Simple Wellness Myotherapy & Remedial Massage
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Dealing With Bursitis? Here’s What You Need To Know

18/2/2020

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Have you recently been diagnosed with bursitis, but aren’t quite sure what that means? We’ve got you covered. Here are the basics you want to know about bursitis and what can be done about it.
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What is bursitis?
Throughout your body, you have bursa – small fluid-filled sacs that prevent friction between your bones, tendons and muscles around your joints. Bursitis is when a bursa becomes irritated and inflamed.

Bursitis commonly occurs in the shoulder, elbow or hip. However, you can experience bursitis in any bursa.

The most common symptoms include pain, swelling and stiffness of the joint. Pain will often increase during the night time, and becomes worse when you move the joint.

What can cause bursitis?
There are many factors that can cause or contribute to bursitis. Some of the most common include:
  • Injury of the joint
  • Repeated pressure and overuse of the joint – this is commonly due to repetitive movements at work or during certain sports
  • Chronic conditions such as rheumatoid arthritis, gout and diabetes
  • Infection in a joint (e.g. after surgery)
  • Age – bursitis is most common in adults aged 40+
  • Being overweight – this can increase risk of hip and knee bursitis

How is bursitis diagnosed?
This depends on who you see. Any health professional will take a case history and do a physical examination.

If you seek help from your doctor, they may order imaging tests to rule out other problems that might be causing your symptoms, or they may order a test of the fluid from your bursa to see if there is an infection.

How is bursitis treated?
The focus of bursitis treatment depends on what caused the problem in the first place. But it’s likely that treating your bursitis will include:
  • Avoiding activities and movements that make your pain worse
  • Resting the area and raise it to reduce swelling
  • Managing pain and inflammation

If the cause is an infection, your doctor may prescribe antibiotics to resolve the infection. A small percentage of people may be recommended surgery if other treatments have been unsuccessful.

How myotherapy can help with bursitis
When it comes to bursitis, there are a few steps that your myotherapist will take.

Firstly, we will assess the joint itself for swelling, inflammation, pain and movement. Once we know what we’re working with, we’ll put together a treatment plan to address the issues.

A treatment plan for bursitis often includes:
  • Massage, trigger point release and gentle mobilisation to reduce the load on the bursa
  • Taping the joint into a more comfortable position to relieve pain and pressure
  • Prescribing movements that stretch and/or strengthen the supporting muscles
  • Working with your GP to continue management of your pain and inflammation

Another useful therapy that may be discussed is hydrotherapy – exercises and movements performed in warm water. This can reduce pressure on the joint, making therapeutic movements easier and less painful.

If you’re dealing with bursitis, the team at Simple Wellness Myotherapy are here to help. To book an appointment with one of our qualified myotherapists, click here.
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​How To Manage Pain After Surgery

11/2/2020

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Have you just had surgery, or are booked in for surgery in the near future? Wondering how to deal with the pain that you experience after the procedure is finished?

Pain management can make a big difference for your recovery and overall wellbeing. Let’s take a look at how you can manage pain after surgery.

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​Why is post-surgery pain management important?
Getting a good hold on your pain levels after surgery is important for your comfort. But there are a few other reasons why managing your pain is essential for recovery.

Some of the most important reasons include:
  • Pain can impact on appetite, so you will often eat very little when you’re in severe and even moderate pain. If you’re not eating, you’re not getting the nutrients your body needs to heal effectively!
  • Pain is a major stressor for the body. This can further deplete nutrients and resources your body needs. But it can also affect other factors such as your sleep and inflammation levels.
  • Poorly managed pain after an acute situation such as surgery can affect the way that your body processes and interprets pain. This can put you at a higher risk of developing chronic pain or a chronic pain condition.
So as we can see, pain management needs to be top priority after surgery!

How to manage your pain post-surgery
Looking for ways to deal with your post-surgery pain? Every case is unique, but there are some simple tips you can try to relieve your pain.

Follow your surgeon’s advice
Your healthcare team will give you guidance on how long before you can do certain tasks, and how frequently to take your medication. These are given to you for a reason – to manage your pain and healing!

Make sure you follow your surgeon’s advice, and seek their consultation if you need to make any adjustments.

Find a way to relax
Pain can be taxing for the nervous system. But relaxation techniques such as guided meditation may be helpful for controlling the sensation of pain. There are plenty of free guided meditations online and on YouTube to try.

If meditation isn’t your thing, find other ways to relax such as reading or spending time in nature.

Focus on resting frequently and deeply
Your body does its best healing when it is resting. Even if you feel that it’s ‘lazy’, your body is actually hard at work when you’re taking a nap or sleeping! Make sure you prioritise rest that is both frequent and high-quality.

Aim for 8-9 hours of sleep per night as a minimum. If you’re not back at work, switch off your alarm and allow yourself to wake naturally. You might also like to make time for a nap in the afternoon, even it’s only a quick 20-minute rest.

How myotherapy can support your body post-surgery
When it comes to post-surgery pain, myotherapy can offer a variety of support techniques depending on the type of surgery and how long ago your surgery occurred.

For example, your myotherapist can:
  • Help to shift excess swelling and fluid that may be inhibiting the healing process
  • Address any muscular or joint issues that may be negatively impacting the injured area – for example, your hips, thighs and calf muscles can affect recovery from ankle surgery
  • Relieve muscular tension and pressure on other areas of the body that have been ‘picking up the slack’ from the surgical area – for example, using crutches can put pressure on your upper back and arm muscles
  • Create a tailored plan for safe movements you can do to strengthen your body as you recover – this allows you return to your usual activities as quickly and safely as possible

Here at Simple Wellness Myotherapy, we are experienced in working with a variety of clients who have undergone minor and major surgeries.

Our goal is to help you on your journey back to your ‘business as usual’ – whatever that may be! To book an appointment with one of our qualified myotherapists, click here.
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A Myotherapist’s Top Tips For Desk Workers

28/10/2019

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If you work at a desk for hours on end, you know that it can be uncomfortable at the best of times. Office workers have just as much risk of injury and chronic pain as other more physically strenuous occupations. You may be at risk of issues including back pain, neck pain, repetitive strain injury or RSI and carpal tunnel syndrome.

So how can you minimise your chance of hurting yourself and stay at the top of your game? Our myotherapist Emily shares some of her tips for staying healthy and preventing pain and injury for office workers.

Stretch often
When you’re focused on your work, you often forget to shift position. Unfortunately, our bodies weren’t designed to stay in a position for hours at a time. That’s why the simplest tip is to stretch whenever you feel stiff, sore or fatigued.

Stretching can also help to boost blood flow to the brain, which means you are more focused and productive.

You can simply stretch at your desk if needed – stretch out your neck, shoulders and back, and do some circles with your ankles. But you can also do a standing stretch, which brings us to our next tip.

Set yourself reminders to move
Small amounts of movement throughout the day add up when it comes to preventing office injuries. But when you’re in the zone, you might forget! That’s why it’s useful to set yourself a reminder or alarm on your phone or computer.

Aim for at least 1-2 minutes per hour of movement. This might be standing and stretching, going and getting a glass of water, making yourself a coffee or tea, going to the toilet or just walking around the office to get your muscles and joints moving.

Give a sit/stand desk a try
Desks that can alternate between a seated and standing position have become popular recently. They allow you the best of both worlds – you can sit for a bit, then switch to standing as a break from sitting.

Have a chat to your employer about whether you can trial a sit-stand desk. The good thing is that many people find sit-stand desks boost productivity, so employers are often open to them.

If you work for yourself or you are the boss, you can hire sit-stand desks and other equipment before purchasing.

Make the most of lunchtime
It can be tempting to eat lunch at your desk and power through the to-dos. But your lunch and break times are an opportunity to move around and give your muscles and joints a break as well.

Get up and get moving. Head to a local park to have your lunch if it’s sunny outside. Grab a coffee from the café around the corner. You can even go for a brisk 5-minute walk around the block at the end of your break to wake up your brain and your body. That way, you’ll go back to work feeling refreshed.

Get moving before or after work
Some days you won’t get much time to move at work, so make the most of the hours outside of work. Find a way to get your body moving on a regular basis.


This doesn’t mean you need to slog away at the gym for an hour every day. You can do some yoga stretches at home, walk the dog or go to the playground with your kids.

If you do find yourself too tired to move after work, try getting up 15 minutes earlier and go for a walk around the block before work. It seems counter-intuitive, but exercise actually boosts your energy and relieves fatigue. Even a little bit each day will add up!


Get a regular remedial massage or myotherapy treatment
Your muscles and joints need care, just like every other part of you. That’s why regular treatments can help to prevent injury and pain.

Our desk worker clients find that a treatment every 2-6 weeks helps to relieve tension and pain. Many report that they have fewer headaches, lower stress levels, improved sleep and mood and greater movement in joints and muscles. So if any of those are on your wish list, regular massage and myotherapy might be the answer!



Is regular massage or myotherapy on your to-do list? Our myotherapist Emily is currently open for new clients. You can book with a session with her here.



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10 Reasons To Get A Massage This Week

3/10/2019

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Looking for an excuse to get a massage? We hear you! Massage can have a variety of benefits, especially when you are treated by a qualified remedial massage therapist. Here are our top 10 reasons you might want to get a massage this week.

You’re stressed out

Let’s face it – most of us live pretty hectic lives. Between family, work, social life, hobbies and more, there isn’t much time for stress-relieving activities.

Putting aside an hour for massage isn’t just about feeling good. Research has found that massage therapy can reduce the level of your stress hormone cortisol, as well as boosting up your feel-good brain chemicals. So it relieves stress physically as well as mentally.

You’ve been hitting the gym lately

Whether you’re doing a 12 week challenge at your gym or getting outside for a bootcamp, increasing your exercise can mean a lot of aches and pains.

Massage is a great option for after a workout to aid with recovery. But you can also book yourself in regularly to address any tightness or discomfort in the muscles that can limit your gym efforts.

You want to be more flexible

Our bodies are designed to be flexible. But our modern world has had a big impact on how flexible the average person is. Between office jobs, Netflix and cars, we spend a lot of time sitting on our muscles instead of stretching them out.

When a massage relieves tension in a ‘tight’ area, it can help your muscles, ligaments and tendons to be more flexible.

You have a new fitness goal or event in mind

Set a goal to run a marathon in 12 weeks? Signed up for Tough Mudder or a Spartan race? Want to be the next Ninja Warrior? Maybe you just want to get back to doing a proper push-up.

Whatever your fitness goal or event, a massage will relieve tension. A remedial massage therapist can also let you know if you have any significant areas of tension or muscle imbalances that may increase your risk of injury.

You’re sore or aching

There are many reasons for feeling sore. But one of the simplest solutions is to get a massage. Massage can soothe away the aches and pains.

If your pain is more chronic, massage can still help to relieve symptoms. In fact, research suggests that multiple massages may be more beneficial for relieving symptoms of pain for issues such as chronic neck pain. Sounds like a good reason to book in a few appointments!

You’ve got a headache

A nasty headache can really screw up your plans and leave you grumpy. So why not get a treatment that can relieve those symptoms?

Research has shown
that massage can reduce the duration of a headache, as well as reducing frequency for those who experience chronic tension headaches.

Think it’s more of a migraine? Massage can still help. One study found massage can reduce migraine pain by up to 68%. Just make sure you’re safe to drive, or ask a friend to drive you to your appointment.

You haven’t been sleeping well

If you’re not sleeping soundly, your body and mind can suffer some nasty consequences. Poor sleep can have many factors involved – caffeine, food choices, technology use, lack of sun exposure, stress, family, work, the list goes on.

The good news is that massage can help address many of these factors as well as priming your body for sleep. There is plenty of research showing that massage can help with sleep. It can even help with sleep concerns for specific groups such as people with chronic pain or pain conditions, heart failure or post-menopausal insomnia.

Your mental health has been a little low lately

Whether you’re feeling blue or are getting anxious over little things, mental health is something to take seriously. When you’re not feeling ok, it can be hard to take steps to help yourself feel better. But one simple and enjoyable step is a massage!

A review of 37 massage therapy studies
found that the greatest impact of massage is its ability to reduce anxious and depressive symptoms. In fact, they suggested that a course of several massage treatments showed similar benefits to psychotherapy!

It’s been a while since you’ve taken care of you

Most of us are great at taking care of others. But we’re not so good at taking care of ourselves – physically, mentally or emotionally.

Massage is a one-stop shop treatment for all of these aspects of self-care. Your body feels good, your stress levels drop and you are looking after your mental wellbeing.

Because you can

We think this is the best reason of all! If you’re looking for an excuse to get a massage, that in itself is a good enough reason for a massage.

To book a massage with our remedial massage therapist Helvi, head to our booking page and select ‘Helvi Topia’ as your practitioner.
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​Lifestyle Tips To Support Your Chronic Pain

24/6/2019

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When you experience chronic pain, you just want to feel better. Unfortunately, there is no quick fix
for chronic pain – it can take time and effort. But there are lifestyle tweaks you can include in your
everyday life that can help with pain.

Some of these can alleviate pain, and some can help you to cope better with the pain. Since every
person is unique, some might work better for one person than another. So start with one, give it a
good go for a few weeks, and see how you go!


Try out meditation & mindfulness
Before you roll your eyes, hear me out! Meditation and mindfulness does not have to be sitting
cross-legged on the floor, chanting. It does not mean you need to ‘stop thinking’ or ‘clear your mind
of any thoughts ever’.
Meditation and mindfulness is more about being aware that your thoughts are just one part of you.
It allows you to tune into your body and senses, and most meditations use long, slow and deliberate breathing patterns. We know that taking time to focus on breathing and calming thoughts can help to slow down a really active nervous system. When it comes to meditations that are designed for
pain, they don’t stop pain, but they do help you to recognise where the pain is coming from and
what it might mean.
The research suggests that it’s worth giving meditation a go. A meta-analysis of 38 controlled trials found that meditation helps to reduce pain, improve symptoms of depression and increase the
overall quality of life.
Most apps and meditation websites have guided meditations for pain, anxiety, stress, or all of the
above. Our favourite nutritionist (who has a condition that can cause chronic pain) Sam is a big fan of the pain (#14) and stress (#31) meditations over at Meditation Oasis.


Introduce gentle movement
It can be tempting to avoid movement when you’re in pain. But gentle movement that doesn’t cause
severe discomfort or pain can be incredibly therapeutic.
The research shows that exercise can increase your pain tolerance and decrease your perception of
pain. It can relieve pain and improve quality of life in those who have chronic pain of some kind.
To start moving again:
Start slow. Begin with gentle movement, and work your way up over a period of weeks or months.
Use non-painful joints and muscles. Endorphins are systemic, so if your pain is in your back, moving
your arms or legs will still help to relieve that pain.
Get yourself a paced rehab program. Working with a practitioner is best for this, as we can monitor
your progress, adjust movements that are too painful or difficult, and cheer you on as you achieve
goals!


Seek social support
Feeling supported doesn’t just make you feel better mentally and emotionally – it can influence your
experience of pain. Countless research papers from the 1970s up until today have highlighted how
important it is for people with chronic pain to have social support.
The care of friends and family can make a big difference. Partners can play an important role in helping you to feel supported, too.
You don't even need to talk to people about your pain if you don't want to, but talking to people about anything can be helpful - even if its small talk about news, weather, music, films.

It can be tempting to push through and struggle, especially if you’re someone who doesn’t like to
bother or burden others. But asking for help or even just a chat with someone you trust can make all
the difference.
Consider joining an interest group, like a coffee club, social group or walking group.


Spend time with pets
This is by far my favourite tip, as I’m a certified crazy cat lady! But it’s also backed by some science as
well. When you play with a pet, your body releases a hormone known as oxytocin. Oxytocin can
increase your pain threshold, drop your stress and anxiety levels and reduce inflammation. It can
also decrease blood pressure and heart rate by activating your ‘rest and digest’ mode.
The best part is that you don’t even have to own a pet – you can borrow a friend’s! And the benefits
go both ways. When you cuddle a furry friend, they also feel happier and healthier.


Work with practitioners who empower you
A good team can make a huge difference for someone who experiences chronic pain. It’s important to work with qualified practitioners who understand how complex pain is. But it’s also best to work with practitioners who want to give you the tools to recover from that pain.
We can’t ‘fix’ you, but we can empower you with the facts about pain, the latest research findings,
and the best quality care possible.
Want to work with a myotherapist/remedial massage therapist who fits that bill? Book in an
appointment with a Simple Wellness practitioner here.
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Why heat is great for chronic muscle pain

1/6/2019

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Do you love your heat pack? Me too!
There are plenty of reasons to keep your heat pack close by, and not just because we're entering winter!

Heat treatment is great for muscle pain - its cheap, effective, and drug-free! Have you ever wondered why heating your sore muscles helps them so much?

Some pains are categorised as ischaemic pain - that means that the tissue has a reduction of oxygen supply which is needed for normal cell activity. This tends to happen if we're in positions that compress or over stretch areas for a long time - like sitting at a desk for a few hours without getting up to move around.  Heating an area increases the local blood flow, which means the blood vessels widen to get more fresh, oxygenated blood into your muscles and joints. 

What kind of pain should you use heat for?
Many kinds of non-inflammatory pains will respond really nicely to heat, including things like cramping and spasming, stiffness and persistent tight or pulling muscles. 
Heat packs are easy to use for neck, shoulder, lower back or hip pain.
​If you have a lot of painful areas, a warm bath can be another great way of getting heat into your muscles - why not add some Epsom salts for the added magnesium benefits for sore, tight muscles!

When should you not use heat?
Avoid heating up any fresh injuries, especially if you have open wounds or if the injury has become infected. These kinds of injuries will be in the inflammatory stage of healing - you'll be able to tell because the area may be swollen, red and hot, and most likely it'll be much more sensitive than usual! 

Of course, you do need to be careful with heat packs or hot water bottles to make sure you don't burn yourself. Always wrap your heat pack or hot water bottle in a something like a pillow case, thin blanket or a towel so you don't have the hot surface directly on your skin. Using heat for too long might give you heat rash, so I usually suggest about 20 minutes at a time.

Heat on its own is more for symptom relief than for resolving the underlying issue. If you have an injury or feel that you have a lot of long term tension built up in the muscles, book a treatment with your local Myotherapist.
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What is Sciatica?

15/4/2019

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You might be familiar with that sharp, shooting pain sensation in your lower back, hip and leg. It can also be felt as numbness, pins and needles, tingling or burning type of sensations. Whatever way the pain or symptoms present, it runs along the Sciatic nerve - which is why this is referred to as Sciatica.

But did you know theres more than one potential cause behind this pain?

Often this pain can be linked to muscle tension in the glutes and hips. The Sciatic nerve runs underneath the muscles of your glutes, and when it gets compressed there it can be a real pain in the bum - literally!
Because this nerve runs all the way down to your feet, the jolts of nerve pain can sometimes be felt anywhere from just localised in your buttocks and hip, to the back of your thigh, behind the knee, straight down your lower leg and even into the base of your foot.

The Sciatic nerve can be impacted at the root of the nerve near the spine, however this doesn't always mean there will be pain. Often this is called a Bulging Disc or Herniated Disc, but you might be surprised to learn that even though "Bulging Disc" sounds pretty awful, studies have shown that more than 50% of people over 40 with no pain symptoms at all can have a disc bulge show on scans.

Irritation or compression of the Sciatic nerve can be common after serious trauma to your leg or lower back. Things like car accidents, falls, and horse riding accidents are all common high impact incidents that can aggravate the nerve. If you've had an injury like this, its wise to seek treatment for it.

Do you have Sciatic nerve pain or nerve symptoms of numbness, tingling and pins and needles? Book an appointment with us to have an assessment and treatment. If we can resolve the issue, we'll create you a treatment plan that includes manual therapies and a take home exercise program. 

More serious causes do exist, so if treatment of the muscles and joints is not relieving your pain, we'll refer you to see your GP to rule out any serious structural or pathological conditions.
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How does myotherapy help with chronic pain?

29/1/2019

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A lot of people who don't have persistent pain don’t realise how much chronic pain sucks. Ongoing pain isn’t just about physical discomfort – it also affects your mental wellbeing, your social life and your long-term health. This is why I have such a strong focus on chronic pain management as a myotherapist.
But what can myotherapy do to help with chronic pain? I’m glad you asked! One of the things I love about myo is that it has so many tools, so there is always one that can suit your needs and tolerance. Here are the main ways I use myotherapy techniques to help you manage chronic pain.
It helps to manage acute flare-ups
When you have chronic pain, it’s common to have a flare-up of symptoms and/or pain levels. Sometimes it can be your nervous system increasing your sensitivity, and sometimes it’s a physical factor such as tight muscles that cause issues.
Either way, different techniques such as taping, massage and mobilisation can relieve the flare.
It can down-regulate the pain response
One of the main problems with chronic pain is that the body becomes more sensitive to pain messages sent by the nervous system. Sometimes the number of connections along nerves can be altered. Other times, there is a greater release of neurotransmitters, which makes the body super-sensitive to sensation.
I cover this a bit more in my pain matrix article, but non-painful sensations can block the danger messages. This means that pressure from a gentle massage or myofascial release stretching can help to reduce pain.
It can look at the root causes behind chronic pain
There are so many factors that can lead to chronic pain, and even more that can aggravate it. But as a myotherapist that focuses on chronic pain, it’s my job to be an investigator into your pain. Your treatment plan might include exercises and stretches that aim to correct any underlying causes of pain.
We’ll also have regular discussions about the lifestyle factors that might be contributing, and ways to modify them. And if I think one of your triggers is out of my zone, I’ll refer you to a trusted practitioner who also works with chronic pain.
It can reduce stress hormones
Want to hear something cool? The relaxation after a myotherapy session isn’t all in your head. Research has found that massage can reduce cortisol, your main stress hormone, by 31%.
As a bonus, it can also boost your levels of feel-good brain chemicals serotonin and dopamine. If that isn’t a good reason for regular myotherapy sessions, I don’t know what is!
It can release trigger points
Ever had a little knot feeling on a muscle, that when pressed, feels so sore but so good? That’s a trigger point. These taut bands are like a micro-spasm of a muscle (not a full muscle spasm like if your leg cramps in the night!) Trigger points can contribute to chronic pain, and they can certainly exacerbate it. Because trigger points tend to have referral patterns, they can also make you feel pain outside of the area that the actual trigger point is found.
As part of your myotherapy treatment, I can release any problematic trigger points around the area of pain. For example, if you have chronic headaches, I might look at the trigger points around your head, jaw and shoulders.
Tape can be used to stabilise joints if needed
If your chronic pain comes with any joint instability, taping is a great tool for managing it after you leave the session. By using either rigid or kinesiotape, depending on the issue, we can stabilise the problem joint or joints. That way, your painful area is supported and you’re less likely to make movements that aggravate the pain. The tape can also be used to help continuously guide and remind your joints of a better position to rest in which helps to take strain off certain areas.
 
Looking to manage your own chronic pain? Your no-pain, all-gain myotherapist is here to help. Head here to book your appointment today
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Basics Of Bursitis: What It Is And How To Manage It Naturally

23/1/2019

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Have you ever been diagnosed with bursitis? It’s one of the most common injuries I see in clients. But you don’t have to just put up with the pain – there are ways that myotherapy can help.
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What is bursitis?
Simply put, bursitis is the inflammation of the bursa. Bursa are the soft fluid-filled cushion sacs that protect the bones, tendons and muscles around the joints. When they are functioning properly, they make it easy for tendons and muscles to move smoothly at the joint. When these fluid-y sacs become inflamed, they get swollen and enlarged, which can make movement difficult due to the physical space the bursa now takes up in the joint. The inflammation process also increases sensitivity in the area, giving you that familiar feeling of pain and aching in the joint.
You have over 150 bursa throughout your body, so that is more than 150 places bursitis can occur. That being said, the most common bursitis I see is in the shoulder and hip joints. Less common locations include the toes, knees and elbows.
What can cause bursitis?
There are a number of factors that can cause or lead to bursitis. The most common are injuries, repeated pressure and overuse of a joint. But there are some chronic conditions that can lead to bursitis such as diabetes, rheumatoid arthritis and even an infection that reaches the bursa.
What are the signs and symptoms of bursitis?
The most common symptoms you’ll come across are:
  • Pain in one area
  • Swelling
  • Warm or hot feeling around the area
  • Pain that is worse when you move the area, especially getting moving after being still for some time
  • Stiffness in the joint
  • Increased pain at night
Because these symptoms are similar to other problems such as arthritis, it may need further investigation before you’re given a definite diagnosis of bursitis. Your doctor might send you for scans and X-rays to rule out other more serious conditions.
What is the medical treatment for bursitis?
Most of the time, doctors will refer you onto a musculoskeletal therapist such as a physiotherapist, osteopath or myotherapist (like me!)
In severe cases, they will do an injection of cortisone, an anti-inflammatory steroid, into the joint. Although this can make you feel better temporarily, it is a bit of a bandaid approach. If you don’t remove the cause of the bursitis, you’ll have to keep getting a giant needle into the joint – ouch! Cortisone injections aren’t a guaranteed fix, and can have a limited time of effect from very short term (days or weeks) to longer term relief (months or years). Some patients may not get any relief at all, even temporary. I always like to remind people who are considering the injection that my opinion is a biased one – I tend to only see the people who the cortisone shot hasn’t worked for, because if it works, they don’t need to come back for treatment for that same bursitis issue!
How can a myotherapist help with bursitis?
Wanting to avoid the big needle into the joint or just prefer to manage your condition naturally? A myotherapist like myself can work on the acute pain and address the causes behind the bursitis. There are plenty of ways that the different techniques of myotherapy can help, including::
  • Finding a comfortable position for the joint, and taping it there to support the joint
  • Reduce the strain on the affected joint by working on the surrounding muscles – using techniques including massage therapy, needling, cupping and trigger point release
  • Find the root cause – sometimes, it might not be the affected joint that is the main problem. Bursitis can be caused or aggravated by any factor that puts strain onto a joint.
  • Prescribe a handful of exercises to help strengthen the muscle groups that will help to bring your joint back to its pain free resting position
When working with someone with bursitis, I’ll also have a chat about their lifestyle. Often, different activities, habits or movements can contribute to bursitis. For example, one of my clients has had bursitis of the big toe. It turned out that when he is sitting, he unconsciously curls his big toe under his foot!
By working on the aggravating factors and finding ways to modify them, we can reduce the pain and inflammation over the long-term.
Is the pain of bursitis holding you back from the things you love to do? Book an appointment today and we’ll get you back on track to health
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​Can The Pain Matrix Explain Your Chronic Pain?

4/12/2018

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Everyone has experienced pain at one time or another. But pain is personal – each of us experiences pain differently. Some of us feel it very intensely, and others not so much. This is because pain depends not only on what happens to your body, but also how your brain responds to it. This is what is known as the Pain Matrix.
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What is the Pain Matrix?
This matrix processes information from the nerves that tell us when we’re in danger or injured. It responds by increasing or decreasing our sensitivity to these messages. These changes – known as top-down regulation – control how intensely we feel pain.
The Pain Matrix involves different areas of the brain that control emotions, behaviour, movement, perception and thoughts. So it’s no surprise that when you’re in pain, all of these different factors can change.

How does the Pain Matrix work?
There are two main changes that the Pain Matrix can induce. Anti-nociception is a reduction in sensitivity to pain, whereas pro-nociception is an increase.
Anti-nociception uses the body’s natural painkillers – endorphins – to block the danger signal and decrease the pain response. Ever seen someone injure themselves in a dangerous situation, like in a car accident, but they can still move to safety without feeling pain? This is because a rush of endorphins temporarily blocks out the message of danger so they can get to safety.
On the other hand, pro-nociception is usually due to swelling and chemical changes in the nerve endings around an injury. Have you ever had a bad paper-cut? Your sensitivity is much higher around the cut, even if you’re not touching the injured part. Sometimes, even moving the other fingers can hurt.

Changes in the brain = changes in the pain
Despite what we used to believe, the brain can continually change its form and function as a form of adaptation. These changes are known as Neuroplasticity. Nerve pathways can physical alter by increasing or reducing the number of connections. Or they can alter the release of neurotransmitters – more stimulating neurotransmitters means more nerve activity, which can increase the sensitivity of the system. 
When it comes to chronic pain conditions, the central nervous system is reorganised. This can include damage to nerves, leading to abnormal connections between them. Pain is more likely to occur than not, as pro-nociception increases and anti-nociception is impaired. This can lead to exaggerated responses to pain including pain caused by non-painful experiences - this is known as allodynia, and can be a common symptom in conditions like Fibromyalgia.
Long term inflammation can lead to a heightened sensitivity of the nervous system. In the presence of inflammation the amount of nerve stimulation needed to send the signal decreases and the nerve firing rate increases. With so many danger messages coming in when there is inflammation present, the nervous system starts to respond on high alert by using its protective mechanism - pain!

Controlling the pain
There is no one size fits all approach to controlling pain, but theres increasing evidence that changes to pain intensity can be influenced by more than just the incoming messages from our tissue - it can also be influenced by our perceptions of danger and safety. This is likely due to the pain matrixes involvement in areas of the brain that deal with emotions, behaviours and thoughts. Pain experts Dr Lorimer Moseley and Dr David Butler of the NOI Group have published a fantastic book called Explain Pain that describes DIMs and SIMs - that is, Danger In Me (DIMs) and Safety In Me (SIMs). They say that any credible indication of danger can increase your perception of pain, and likewise a credible indication of safety can decrease the pain. We'll dive deeper into this research in future blogs.

The Gate Control Theory involves a more physical approach to pain control.
Have you ever bumped into something, then rubbed the area to make it hurt less? The Gate Control Theory is that non-painful sensations such as pressure can block or override the danger messages and reduce pain. The nerves that tell us about pressure are faster and more effective than those that tell us about danger. This might be part of why something like a good massage session helps with pain. Massage is also a great way to stimulate some feel-good endorphins, which promotes anti-nociception to reduce painful sensations!

If you’re looking to minimise your pain, a combination of massage, exercise therapy and other myotherapy treatments can help. Have a look at my online booking calendar to book in for an appointment.
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    Mel Hanley

    Mel is a Myotherapist based in Ferntree Gully.
    She's a nerdy, geeky bookworm who loves to help explain complex pain in an easy to understand way.
    ​She has a special interest in chronic pain conditions like fibromyalgia and Ehlers Danlos Syndrome, and more.

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Simple Wellness Myotherapy Clinic
Level 1,
1571 Ferntree Gully Road, Knoxfield VIC 3180
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​Mel@simplewellness.com.au
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Mel Hanley and Emily Wells are registered as members of Massage & Myotherapy Australia as Remedial Massage Therapists and Myotherapists
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