Our Myotherapists help a lot of people with scoliosis of varying degrees, from very mild curves to more exaggerated curves that permanently alter posture. Myotherapy is not a cure for scoliosis, but ask any of our patients and they'll agree that managing the pain and muscle fatigue is much easier with a regular treatment to help manually decrease the load and pressure on their spine. What is Scoliosis?
Scoliosis is a curvature of the spine to the right or left, creating a C or S shaped spine. It usually begins at puberty during growth spurts. Most people with scoliosis will have mild symptoms that can be managed by staying active and using therapies and tools that manage muscle tension and discomfort. What do Myotherapists do to help someone with scoliosis? As always, we start with an assessment. We'll look at your back, and how you move and check where you feel pain during your movement. You'll probably notice you have regular patterns that your scoliosis follows - like one hip or shoulder sitting higher than the other, one shoulder that rolls forward or backward more, or a particular painful spot that gets really tight or feels like it builds up pressure. Hands on massage treatment is always a favourite with our patients. Why? It feels good! And it helps to stimulate the over-tired muscles supporting the spine. This can help reduce the muscle tension and fatigue, and let those high-pressure areas feel some relief. Cupping is a technique that works particularly well for a lot of our scoliosis patients. We use cupping to help get a quick change in muscle tightness and reduce trigger point areas, while also bringing lots of new, fresh blood to the muscles to help them heal and release. The cups have a pressure valve and a pump that we use to create the gentle suction effect, which stretches the muscles and connective tissue under and around each cup, and stimulates increased bloodflow to that area. They can feel a little pinchy at first especially over tight areas, but after a few minutes that feeling usually goes away, and when the suction is broken the pressure releases and leaves the muscles feeling warm, stretched and more mobile. The relief that comes after a treatment can be extended by using taping to help support your spine, hips and shoulders. Did you know you can keep the tape on for up to a week? How often do I need to see a Myotherapist? When you first come in, we like to see you again within 1-2 weeks to see how your first treatment settles in. From there we can work out the best schedule for you to keep painful flare ups at bay. This is really different person to person, but the average is about every 2-4 weeks - for some people we spend a little longer doing weekly treatments until it starts lasting longer, and for some people we can move to a 6-8 week schedule. If you experience a pain flare up, come in for an appointment so we can settle the flare as quickly as possible and get you back to your normal maintenance routine. How do I get an appointment? Appointments can be made online or you can phone Mel on 0401212934.
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Does this sound familiar?
These can be signs of hip bursitis, which is an inflammatory condition that can be a very common cause of hip pain. 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. 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! Anyone with long term pain will likely relate with this statement my sister recently made about her chronic back pain and exercise: "Yeah, the pain flare ups seem to be less frequent with exercise. But also feels hard to convince myself to exercise, because if I stretch too far it hurts real bad, too??" This situation is so common with people I see every day in the clinic. The pain has been there for a long time, but thinking on times that they've been most physically active, that tends to be the times that the pain has been its least intense, frequent and invasive. So if we know that staying active can change the intensity, frequency and overall impact pain has on our lives, why is it so hard to convince ourselves to do the exercises? Its an internal fight that a lot of people have with themselves. 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! Yesterday, Premier Dan Andrews announced an update regarding COVID-19, and extended the State of Emergency til May 31st.
Some positive changes and updates were announced. From tomorrow onwards, people can start to visit their loved ones, and have up to 5 guests in their homes. The testing results from over 140,000 tests in Victoria identified 30 new cases, which is about 0.018% of all the tested individuals. The numbers of infections and hospitalisations here in Victoria are relievingly low, compared to other similar sized cities across the world. However, the Premier has encouraged people that if they can work from home, they must continue to work from home. The 1.5m social distancing requirements are still in place. There are now 5 reasons allowable to leave your home - seeking medical care, going to work, doing essential shopping, exercising, and now to visit family or friends. We will remain closed a little longer, but we feel like things are starting to shift and we hope to bring better news of reopening soon! The May 50K officially started just a few days ago. That means my practice runs are wiped off the board, and we're starting the 50km target from May 1st til May 31st! I've just logged another 4km run today, so I have about 42km to go for the rest of the month. The May 50K is raising funds for research for Multiple Sclerosis. Its a condition that hits close to home for me because I work with patients who have MS. Its such a varying condition, some people have few flares and mostly manageable symptoms, where others have constant symptoms and complications. The days are getting colder and wetter, so that doesn't exactly make it an enticing environment for running, but I'm finding that once I do actually get going, its quite good. I like the challenge, and I know I need the fitness.
The thing I enjoy most about the running is afterwards. I know I bang on about this to patients, but honestly, the endorphins that flow after exercise is pretty magical. The running itself can feel hard physically and mentally, but almost as soon as I stop I feel that nice shower of reward brain chemistry, and I feel like "perhaps I could do that again!" As a team, the Myotherapists for MS are doing quite well. Mat Richardson from Tecoma Myotherapy has set himself a double goal of 100km for May. He's just a fantastic guy and brilliant therapist, who I am very lucky to have close by to throw ideas around with and lern from his many many years of industry experience. Rhianna Bridgett from The Wellness Nest in Docklands has set herself the goal of 50km walking. I'm a bit not-so-secretly a fan girl - she's one of my lecturers at Endeavour College for my Bachelor degree in Myotherapy, and one of the most amazingly hard working, genuine people I've been lucky enough to meet. Some days the lockdown isolation is really getting to me, as I'm sure it is for most people. I'm so glad to have The May 50K to focus on right now, so I can still feel like I'm doing something to help patients with Multiple Sclerosis, even if its not providing actual treatment. I'm very much looking forward to being able to reopen soon when the restrictions lift! For now, follow my running efforts on our Facebook page, and if you can, we would love your support by donating to help us achieve our team goal of raising $1500 for MS Research this month! 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. We might not be able to see our MS patients face to face right now due to Covid19 restrictions, but thats not stopping us from helping in other ways!
We've created a team in The May 50K, which is a fundraising challenge to raise much needed funds for MS research. Our team is called Myotherapists for MS! The goal is to run 50km throughout May and raise donations and awareness to help support research for Multiple Sclerosis. What is Multiple Sclerosis or MS? Its a neuro-immune condition where the persons own immune system attacks their nervous system. It targets the myelin sheath, thats the insulating barrier between the nerve and its surroundings. Without myelin sheath, the nerve can't function in its usual way, and scarring (sclerosis) of the nervous system occurs. The normal nerve messages can get mixed up or lost, and it can cause a huge range of issues including:
Who are the Myotherapists for MS? Our team was created today by Mel and her good friend and mentor, Rhianna Bridgett. We're aiming to get a few more Myotherapists on board to help us stay motivated and to meet our goal of raising $1500 for MS. So far, the team includes:
Want to support us? Firstly, we all know and appreciate that these are hard times, the like of which most of us have never lived through before. So while donating is awesome, and we love and appreciate you if you are able to contribute a donation, its not the only way you can help our cause. What we would love to see more than anything is your support, inspiration and motivation! Basically - Keep us accountable! Make sure we complete our goals! Follow our journey on Facebook and boost our team morale by liking, loving, laughing at our posts, leave us a comment of encouragement, and share our achievements. Can you donate? If you can, we appreciate your support!! Want to know what your donation can achieve?
You'll also get a receipt automatically emailed out to you for tax time for any donation over $2 so you can claim the deduction. Go team!! Victorian Premier Daniel Andrews has announced an extended State of Emergency over the weekend, adding another month to the current COVID-19 situation. The State of Emergency has been extended to May 11th.
We’re now in Stage 3 Restrictions, and all Victorians are being urged by the Premier and the Health Department to stay at home when it is at all possible. Fines are being issued to people who are not adhering to the restrictions, including businesses and individuals. Myotherapy and Remedial Massage are currently listed as non-essential services, so our doors will remain closed a little longer. We also respect that so many of our patients are in high risk categories, so remaining closed at the moment is the most ethical action we can take to protect our vulnerable patients. This is a hard time for us as practitioners, as I’m sure its also a terrible time for people with chronic pain who are now unable to receive treatment as normal. AHPRA registered practitioners are still permitted to operate, so that includes practices that are covered under Medicare Benefits Schemes, like physiotherapy and acupuncture. Myotherapy is not currently part of AHPRA or Medicare. If you need urgent treatment, we encourage you to contact our friends Amanda at Upwey Acupuncture, or Travis and the team at Pathways Physiotherapy in Ferntree Gully. We will keep reassessing the situation as new information becomes available, however we don’t anticipate reopening before the May 11th State of Emergency period. Please keep safe and healthy as best you can, and know that we are looking forward to being able to announce our reopening date as soon as its safe to do so. |
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