongoing pain or sensitivity after an injury that causes a lot of damage. Chronic pain can also be part of many health conditions, like hypermobility and Ehlers Danlos Syndrome, Fibromyalgia, Multiple Sclerosis, and other conditions that affect your nervous system or connective tissue. Chronic pain also describes pain that comes from repetitive patterns of movement or positioning, usually starting as a mild irritation that can build up to be very painful, like De Quervains or "Mummy Thumb" which a lot of new parents experience as intense wrist and thumb pain from holding and feeding their new baby.

As a very generalised observation, acute injuries tend to follow fairly predictable recovery pattern as long as normal tissue healing occurs. In fact, the pain of an acute injury can often go away even before the tissue healing has completed, like in the case of a mild ankle sprain where you may be able to weight bear and return to normal movement within a week, even if the tissue around the ankle is still in repair mode. The severity of the acute injury will usually give us an indication of your expected healing time - a mild injury takes a shorter time to recover than a severe injury, this follows our common sense understanding even without medical training.

But what about chronic injuries or pain? How can we estimate how long an old injury will take to feel better? And importantly, can we realistically expect long term pain like a very old injury or pain from a lifelong disorder or disease to fully recover? This is where pain starts to become complicated, because in chronic pain patients there are lots of factors involved in the pain outside of damaged muscles, joints or nerves.

Chronic pain in one area of your body can lead to pain developing in other areas when your body tries to find different ways of getting things done. If gripping a heavy object becomes painful in your wrists, you may find yourself balancing it on your forearms and tilting backwards from your pelvis instead. As a short term work around this might be ok, but over time you might find yourself with chronic wrist pain AND chronic lower back and hip pain. Unfortunately, if you have a few "layers" of pain areas, this can mean that its likely to take longer to unravel some of the patterns that have lead your body to being in pain.

Chronic pain tends to be unpredictable in how long it may take to resolve. For people with pain stemming from lifelong conditions like genetic disorders, autoimmune disease or neurological disorders, the pain is likely to come and go in flares, and our aim for these people is to reduce the severity and frequency of the flares that are a part of their condition.

What other factors can contribute to how quickly you recover?
Adaptations to movements and positions:
Firstly, we need to identify movements or positions you currently do that either exaggerate or relieve your pain. Some of these will be easier to adapt than others - if you notice sitting longer than an hour increases your pain, an easy adaptation may be to get up every 30-60 minutes for a brief stretch. If you spend the majority of your day sitting at your computer, we can look at starting and ending your day with a back extension exercise to decompress your lower back. If we find some movements that relieve your pain, we can look at ways of increasing your time spent doing those movements.
We know that we won't be able to change all of the repetitive movements and actions that are needed in your daily life at work and at home, so realistically understanding that some of those things are contributors to your pain means we need to focus on the things we can influence so we can reduce the impact of the things we can't change.
There are lots and lots of options for changing some of the movement and position habits your body has built up, and our therapists can help with some suggestions during your appointment.

Exercise:
Finding a suitable type of exercise for your pain can be very helpful in building strength around the area and in stimulating your body to release its own brand of feel good hormones and neurotransmitters that reduce pain sensations. Exercise might sound very overwhelming to start off, especially if you have a lot of interconnected areas of pain, so our therapists will start you at an appropriate level for where you are at. That might be some mild stretches, a gentle walk or swim, or even a visualisation of doing certain movements.

Diet/Nutrition:
What you eat influences how your body repairs and recovers. If you have food sensitivities or intolerances this can also effect your bodies inflammatory response - the more inflammation, the more sensitive our nervous system is to pain. If you were already eating a good diet prior to your injury, you are likely in a better position to recover quicker than someone who was eating nutrient-poor food or a diet that caused inflammation. A nutritionist may also be able to recommend supplements that can support your bodies natural healing processes.

Fitness & General Health:
You may be more likely to have an easier recovery from injury if you were in fairly good health and physical condition before your injury. Your recovery may be slower if you have pre-existing health concerns, including things like diabetes or autoimmune disease. Its never too late to start working towards a healthier lifestyle!

Sleep:
Good sleep is crucial to good healing. Pain can make sleep very difficult, and this can become a bad cycle of intense pain leading to poor sleep, resulting in feeling fatigued, which causes pain to increase, and so on. Breaking this cycle and getting some proper rest can help with recovery. Using extra pillows to support your body may allow you a longer and deeper sleep. There are also lots of great sleep apps or meditations that some people find useful in falling asleep or getting back to sleep if you wake up in the night. Speak with a nutritionist or pharmacist about night time supplements that can help aid with sleep.

Nervous System Health:
Chronic pain is often just as much about your nervous system as it is about your musculoskeletal system. This means if you are highly anxious, stressed, depressed, or just have a lot on your plate right now, that your pain levels may be higher than normal. The nervous system controls your entire body, so while we're not saying "your pain is in your head, you're making it up!" what we are saying is that if your nervous system is working overtime then its much more likely that your pain will be noticeable even in response to small actions. Think of it like a kettle that has just boiled, it takes much less time to reboil the kettle because its already hot. The nervous system is similar, it will take much less action for your nervous system to turn up the volume on your pain because its already on high alert.
Finding ways of supporting your nervous system is crucial for long term chronic pain conditions. This is also why medications for anxiety and depression are often prescribed for people with ongoing pain. There are lots of natural or herbal supplement options available through Naturopaths and health stores. Setting a nervous system health routine for yourself is also a hugely valuable part of managing stress and overwhelm, and this might include things like mindfulness, meditation, relaxation, affirmations, or anything else that helps you to tone down nervous system activity.

Self Care Tools:
Treatments with your practitioner are great, but having the tools and know-how to apply treatment principles at home goes a long way to helping you take charge of your recovery. We can teach you how to use a range of tools for releasing tight spots in your body so that you have some tricks up your sleeve for between treatments.

Treatment:
Get the type of treatment that your body responds to. Some people respond best to hands on treatments like massage, cupping and dry needling. Some people go better with active exercise based treatments. Our therapists can advise you of the treatment types that have been reported to work best for your type of pain, but ultimately each individual body can react differently, and we'll work towards finding the best combination of treatment techniques for you.
Be aware that trying too many treatment types at once for the same issue can make it very difficult for any of your health practitioners to determine which treatment is effective. This is also why we'll often pick a small number of Myotherapy techniques to use in each treatment, because if we use absolutely everything we know all at once, its very hard to know what worked and what didn't.
Go into your first treatment expecting that it might take your body a little while to start making long term changes, especially if your pain has been there for a long time and if repetitive movements and positions seem to be a big part of your pain hanging around.

Try your first appointment with us for $97 (normally $115)
Book an appointment with us now.

When you have chronic pain, you get very familiar with pain that makes itself known every day. You may have some good days and some bad days, but either way its good to have a toolkit of things you can do at home to help reduce, manage or avoid pain flare ups.

This is even more important now, while Melbourne is under Stage 4 Restrictions in response to COVID19 and seeing your Myotherapist is no longer an option.

Your toolkit will likely be different to someone elses, but these are some of the things that you can incorporate at home to help keep pain as low as possible.

Gentle movement - Walking, yoga, pilates, dancing, cycling, and other low impact exercises to keep your joints and muscles mobile. What you can achieve may change day by day, work within your own limits. There are plenty of free or affordable online options, my favourite that I'm personally using throughout lockdown is Erica Webb Yoga & Pilates virtual studio ($37 a month for unlimited classes)

Stretching - Make time to stretch each day, especially the muscles that feel tightest. If you're working from home, its really easy to get stuck sitting for hours at your desk - or couch, coffee table, hammock, whatever your work from home set up looks like.

Self care tools - Foam rollers, tennis balls and spiky balls, acupressure mats, TENS machines: these can all help reduce muscle pain and tension. Don't have one? You can pick these up cheap online on eBay or through sports stores.

Hot or cold therapy - Heat packs, hot water bottles, electric blankets to keep you warm and take away some of the ache. Ice packs or cool compresses can work better for acute inflammation areas or for numbing persistent pain.

Nutrition and hydration - Eat well, drink water, and avoid foods that tend to flare up your pain. Pre-plan meals and snacks so you can have some easy to grab options on bad pain days where you don't have the energy to cook (or clean!)

Stress management - Easier said than done during a pandemic, right? Find things that bring down your stress levels, that will be different for each person, but some classics include reading, listening to music, taking a nap, having a warm soak in epsom salts, booking a telehealth appointment with a counsellor, writing in a journal.

Seek support - Don't suffer alone! Reach out for a conversation with your friends, family, coworkers, neighbours. Don't forget there are plenty of services to support you, including talking with your GP, a counsellor, and support groups online.

Pain relief - I know a lot of our patients choose not to use pain relievers, but in these times where its hard to get access to hands on treatments that help, you may find that taking pain relief is helpful. This may include prescribed medications from your GP or over the counter recommendations from your pharmacist.

Gels and creams - There are a heap of options for topical pain creams, the most commonly used ones include Deep Heat, Fisiocrem, and Voltaren. My personal favourite is a non-pharmaceutical blend by Doterra called Ice Blue Rub, its got a cooling menthol effect that is fairly long lasting, but it is on the pricey side for a cream. A little goes a long way!

Sleep - What can you do to optimise your sleep cycle? A well rested body has the best opportunities to repair and recover. Some things to experiment with are an earlier bed time, switching off screens well before bed, changing your pillow, listening to relaxing music.


We hope it won't be long now until we're able to offer hands on treatments again. As soon as we know more, we'll make an announcement and get our online booking page active again.

Does this sound familiar?

• Aching hip pain when you wake up
• Hard to stand up if you've been sitting down for a while
• Hurts to walk up or down stairs
• Painful to sleep on your side
• Night time pain that can wake you up

These can be signs of hip bursitis, which is an inflammatory condition that can be a very common cause of hip pain.

The good news is that we help people with this all the time, and we can get you started on a treatment program to help reduce the pain and build up the strength in your hip!

What is Bursitis?
Bursitis is the name of a condition where the bursa in your joints become inflamed. Bursa are the fluid-filled sacs that help cushion joints and reduce friction as the joint moves. Healthy bursa are important in pain free movement.

When the bursa becomes inflamed it swells and becomes highly sensitive. The joint doesn't move easily, and the muscles surrounding it can become painful and tight trying to protect the joint.

Bursitis can cause acute pain that increases with physical activity. If the inflammation remains active for a long time, the pain can progress to a chronic state.

What causes hip bursitis?
The most common causes of bursitis are things like overuse or strain on the hip joint. This can happen through a high level of exercise or activity, or through repetitive unbalanced activities like holding a baby on one hip, or leaning your weight to one side to avoid pain in other areas like your lower back, knee or ankle.

Other causes can be less common things like infection or gout within the joint. People with autoimmune conditions like rheumatoid arthritis can be more vulnerable to developing this inflammatory condition.

How can we help?
Remedial massage and myotherapy can help relieve painful symptoms of hip bursitis. We can reduce muscle tension around the hip joint, and assess the other areas above and below the painful hip so that we can address any issues that are contributing to your bursa becoming irritated. Taping for stability and support can be very useful, and can help relieve pain for longer. We can give you a program of exercises to gradually strengthen  your hip without increasing the irritation.
Book a time with us to get the ball rolling.

Should I see a doctor?
If your hip pain has been ongoing for quite some time, it can be a good idea to check in with your doctor.
Your GP can advise you if a course of anti inflammatory medication will be helpful for you, or you can ask your pharmacist for an over the counter recommendation for symptom relief.
We're lucky to be located inside Together Medical Family Practice in Knoxfield, where you can get access to a fully Bulk Billed GP in the clinic with us and an understanding pharmacy team downstairs.

In practitioner language we call it Fear-Avoidance Behaviours, which basically means not doing the beneficial thing because of the fear of causing pain even if you know long term the beneficial thing reduces the pain intensity and/or frequency. It’s one of the biggest struggles for people with chronic pain.

I think a lot of the solution to it is finding a really enjoyable activity. In my sisters situation, she started taking MMA classes last year. A weird choice for someone who is already in pain, right? But even though shes learning some serious fighting moves and coming away with some proper bruises, her long term back pain has been more under control than it had been in ages.

I explained it to her like this.
"You’re not there to slug away at a pointless activity that you don’t enjoy. You have fun, you learn, it’s interactive, the people are nice and supportive, it’s social, it’s not 100% competitive, you get to do it as a family activity with Matt and the kids. So it’s probably so much more appealing than going for a run or going to lift weights at a gym by yourself for an hour a few days a week."

And I think she got it!
"Absolutely! Ohh that all makes so much sense... it's so true though. Going to the regular gym or even working out at home is like... ugh. No thanks. But going to MMA is so easy?! Because it's just fun... I mean, it's actually a really complicated work out, and some of it SUCKS... but is somehow so damn fun?!"

While she's having all this fun kicking and punching, she'll definitely be using a lot of back muscles to coordinate and control the movements, and core muscles, hip stabilisers, all the areas that single exercise prescription focuses on. The difference is instead of doing separate specific exercises for each muscle group, it’s all just rolled into a sequence of movements and blows and dodges, mixed in with an instructor that makes her laugh and being able to spar with her partner. This is way more enjoyable for her than doing strict sets and reps of isolated exercises.

Some people love doing the specific exercises, and guess what, thats awesome too because if you love it and enjoy it, you're more likely to do it!

Lets talk neuroscience
We already know that almost any kind of exercise produces endorphins, which are these wonderful little brain chemicals (neurotransmitters) that are natural pain and stress relievers.

Endorphins act a little differently on the Peripheral Nervous System (all the nerves in your body that aren't part of your brain or spinal cord) and the Central Nervous System (the brain and spinal cord)

They work by binding to opioid receptors in the Peripheral Nervous System. Its like your own personal stash of codeine, and your body makes it in response to exercise! They also work by reducing the amount of inflammatory chemicals that the nerve produces.

In the Central Nervous System, endorphins also bind to the opioid receptors. Here their effect is to reduce another neurotransmitter called GABA. With GABA reduced, your brain is able to produce more dopamine - the pleasure neurotransmitter! Interestingly, these opioid receptors in the brain are most abundant in regions of the brain that control pain regulation.

So how is it more helpful to have a fun active hobby?
Researchers found that endorphin release varies depending on the intensity of the activity, suggesting that higher physical intensity leads to increased endorphins compared to more moderate activity.
But is the endorphin rush better from a fun activity vs an activity that you find boring or tedious?
I'm honestly not sure, but what I do believe with certainty is that most people are way more likely to actually DO the exercise if its something they find fun and enjoyable and actually have a desire to do it.

Realistically, it probably doesn't matter WHAT you do, more that you just DO IT!

Do you know what sets off your pain into a flare up? We call these triggers, and they can be different for everyone.
 
Knowing your triggers can be particularly helpful if you have a pain condition that has a flare/settle cycle, because it can help you avoid triggering things or situations, or help you prepare for an oncoming flare.
 
We often see people who don’t know what their triggers are. This can be a pretty scary situation for them, because their pain seems random and uncontrollable, but for most people there are at least some consistent triggers for their pain and with a little investigation we can usually pin down some of the big ones.

Some of the most common triggers include:
 
Stress – Of course! Stress and demands pulling in every direction is bad enough when you don’t have pain, but this is one of the really big triggers for setting off bad pain flares.
 
Over doing it – Pushing yourself too hard is probably one of the most common triggers for an increase in pain. This can look like lifting something heavier than you’re capable of, walking further than you normally can, rushing around doing more errands than usual. The trap is usually that you have a day where you actually feel pretty good and capable, so you do as much as you can while you're feeling good and then - bam! On comes the flare from over doing it!
 
Change in air pressure – Theres not a lot of great research on this, but I can tell you from clinical experience there are a huge number of people who get pain flares when the weather changes, particularly if a storm is about to roll in. Headaches, migraines, joint pain, nausea, nerve pain – these can all flare if the air pressure changes suddenly. Sometimes people affected by this trigger can tell its going to rain hours before it starts because they start to feel those symptoms.
 
Temperature – Sudden changes of temperature can also flare up some pains. This usually happens in the peak of summer or winter, especially if you go from a cool air conditioned space into the Melbourne heat wave, or getting out of your warm car into the cold air of a single digit day.
 
Medication – Changes to medication or forgetting to take medication can set off a pain flare up. If its from changes to medication, make sure that you note it down and let your GP know when you see them next.
 
Sleep – Usually it’s a lack of sleep that causes the pain to increase. Sleep deprivation can lead to feeling run down, slowed thought processes, memory issues, low mood, and can increase sensitivity to pain. I recently wrote a blog with some general tips for aiding your sleep cycle, which you can read here.
 
Illness and infection – Picking up a cold or virus that’s going around can certainly flare up existing pain conditions. Your body uses a lot of extra resources when it needs to fight off illness or infection, so this can be particularly involved for people who already have weakened immune systems.
 
Certain movements – Sometimes your pain can be increased by specific movements, like shoulder pain that hurts more if you reach overhead. As Myotherapists, we can help you identify the specific movements that are responsible, and create a treatment plan that addresses those areas so we can get you moving better and with less pain.
 
Food – Food allergies or sensitivities are very common, and some of these can trigger pain and inflammation. Common ones can be things like gluten, sugar, and processed foods. A Nutritionist like our friend Samantha Gemmell can help you identify foods that may be causing you to have flare ups and help you plan some alternatives.
 
Chemicals – Sensitivity to chemicals can also increase pain. Consider the types of dish liquid, washing powder and cleaning chemicals you use at home. If you consistently get flare ups after using these, it may be time to try alternative products and see if it makes a difference.
 
Body products – Similar to chemicals for cleaning your house, the products you use on your body can also trigger pain in some people. This can include body wash, hair care, skin care and make up, deodorants and dental products.
 
 
These are just some of the common things that we see. We always recommend that you keep a good eye out and become a little investigator into your own triggers. Sometimes a trigger or symptom journal can help in identifying the things that are setting you off. If you want to do this, we suggest you start by taking note each time you experience a flare up and jot down anything you have done, eaten, interacted with around the time of the flare up. This will help you start to notice patterns that your pain follows.
 
Some things will be easier to avoid than others – for example, not eating gluten will be much easier to do than not being exposed to air pressure. But for things like weather that are out of your control, you can make a mitigation plan by checking the Bureau of Meteorology and planning to be somewhere comfortable and safe if a major storm is predicted.
 
We can also help you identify some of these triggers and help you make plans for your triggers. Talk to us about this at your next appointment so that we can support you.

Hi Erica! Thanks for joining us.
Could you start off by telling us a little about yourself and the Mindful Movement Virtual Studio?
Thanks guys! I’m a Yoga, Mat Pilates and Somatic Exercise Coach based in Melbourne, Australia. 
 
As well as a mindful movement coach, I am a mother to two young boys and a writer and illustrator. At my core I'm curious, kind, committed and just the right amount of quirky!
 
I truly believe that movement is powerful. Mindful movement is more powerful still. That’s why I created The Mindful Movement Virtual Studio.

The Mindful Movement Virtual Studio is an online Yoga, Pilates and Somatic Exercise Studio. It allows you to do your movement practice from anywhere, anytime.

But it’s more than just a library of classes. It’s also a space where you’re supported! We talk about mindset, forming habits and other practical elements that make a home practice do-able and sustainable.

As part of the Studio, we also offer live masterclasses, weekly Q&As and more.

Who is this Virtual Studio for?
People who want to feel better in their own bodies! Many of my clients are busy women who want to feel better and know they need to commit to look after themselves and take responsibility.

It’s also for people who simply don’t get the chance to go to a local yoga class. It might be that you’re juggling around kids, or that you have pain or a condition that makes it difficult for you to make a regular class.

Is there anyone who wouldn’t benefit from this service?
I can really only think of two:

1. People who aren’t ready to commit to moving their body in a way that feels good
2. People who want to do extreme yoga poses with fancy contortions that look great on Instagram. This studio is about making your body feel good, not for looking good for social media!

Does someone need to have experience with yoga to benefit from the Virtual Studio?
Not at all! Many people who join are brand-new to yoga. But for those who do know their yoga, it’s beneficial because we use a lot of techniques and poses that aren’t commonly used in the average yoga class.

Do we need to commit a lot of time to see the benefits?
No! Most of the classes are 30 minutes or less. There are some that are only 5 minutes, and some go up to an hour. So it’s more about committing little chunks of time on a regular basis, rather than committing to a dozen hours every single week.

Do we need to be skinny, super fit, bendy or decked out in the latest activewear to do these classes?
Firstly: you can rock up in your PJs if you want to!

Secondly, these classes are designed to be inclusive – you can be whatever size, fitness level and flexibility level and still reap the benefits.

Do we need fancy equipment?
A few of the classes incorporate props, but there are always at-home alternatives you can use. Many people use pillows and blankets as their props! However, you can always filter the classes to find a prop-free video if you need.

Are the classes appropriate for people who have pain or ongoing injuries?
If you have a condition or injury that might impact your ability to engage in physical activity, I always recommend getting clearance from your health professional first.

With that in mind, the majority of classes are gentle and have variations to suit almost any issue. For example, some of the classes can be done while seated.

Some of the more advanced classes may not suit for some types of injury or pain that affect the function of your muscles. If you’re unsure, you’re welcome to contact me directly about a specific class and whether it’s right for you.

What if we need a little extra support with anything?
I’m here to help! I make sure that I’m available for people to ask questions. Feel free to reach out if you need anything.

Ok, you’ve got us: how do we sign up?
If you’re ready to prioritise YOU, make time to move well and feel well, head to this link to join! The doors are open until Sunday 15th March.