Category: Blog

Knee Osteoarthritis (KOA)

Osteoarthritis (OA) stands as one of the prevailing chronic and degenerative maladies affecting cartilage, particularly prevalent among the elderly populace, with a notable predilection towards women. It is a common condition of the musculoskeletal system that can occur in any joint such as the upper limbs or spine, but it is mainly observed in large joints of the lower extremities, such as the hip and knee. These weight-bearing joints bear the brunt of loading activities, which require smooth, successful completion and absorption of loads or vibrations. Moreover, the progression of OA involves the gradual deterioration and depletion of articular cartilage concurrent with osteophyte development, synovial membrane inflammation, and hypochondriac bone destruction. Clinical manifestations include pain, stiffness, swelling, joint deformities, and functional impairment, with advanced stages potentially leading to muscular atrophy, further compromising the quality of life for afflicted individuals. OA is also among the diseases with the highest rate of comorbidity, which include: cardiovascular diseases, diabetes, obesity, chronic obstructive pulmonary disease (COPD), chronic pain and even depression (de Rooij et al., 2014).

Research by Tsokanos et al. (2021) has indicated that therapeutic treatments such as manual therapy (MT) and exercise contributes positively toward the treatment of patients suffering from KOA by reducing pain and increasing functionality. In addition, Nejati et al. (2015) had previously shown that performing exercise while also receiving MT for the knee showed significant positive effects that lasted up to a year.

Manual therapy encompasses a variety of hands-on techniques performed by trained healthcare practitioners to diagnose, treat, and manage musculoskeletal and neuromuscular conditions. Some common manual therapy techniques include:

• Joint Mobilization: This technique involves the passive movement of a joint within its natural range of motion. It aims to improve joint mobility, reduce pain, and restore function. Joint mobilization is often applied to the spine or extremity joints.
• Soft Tissue Massage: Massage therapy involves the manipulation of soft tissues, including muscles, tendons, and ligaments. Various techniques such as effleurage, petrissage, and deep tissue massage are employed to enhance blood circulation, reduce muscle tension, and promote relaxation.
• Myofascial Release: This technique focuses on the fascia, a connective tissue that surrounds muscles, bones, and organs. Practitioners use sustained pressure to release tension and tightness in the fascial system, promoting improved mobility and reducing pain.
• Trigger Point Therapy: Trigger points are localized areas of muscle tightness and tenderness. Therapists apply pressure to these points to release tension and alleviate pain. This technique is often incorporated into massage or manual therapy sessions.
• Strain-Counterstrain: Also known as positional release, this technique involves placing the body or a specific joint in a position of minimal strain, allowing muscles to relax and pain to diminish. It is particularly useful for treating muscle spasms and acute pain.
• Stretching Techniques: Manual therapists use various stretching methods to improve flexibility, enhance range of motion, and alleviate muscle tightness. This may include static stretching, dynamic stretching, and proprioceptive neuromuscular facilitation (PNF) stretching.
• Neural Tissue Mobilization: This technique focuses on mobilizing and releasing tension in the neural structures, such as nerves and nerve roots. It aims to address conditions involving nerve compression or irritation, such as sciatica.

As part of a comprehensive approach to managing musculoskeletal disorders and promoting overall well-being, myotherapists here at HBM may employ these techniques, among others, to treat KOA.

Listed below are some details of a client dealing with KOA who is seeking treatment here at HBM, which may also serve as a case study:

Age: 70+

Gender: F

Symptoms: Pain and swelling in both knees (particularly in right), with apprehension and restriction fully bending and straightening knees out.

Medical history: Recent scans showing severe OA of R knee, no previous surgery to lower limbs.

Lifestyle: Retired but still active. Walks at least 10k steps/day, and goes for aquarobics class daily.

The client has to date received 2x treatments here at HBM in the span of a month and noted an improvement in pain and functionality. After the second treatment she mentions how the treatment has given her hope for managing her knee pain again.

If you or someone you know are dealing with KOA, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapist Jerry Song.

The Role of Myotherapy in Treating Headaches and Migraines

Headaches and migraines represent some of the most prevalent and burdensome neurological disorders worldwide, impacting individuals across diverse demographics and age groups. Understanding the scientific differences between these two entities is crucial for accurate diagnosis and appropriate management. Below, we outline the key differentiators between the two:

• Neurovascular Mechanisms:
  • Headaches: The term “headache” is a broad descriptor for pain or discomfort in the head or neck region. It can result from various causes, including tension, sinus congestion, or other non-specific factors. While the exact mechanisms of tension-type headaches, for example, are not fully understood, they are generally considered to involve muscular tension and contraction.
  • Migraines: Migraines, on the other hand, are a type of primary headache with specific neurovascular involvement. The prevailing theory is that migraines involve abnormal brain activity and interactions with the trigeminal nerve, leading to the release of neuropeptides and vasodilation of cerebral blood vessels. This process is believed to contribute to the characteristic throbbing pain associated with migraines.
• Aura:
  • Headaches: Most headaches, particularly tension-type headaches, do not typically present with auras. Auras are transient neurological symptoms that precede or accompany certain types of migraines.
  • Migraines: Migraines with aura are a subtype characterized by the presence of specific neurological symptoms, such as visual disturbances or sensory changes, preceding or during the headache phase. These auras are thought to be related to cortical spreading depression, a wave of altered neuronal activity in the brain.
• Duration and Intensity:
  • Headaches: Headaches can vary widely in duration and intensity. Tension-type headaches, for instance, are often described as a mild to moderate, non-pulsating pressure or tightness.
  • Migraines: Migraines typically last longer than common headaches, often between 4 to 72 hours if untreated. They are characterized by moderate to severe pulsating pain, often unilateral, and are associated with other symptoms such as nausea, vomiting, and sensitivity to light and sound.
• Triggers and Contributing Factors:
  • Headaches: Triggers for common headaches can be diverse and may include stress, lack of sleep, postural issues or environmental factors. Secondary headaches may have specific underlying causes, such as infections or other medical conditions.
  • Migraines: Migraines often have identifiable triggers, including hormonal changes, certain foods, sensory stimuli, and stress. Genetics also play a role, as migraines tend to run in families.

Manual therapy, encompassing various hands-on techniques, has emerged as a promising adjunct to conventional treatments and offers an alternative to drug consumption (Puledda et al., 2018).

• Manual Therapy for Headaches:

1. Peripheral Joint Mobilisation:

• Peripheral joint mobilisation focuses on articulating and mobilising joints outside the spinal region. This technique, often applied to the temporomandibular joint (TMJ) or other peripheral joints, can be effective in addressing musculoskeletal imbalances contributing to certain types of headaches. By improving joint mobility and reducing tension in peripheral structures, this approach may offer relief without direct manipulation of the spine.

1. Active Release Technique (ART):

• Active Release Technique involves combining precisely directed tension with specific patient movements to address soft tissue restrictions. This technique is particularly effective in targeting myofascial trigger points and releasing muscular tension, offering an alternative to myofascial release techniques for tension-type headaches.

1. Postural Correction Exercises:

• Emphasising corrective exercises for postural realignment can be an alternative approach to cervical mobilisation. Strengthening and stretching exercises targeting the neck and shoulder muscles may address postural imbalances, promoting long-term relief from tension headaches associated with poor posture.

1. Myofascial Release Techniques:

• Myofascial release, encompassing soft tissue manipulation and stretching, targets muscular trigger points and fascial restrictions contributing to tension headaches. By releasing myofascial restrictions, these techniques promote improved blood flow and muscle flexibility, potentially providing relief from chronic tension-type headaches.

1. Cervical Mobilisation:

• Cervical mobilisation techniques focus on restoring normal range of motion in the cervical spine. Through gentle and controlled movements, these interventions aim to reduce cervical joint dysfunction, addressing underlying mechanical factors associated with certain headache types.

• Manual Therapy for Migraines:

1. Connective Tissue Manipulation:

• Connective tissue manipulation involves gentle stretching and mobilisation of the fascial network throughout the body. This technique aims to improve the mobility and elasticity of connective tissues, potentially influencing the central nervous system and reducing migraine-related hypersensitivity.

1. Manual Lymphatic Drainage:

• Manual lymphatic drainage focuses on gentle rhythmic movements to stimulate the flow of lymphatic fluid. This technique may be beneficial in reducing congestion and promoting drainage, potentially addressing migraines associated with fluid retention or vascular factors.

1. Proprioceptive Neuromuscular Facilitation (PNF) Stretching:

• Proprioceptive Neuromuscular Facilitation involves a combination of stretching and contracting muscles to enhance flexibility and neuromuscular control. Applied to muscles associated with migraines, PNF stretching may contribute to the relaxation of hypertonic muscles and improve overall muscle function.

1. Soft Tissue Mobilisation:

• Soft tissue mobilisation techniques, including massage and trigger point therapy, target muscular tension and trigger points commonly associated with migraines. By promoting relaxation and reducing muscular hypertonicity, these interventions may contribute to a decrease in the frequency and severity of migraine attacks.

1. Neuromuscular Techniques:

• Neuromuscular techniques focus on addressing imbalances in the neuromuscular system. Practitioners apply targeted pressure to specific points, aiming to normalise neural function and alleviate trigger point-related pain. This approach may be particularly beneficial in managing migraines with associated myofascial pain.

Bevilaqua et al. (2016) reported a greater reduction in the frequency of the episodes after applying cervical mobilisations and massage and myofascial release twice a week over a 4-week period, and thus, a higher frequency of treatment may have yielded better results. As part of a comprehensive approach to managing headaches/migraines and promoting overall well-being, myotherapists here at HBM may employ these techniques, among others, as appropriate.

Listed below are some details of a client dealing with headaches who is seeking treatment here at HBM, which may also serve as a case study:

Age: 50+

Gender: F

Symptoms: Pain in suboccipital region causing referral symptoms in the head.

Medical history: No injury to head/neck region, frequent debilitating headaches. Takes Panadol/neurofen to help with pain but they don’t help much usually.

Lifestyle: Works at a desk and sits in front of a screen for long periods. Took up piano lessons recently which places her in a similar position postural-wise.

The client has received 5x treatments here at HBM over the past 2 months to manage her headaches, and even after the first treatment has had great improvement on her symptoms. Educating her on the importance of compliance to treatment has made a big difference on her quality of life.

If you or someone you know are dealing with headaches/migraines, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Myotherapy VS Remedial Massage

“What’s the difference between Myotherapy and Remedial Massage?” It’s a common question asked by clients on weekly base if not on daily base. Fair enough given that most clients aren’t even aware of the difference of relaxation massage and remedial massage. Please click the linkage to see our related blog.

Myotherapists and Clinical Myotherapists are highly trained individuals who graduate with either Advanced Diploma or Bachelor’s Degree after the completion of 2-4 years of study at University. This enables Myotherapists to have a greater understanding of the human body, anatomy, and physiology when compared to a Remedial Massage Therapist.

Myotherapists have extensive knowledge of the musculoskeletal system. The aim when treating and assessing an individual is to trace any pain, complaint or discomfort as far as possible back to the original cause, with the goal of healing both the cause of the concern, as well as the symptoms in which they are presenting with.

Myotherapists have the skills and qualifications to assess and treat muscles, joints, and nerves using a variety of treatment modalities including:

Soft tissue manipulation
Trigger point therapy
Myofascial stretching
Dry needling
Cupping
Kinesiology Taping
Rehabilitative exercises

Myotherapists provide evidence-based assessment, treatment, and rehabilitation for a wide range of musculoskeletal pain and associated conditions, for example:

Back pain
Neck and shoulder pain
Headache/migraine
Sports injuries
Rotator cuff problems
Occupational injuries
Achilles tendinopathy and other ankle injuries
Jaw pain and clicking
Fibromyalgia and other chronic pain presentations
Tennis elbow

You don’t need to be in pain to visit a Myotherapist. Prevention is always better than cure. There’s famous Chinese saying “上医医未病之病，中医医欲病之病，下医医已病之病。” Translation:“The best doctor treat unfound disease, the better treat occurring disease, the inferior treat occurred disease.”

When you feel stiff in some parts of the body, it’s signal of an upcoming problem such as too much tension built up, affecting the flexibility, reducing the range of motion, followed by pain if not treated in time.

Once symptoms have settled treatment may focus on restoring optimal activity (rehabilitation), reducing the likelihood of further injury and keeping you moving and performing at your best.

Myotherapists must be registered with a nationally recognized association such as ANTA (Australian Natural Therapists Association) or MAA(Myotherapy Association Australia).

Remedial Massage Therapists work exclusively on manipulating both the superficial and deeper layers of muscle as well as connective tissue to enhance function, release muscular tension, aid in the healing process, and promote relaxation and well-being.

Remedial Massage is more commonly performed on conditions that are either already diagnosed, or non-specific injuries (such as soreness or tightness) to provide some form of relief, whether it be a chronic pain complaint, postural related muscle tightness or simply want to relax.

Click on this link to book an appointment for a session of myotherapy or remedial massage.

What is Cupping?

At Holistic Balance Myotherapy, we strongly believe in natural therapy. Our body has an incredible self-healing function, but long-term negligence can kill that sense slowly. Cupping is one of the most common techniques we use on a daily basis to help clients with stiff muscles and pain relief. Here’s some basic knowledge about cupping.

Micheal Phelps’s cupping marks drew the attention of many audiences during the Olympic games. Cupping is also favoured by many other athletes and celebrities like Jennifer Aniston, Gwenyth Paltrow and Victoria Beckham, to name a few. But really, cupping isn’t something for Olympians or celebrities only.

Cupping is something we do for patients on a daily basis. Often can get breakthrough results for some clients who suffers from stiff or sore muscles, some even have been massaged on regular term but no real beneficial. Because massage alone is challenging to remove the toxin inside the body, while negative pressure from cupping can break down the stiffness quicker than compressing alone, the toxin is a big bonus on top of that.

Cupping is not unique to Chinese Medicine.

Many practitioners think cupping is one of the most popular techniques in the Chinese Medicine toolbox. But cupping is found in the Middle East, eastern Europe, Africa, and throughout Asia. The earliest pictorial records date back to the ancient Egyptians around 1500 B.C; translations of hieroglyphics detail the use of cupping for treating fever, pain, vertigo, menstrual imbalances, weakened appetite and helping to accelerate the healing crisis.

Cupping has been studied.

Cupping may fall into the category of folk medicine, but that doesn’t qualify it as some woo-woo fringe crazy sauce vintage therapy. There are plenty of research studies such as this, this, and this where it has been specifically looked at for pain intervention. Clinical experience technically falls into the category of “Evidence Based Medicine”; and It’s our not-so-secret-clinical-experience-weapon for migraines, shoulder pain, neck pain, lower back pain, tennis elbow, golf elbow, IT band syndrome.

Because cupping works so well, everyone wants in on the action. You’ll sometimes see massage therapists, physical therapists, and chiropractors offer something called “myofascial decompression (MFD)”. Let me be clear: it’s cupping. There are a million different techniques: fire cupping, vacuum cupping, wet cupping, dry cupping, massage cupping, bamboo cupping, horn cupping, and magnetic cupping to name a few. We now have machine cupping, which works fast and magically to suit tight time frames. Rule of thumb; if you can drink from it, you can use it to cup.

THOSE AREN’T BRUISES YOU’RE SEEING

Bruising is caused by impact trauma leading to the breakage of capillaries and a reactionary rush of fluids to the damaged location from the tissue injury. There is no compression in cup therapy. The marks are the result of having internal unwanted toxins pulled up to the skin, which can include such things as lactic acid, lymph fluid, stagnant blood, or medications. When a condition exists within a deeper muscle layer and is dredged up during treatment, discolouring will appear on the skin. If there’s no gunk, there are no marks.

Click on this link to book an appointment for a session of cupping therapy.

Relaxation Massage vs Remedial Massage

Many of us take our body for granted and lack of care and maintenance. When they feel like a massage, they have little knowledge about different types of massage and couldn’t decide whether need a remedial massage or simply a refreshing and stress reducing relaxation session. Here’s some explanation about the difference of relaxation massage and remedial massage, to help you decide which one to go for.

What is a Relaxation Massage?

Relaxation massage is usually a full body treatment that uses continual contact and long, flowing strokes which warm the body and help the body and mind to relax. Happy hormones such as dopamine, serotonin, and endorphins are released which give that post massage glow. Relaxation massage has also been shown to reduce the stress hormone cortisol, which in high levels can contribute to sleep deprivation, anxiety and depression. It is a pain-free way to relax both your muscles and your mind.

What is a Remedial Massage?

Remedial massage is defined as “the systematic assessment and treatment of the muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management.” A remedial treatment focuses on a specific area of the body that is producing pain or not performing correctly. The main aims of the treatment are to reduce pain, increase the range of motion and correct postural abnormalities.

Remedial massage treatments will begin with a medical history, a discussion of what has brought you in, a few postural, range of motion and specialised tests which will help the therapist to pinpoint which area needs the most work. Then the area is treated using the most appropriate treatment. After the treatment some of the initial tests are redone which will determine if there has been a change in range of motion or pain levels. The level of improvement will help to determine the treatment plan going forward.

In remedial massage, there are multiple techniques used including, deep tissue, myofascial tensioning, cupping, trigger point, application of heat and stretching.

Deep tissue involves first relaxing the most superficial layers of muscle and sinking in deeper to the belly of the muscle where tension lurks.

Myofascial tensioning is the release of fascia which is the connective tissue holding our muscular system in place. When the fascia is tight the muscles cannot move correctly which in turn causes toxins to build up causing pain and restriction.

Cupping is one of the oldest treatments in the world and in remedial massage is used to release toxins from the muscles. It is done using either glass, plastic or silicon cups on the skin with the air sucked out with either heat or vacuum, this pulls the skin and muscle up resulting in increased blood flow.

Trigger points are small balls of muscle fibre that have gotten stuck together. This can be caused by many things including overuse, dietary deficiencies and incorrect posture. Trigger points can refer pain all around the body. They are treated with direct pressure and release which flushes the area with fresh blood.

The application of heat increases blood flow to the area by dilating blood vessels. When the blood is warm and flowing, toxins are removed and muscles function better.

Stretching increases blood flow and by lengthening the muscle fibres the body can achieve better posture.

WHEN TO HAVE A REMEDIAL MASSAGE

If you are experiencing any pain in a specific area of the body including sharp shooting pain, dull aches or headaches.

If you spend hours a day with the body in one position, for example hunched over a computer or with legs crossed, this over lengthens or shortens areas of the body which may cause postural abnormalities.

While relaxation treatments have many benefits and will help you to feel revitalised and renewed, if your muscles are not working correctly the effects aren’t just on your body but can affect your emotional well being. The longer dysfunction is left unchecked the harder it can be to reverse. A high quality remedial massage is recommended before relaxation massage.

Click on this link to book an appointment for a session of myotherapy or remedial massage.

Five Keys for Balance

1) Food: the body’s fuel

A nutritious diet is one of the essential sources of fuel the body requires to maintain optimum health. Therefore, it is important to get to know the nutrients that suit your body type and then maintain a balanced diet that suits your body best. The key to a balanced diet is the right mixture of vitamins, proteins, carbohydrates and lipids. However, global pesticide pollution and the ever-increasing availability of processed food make it more and more difficult to acquire nutrition from food. This is why consuming dietary supplements in the form of vitamins, multivitamins or minerals is necessary to help keep your body be fit and healthy.

2) Chi: the body’s life energy

In traditional Chinese culture, Chi is an active principle forming part of any living thing. The body has natural patterns of Chi that circulate in channels called meridians. If a path is blocked, the Chi does not flow properly; blocked or un- balanced Chi movement can disrupt the function of body organs.

Clearing meridians to let the energy flow properly promotes overall body wellness. Often used techniques include physical training regimens and bodyworks.

3) Exercise and physical wellness

Cardiovascular exercise keeps the heart and lungs pumping and healthy. A regular, vigorous exercise routine, that is performed for approximately 20 minutes a day or more, will also promote energy levels, help to keep you well and promote a strong immune system.

Additionally, blood pressure and cholesterol levels also tend to be lower for those who exercise than those who are inactive.

4) Breathing, meditation and mental wellness

It is now acknowledged that the mind can have an extraordinarily potent effect on the body. Meditation has been practiced in all major world religions for centuries, either in prayer and contemplation, or as a way to achieve a state of bliss. Today many people use it to induce a state of relaxation and harmony.

Studies suggest that meditation may help to reverse or reduce stress, anxiety, high blood pressure, migraines, depression and insomnia. Proper breathing, or diaphragmatic breathing, is also a way to achieve mental wellness. It allows you to tap one of your body’s strongest self-healing mechanisms.

5) Body Maintenance

Due to stress and overwork, we deplete our body and mind of energy and other resources. However, we hardly think of recovering the expended energy back to our body. Eventually, our body and mind will likely lose balance and health, leading to an imbalanced life.

As beneficial for the body as good nutrition and regular exercise, body works help promote total wellbeing. Maintaining your body with a massage once a month encourages a sense of relaxation, reduces stress and fatigue, and restores loss energy.

Improve in one of these elements and experience the positive effect on all aspects of your life.

Click on this link to book an appointment for a session of myotherapy or remedial massage, a holistic approach to our health.