Many people are familiar with the term "bulging disc" in regards to lower back pain. It can feel like an intense, sharp, stabbing sensation that can often travel down your leg through your hips and bum, sometimes as far as your feet. This is a common diagnosis when you start to develop back pain. You get a scan which shows changes in the disc, and the pain matches the effected nerve area. It can be a scary diagnosis. But you may be surprised to know that a lot of people who don't have pain have also been found to have changes in their discs. I find this study to be really encouraging, because it shows that people who have significant changes to their disc structure can still live a painfree life. It suggests that the disc changes may have already been there for some time before any painful symptoms even began, and gives hope that even if the structure doesn't change, that the pain can change. Lets have a look at this interesting literature review, particularly in regards to the findings around disc degeneration, disc bulges and disc protrusions. This is a literature review of 33 separate studies that investigated the imaging of spinal degeneration in painfree people ranging from their 20's to their 80's. It was published in the American Journal of Neuroradiology in 2014. In total, the review takes into account MRI and CT scan imaging on 3110 individuals with no painful symptoms. As you would likely predict, the number of findings increased with the participants age group, showing age-related degeneration occurs even in people who aren't experiencing pain. Lets have a look at the imaging results for the disc degeneration, bulge and protrusion categories: Disc degeneration - changes to the disc and surrounding vertebrae that result in loss of cushioning and support, may include signs of osteoarthritis at the joint. The Results: Disc degeneration in painfree participants was identified in:
Disc bulge - changes that alter the shape of the disc and can make portions of it "bulge" out of place, which can apply pressure to nearby nerves. The Results: Disc bulge in painfree participants was identified in:
Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves. The Results: Disc protrusion in painfree participants was identified in:
What does this mean for your bulging disc? It means that theres a good chance that your structural changes were already present before your back became painful. The area may be irritated or flared up right now, but these findings are a good indication that even if your scans don't change, your back pain still can settle down. It means that a scan showing disc changes doesn't have to be a life sentence of pain. Does this mean bulging discs DON'T cause pain, then? Don't get me wrong, bulging discs can be painful, and for some people it can be severe. This study just helps to show us that theres more to back pain that what shows up on MRI or CT scans. Structural changes are just one layer in the complex onion that is back pain. We can help! There are lots of ways we can change your experience of back pain through massage and myotherapy techniques like dry needling, taping and support, strengthening the surrounding muscles with exercises that are appropriate for you, and supporting your understanding of how your back functions. Book a time to come see us to talk about your back pain and creating a treatment plan to reduce it. We're pleased to say that after weeks of being closed due to COVID19, we're very close to reopening! We're sure you're as excited as Emily and I both are to get back into our treatment room for the myotherapy and remedial massage therapy treatments you've been missing! We've been given the OK to reopen 4 days a week by our medical professional landlords, Dr Wajib Dib the GP we share our clinic with at Together Medical, and Amer Dib the pharmacist who owns and runs Knoxfield Pharmacy downstairs from us. They've been happy with the policies and procedures we've put in place for sanitisation and screening, and are welcoming us back from the start of June.
Needless to say, due to COVID19 we’ve needed to optimise the cleanliness of our space and put in place procedures to maintain social distancing outside of your treatment. These are the changes we’ve made to ensure your health and safety during your appointment:
What else is new? We've broken up Myotherapy and Remedial Massage into 2 categories. We hope this will make it easier for you to know what type of treatment you want to book. Myotherapy If you have an injury to be assessed, a chronic condition needing expert maintenance, or want more advanced treatment techniques like dry needling, cupping, mobilisation, taping, or a tailored exercise plan, you can book a Myotherapy appointment. We've also removed the need to book an Initial or a Return session for Myotherapy treatments, you can now just choose the appointment length you need. Remedial Massage This means if you would prefer "just a massage" to address your aches and pains, you can book for a Remedial Massage and get what you're expecting - feel good, hands on massage! Perfect for muscle soreness and general preventative care! Appointment Length and Fees From June 1st, we'll be offering the following appointment types: Myotherapy - 30 mins ($79), 50 mins ($99), 80 mins ($134) Remedial Massage - 30 mins ($70), 60 mins ($100), 90 mins ($130) Ready to book in? Pick a time from our online booking page for when we return in June! Multiple Sclerosis is a many, many layered condition that has a long list of symptoms, including pain, fatigue, and weakness. There is currently no cure for MS. But just because there is no cure, does that mean there is nothing that can be done to help reduce these symptoms and maintain muscle health? From clinical experience, I've found massage and a variety of myotherapy techniques to be incredibly useful for patients living with MS. You can read more about my clinical experience with treating MS in this blog. I've been running for The May 50K during COVID19 isolation to raise funds and awareness for MS, so I thought its only fitting that I write up a bit of a literature review on the research! You can read the article here for the full study details, as published in the International Journal of Therapeutic Massage and Bodywork in December 2016. What does the research say specifically about massage therapy and MS?
There are a few things to keep in mind when we read this study. Firstly, manual therapies are hard to study, because the techniques used are almost always different every single treatment. As experienced therapists, we select techniques that are the most relevant to the patient each time they come for an appointment, and our selections are based off what we assess in the consultation, as well as what the patient agrees to on the day - for example, some days a deep pressure trigger point treatment can be tolerable and helpful, and other days it may feel too much. Secondly, Multiple Sclerosis affects people in widely different ways. There is no one "best" treatment technique for MS, and the symptom types, areas and intensity are vastly different from person to person. Keeping that in mind, lets have a look at how these researchers completed their study, and what they found. How did they design a study for massage therapy for Multiple Sclerosis? A specific massage sequence was designed for the study. This sequence was to be followed to the letter for every patient at every session, regardless of the symptoms on the day. This isn't an ideal way of providing a treatment in a clinical setting, however in a research setting its important to be able to make the tested treatment or therapy able to be reliably the same for every subject in the study. The sequence involved a full body massage therapy routine which included gliding strokes, kneading, cross fibre friction, and trigger point treatment. The 24 participants were scheduled for a weekly one hour treatment using the specific massage routine for 6 weeks. If a participant missed a scheduled treatment, they aimed to reschedule it within a week, so that each participant received 6 identical treatments over the course of no longer than 8 weeks. How did they measure and assess it? Five measurement scales were used to assess the outcomes in a variety of symptoms. The participants recorded scores for
What did they find out? The results overall suggested that massage therapy was a safe and useful tool in providing relief from fatigue and pain, and improving mental health and general quality of life. Fatigue - The MFIS indicated that 22 out of 24 participants reported decreased fatigue scores. There was a significant correlation between fatigue decreasing and pain decreasing. Spasticity - 19 out of 24 participants completed the MAS spasticity evaluation, and of these, 16 reported experiencing spasticity symptoms ranging from slight to considerable increase in muscle tone. There were no significant changes in spasticity after the end of the 6 week treatment period. Pain - On average, participants reported a significant 18% reduction in pain on the MOS Pain Effect Scale. The reduced pain scores correlated with improved mental health scores. Mental Health - A significant increase in the total scores on the MHI indicates overall mental health improvement. A small number of participants did not improve on some subscales, such as anxiety (3 participants) and depression (1 participant) Quality of Life - Overall, the quality of life scores on the HSQ showed improvement. Emotional and Social subscales showed more improvement than Health and Physical. The results indicated that as fatigue and pain decreased, measures of quality of life increased. Can we help you? Do you have MS and want to discuss treatment options? Our clinic is temporarily closed due to COVID19, but we expect to reopen by June. Check our availability on our online bookings page for updates. Are you receiving assistance from MS Employment Services? You may be eligible for funded Myotherapy treatment through your Occupational Therapist. Contact your OT to see if you can apply, and they will forward us the documents to begin the process for you. Do you have MS, you're currently working or seeking work, and you're not receiving assistance? Check the MS Employment Services website to see if you're able to receive support. 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. 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:
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:
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:
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. 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. 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:
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:
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. Does this sound familiar? Terrible pain in your first few steps in the morning. Pain on standing up if you’ve been sitting for a little while. Putting weight on that foot can be agony. You feel it strongest in the heel or arch of your foot. Once you get moving it seems to calm down. If you're saying yes to these symptoms, you could be dealing with a condition called Plantar Fasciitis. Its quite common, and one of the most frequent foot pains that our myotherapists help people with. Plantar Fasciitis is a very painful condition that affects your heel and the sole of your foot. Often the mornings are the worst pain, people often explain they feel like they have to hobble about for the first few minutes of their day.
Usually it affects one foot or the other - some very unfortunate people can get both feet affected at the same time. Symptoms include heel pain; arch pain; altered walking patterns; cramps or spasms in the sole of the foot. Usually the pain reduces after getting moving, but those first few steps can be uncomfortable through to excruciatingly painful. What kinds of treatments work best for Plantar Fasciitis? The techniques I've found that work the best for people with Plantar Fasciitis are:
The hands on treatment sessions are only part of the recovery plan though. Like with most pains or injuries, looking at the way you move and stretch outside of your time in the clinic is important to helping you feel better, quicker. Our therapists will show you some simple but effective movements that help you to stretch your foot and leg to reduce the pain. We can also offer you some temporary pain relief suggestions like ice bottle rolling and using spiky physio balls. Ready to look at a plan for kicking Plantar Fasciitis? Book a 60 Minute Initial Consultation with us. We'll assess your movement and muscle balance, give you a feel-good hands on treatment, and walk you step by step through your treatment plan. Headaches are one of the most common issues our Myotherapists and Remedial Massage Therapists help people with. There are a bunch of variable ways that headaches can turn up - sometimes affecting only one side or the other; sometimes just the top, sides, or back of your head; sometimes very pinpoint spots like right behind your eyes; squeezing tension bands across your temples and eyebrows; starting from your jaw and spreading upwards; or just generally your entire head.
No matter which type you get, its never a good day if you need to persevere with a headache. There are a lot of factors that can influence headaches. Trigger points in your neck, shoulders and face can send some intense referred pain headaches, and these trigger points respond particularly well to hands on treatments like remedial massage, cupping and gentle mobilisations. Dehydration and exhaustion can be linked with headaches. If you suffer regularly, keep an eye out for your usual water intake and sleep patterns. By improving your quality of sleep and the amount of water your body has available to use, you may find your headaches reduce or go entirely! Stress and hormonal changes can also lead to headaches. Have you ever noticed how your neck, shoulders and face become much tighter when you're under stress? Do you clench your teeth, or hunch into a protective position? Some women find that they get a headache at specific times during their cycle due to changing hormone levels. Hormones are something that are outside of our scope as remedial massage and myotherapists, but many of our patients have found Acupuncture to be a useful tool in balancing hormones. Our good friend Amanda at Upwey Acupuncture can help you explore hormonal treatment options, including menstrual and menopausal symptoms. Eye strain can bring on headaches, as I found out last year! We got a new TV and I got intense tension band headaches every time I watched it for longer than about 10 minutes. My optometrist checked my vision and prescribed my glasses to help reduce the strain on my eyes, and it helped resolve my headaches! If you already wear glasses, is it time for a check up? If you don't wear glasses, perhaps an eye test could be helpful for you. Aside from taking over the counter medications like Panadol, how can you get help with easing and resolving a problematic headache? A great first step is to book with one of our therapists so we can assess your headaches and determine if they have a musculoskeletal origin. We can often help people get rid of their headache and set them up with a plan to prevent future headaches. A Short 40 Minute Initial Consultation is ideal for your first appointment to investigate your headaches. You’ve been told you have Tennis Elbow, but you don’t even play tennis? The pain can catch you off guard, and make normally simple tasks feel really difficult - opening jars, turning door handles, shaking someones hand, maintaining your grip on something. This type of pain can feel like a deep muscle aching, a stretch in the muscle, sharpness when you move, or a combination of these feelings. Our Myotherapists and Remedial Massage Therapists can help by creating a treatment plan for you that relieves the pain and gives you back your strength and ability to turn, twist and grip again.
Tennis Elbow is a painful condition of irritation and inflammation of the tendons around the outer side of your elbow. Its normal to feel the dull, constant ache throughout the day, and have the pain turn into sudden, sharp or shooting pain when you move your elbow or wrist, or try to grip something or twist a lid or door handle. It can happen if you spend a lot of time doing repetitive wrist movements like typing, using tools, carrying something heavy for a long period of time. We see it with people who play musical instruments too, or video gamers who get so into the game they forget to take a break for hours on end. Our typical treatments for this kind of pain will look at assessing your movement and strength first so we can plan out some short and long term goals. Our short term goals are usually the ones you want the most - to get rid of this awful pain!! But its also important to plan for the long term goals of recovering the strength in the area so that this feeling doesn't come back. A series of hands on treatments can help to reduce the pain and sensitivity in the area, and we'll give you a few movements that help that you can focus on between treatments. This is a pain that tends to respond well to doing some stretch and strengthening movements each day, starting with small easy movements, working up to more challenging or weight resisted ones. The hands on part of your treatment may include some remedial massage, cupping, active release techniques, dry needling, and trigger point therapy. Afterwards we can support your elbow with kinesiotaping to reduce pressure over the joint and tendons. Do you need help with elbow pain? Our therapists are ready to help assess your pain and work with you to create a treatment plan to reduce the irritation and restore your movement and strength. Book your first consultation with us now! Most people have heard of the Rotator Cuff being a big culprit of shoulder pain, but do you know what it is and how to get help? Our Myotherapists and Remedial Massage Therapists help a lot of people with Rotator Cuff pain - its one of our most commonly treated pains! The Rotator Cuff is a group of 4 muscles that all work together, and they have different actions. So when you come in with a Rotator Cuff injury, the first thing we’ll work out for you is which muscle is causing you to feel the pain.
The job of the Rotator Cuff group is to move and stabilise your shoulder, and it does that by making what I like to light heartedly call the Shoulderblade Sandwich. Imagine your shoulderblade bone (scapula) as the filling of the sandwich, and the Rotator Cuff muscles are the bread on either side. The muscles on the outer side work to lift your arm and rotate it outwards away from your body, and the inner muscles rotate your arm inwards. The most common issues we see with Rotator Cuff complaints is tight muscles referring pain, or muscle tears. Rotator Cuff referral pains can be felt locally around the shoulder, as well as further down your arm, elbow, wrist and hand. If you've got a Rotator Cuff tear or a partial Rotator Cuff tear, you'll likely notice pain and difficulty on raising or rotating your arm. Muscle tears can be identified on an ultrasound. If you’ve already had the ultrasound and been given the report that you have a tear, the next step for you is to rehabilitate that muscle, and we can help! Pain from shoulder and Rotator Cuff injuries usually respond well to hands on treatments like massage, cupping, or dry needling. We also like to help stabilise your shoulder using kinesiotaping. So how do you get help if you think you might have a Rotator Cuff problem? Firstly, book a time to come see us so we can help you find which of those 4 muscles is acting up. We’ll do some muscle testing and make a plan for reducing your pain and getting you strong again. If we think you may need an ultrasound to check for possible muscle tears, we can refer you to Dr Waj Dib here at Together Medical Family Practice in Knoxfield. Dr Dib is a fully bulk billed GP who can send you for scans if you need them. When we make New Years Resolutions, we usually focus on what we want. We want to be fitter, thinner, better organised and able to give up bad habits. But have you ever wondered what resolutions your body might like you to make?
Our head myotherapist and resident body-whisperer Mel has 5 resolutions that your body is begging you to make this year. Move more throughout the day Our bodies were not designed to sit at desks for hours every day. They were designed to move constantly in a variety of different ways. Unfortunately, most of us can’t change jobs just to suit the body’s preferences! But you can find little ways to move more frequently throughout your day. For example, you could:
When you get up and change position regularly, your body will thank you. Regular movement can also reduce the risk of injury and pain that can occur when you’re physically inactive. Stretch out regularly Another important way that your body loves to move is with a good stretch! But when we sit for hours at a time, our muscles can tighten up and leave us feeling sore. So whether it’s at work, at home or even at the gym, find a way to incorporate a regular stretch. Make sure that you stretch until you can feel the muscle stretching out. But don’t go too far – pushing a stretch too deep too quick can lead to injury. If you do feel any sharp pain while stretching, you might have just stretched too far. But you might have an underlying injury that needs to be checked by your myotherapist. Focus on good quality sleep Our bodies do their best healing work as we sleep every night. So if you’re not getting enough deep and restful sleep, your body can’t maintain itself properly. A good rest isn’t just about how many hours you sleep. It’s also important to get quality rest, so your body can go into healing mode. Sleep is particularly important if you experience chronic pain. A poor night of sleep can worsen your pain the following day. But this goes both ways – worse pain during the day can impact on your sleep that night. Find a healthy way to manage your stress A lot of the less healthy choices we make can come back to stress. How we eat, move our bodies and unwind in our spare time often reflects how we deal with stress. But on the flip side, these factors can also make a big difference with how we manage stress. That's why it's a good idea to find a healthy way to manage your stress. There are plenty of options out there, including:
Take a proactive approach for body care When it comes to our health, most of us wait until something goes wrong before we actually do anything about it! But if we can switch to a more proactive approach to taking care of our bodies, we can get onto issues early or even prevent them. Book yourself in for a check-up with your GP, dentist, optometrist and any specialists you see regularly. When it comes to your muscles and joints, the team at Simple Wellness Myotherapy are here to help. To book in for a tune-up your body would approve of, head to our booking page here. |
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