Our services.
Myotherapy
Myotherapy involves a thorough assessment process to identify dysfunctions within the body. It entails causative effect of posture and injury to rebalance the body and return to full function. The knowledge of the functional body and the effect of pathologies are extensive and treatment may include a number of modalities under the myotherapy category.
The history of myotherapy was developed in the early 1970s, by Bonnie Prudden, an American exercise and fitness expert and author of a number of books. She created a new system of manual therapy based on the work of Janet Travell and David Simons who established neuro-physiological basis of myofascial pain and dysfunction, and has evolved to include the assessment techniques and treatment modalities.
Myotherapy is fast becoming an evidence-based research area, an important progression towards understanding the benefits it has as a preferred choice of treatment.
Remedial Massage
Remedial massage involves a systemic assessment and treatment of the muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management.
It is an umbrella term that covers a variety of techniques in soft tissue therapy. The aim of remedial massage therapy is to reduce or eliminate pain, restore normal function of muscles and joints, and increase range of motion in ligaments and connective tissues of the body.
Remedial massage is also well understood as a modality in preventative or maintenance in good musculoskeletal health.
Dry Needling
The theory behind dry needling is to identify myofascial trigger points in the body and utilise needling techniques to release muscle pain and disorders.
Myofascial trigger points is characterised by localised muscle tenderness and persistent pain. A presence of a myofascial trigger point is the consequent development of nociceptive pain (unpleasant nerve signals) – usually caused by direct trauma, injury or muscle overload. These myofascial trigger points are commonly developed in the muscle belly or its peripheral attachments.
Physiologically, dry needling has pain suppressing mechanisms which have the ability to repress pain signals to the brain, known as the gate control theory. For a person suffering with autoimmune or nerve related disorders, such as fibromyalgia, this can be a good option to consider.
Dry needling is also ideal when deeper layers of the muscles cannot cause significant changes due to the difficulty in accessing the multiple layers of soft tissues if treating only with manual therapy. A good example will be your glute muscles, due to the multiple thick layers that overlap in this area, dry needling is an effective method to release tightness in this region. Additionally, being a highly sensitive area for most people, the option to use needling over manual release will most likely reduce the pain and sensitivity.
Electrotherapy
Mild electrical currents from a TENS (Transcutaneous Electrical Neuromuscular Stimulation) device can be transmitted through the skin for several clinical uses. These currents can be adjusted in different wavelengths and strengths to produce muscle contraction, reduce muscle spasm and inflammation, and modulate pain by stimulation of nerves, and retraining of muscles when the device is set on rehabilitation mode (NES – Neuromuscular Electrical Stimulation).
An effective treatment is determined by placement of electrode pads on the body. In myotherapy, there are several concepts used in deciding how to treat musculoskeletal conditions. Trigger points, assessing dermatomes and activating weak muscle groups are several approaches to a treatment protocol. Furthermore, deciding on the intensity, speed and timing of the treatment are all inclusive of effective treatment planning.
Myofascial release
Myofascial release (MFR) is a form of manual therapy used for the effective treatment of rehabilitation of soft tissue and fascial aches, pains, tension and restrictions. The fascia, traditionally accepted as a thin layer of connective tissue around the muscles, is treated with slow manual release in order to restore muscle balance and function.
As more research has begun to understand the physiology of myofascial release, it is believed to stimulate mechanoreceptors through the neurological pathways. As a result, these in turn, trigger tonus changes in skeletal muscle fibers. Furthermore, an input from sensory neurons can amplify nociceptive signaling, a pain receptor that blocks pain signals to the spinal cord. (Lebert 2020)
Pre & Post Natal Care
Myotherapy during pregnancy can assist in many health benefits, similar to the benefits of any general musculoskeletal treatment. However, there are common misconceptions that manual therapy should be avoided, particularly during the 1st trimester to avoid miscarriages.
Miscarriages are often multi-factorial and complicated systemic problems of the body. In rare cases it can be due to genetic predisposition. A doctors’ clearance is not necessary unless there are underlying complications that requires attention.
As your body changes through the different stages of pregnancy, so does the treatment approach to assist in overall systemic body changes, whether it is hormonal, musculoskeletal or mental. It is common to experience musculoskeletal pain and fluid retention due to the extra weight that puts on a pregnant body. The overall benefits of treatment during pregnancy, therefore, outweighs of not receiving one at all.
Exercise prescription
Exercise prescription is an area where myotherapist may choose to specialise in, particularly if the therapist is engaged with people who are actively involved in many sporting activities. This is really due to a greater genuine interest in the physically active group. However it should not be categorised into an area where only the serious athletes are suitable.
Why is that so? Exercise creates changes in both at the local tissue level and in the central nervous system (Khan 2018). To expedite your healing rate and create better movement in your joints and muscles, manual therapy is only half the equation, the other half will be the responsibility of the therapist to educate the client on exercise prescription. The purpose is to develop ongoing strength, flexibility, better range of movement and hence continue on your daily activities.
A program can be developed according to your condition, usually in 4 phases of rehabilitation:
Acute management
Restore activities of daily living
Returning to sports/daily activities
Prevention of re-injury
Exercise prescription can be incorporated in a practical way as part of your daily routine to increase significant results.
Muscle Energy Technique (MET)
MET is a form of manual therapy designed to improve musculoskeletal function through stretching of tight muscles and mobilising of joints. As a result, there is a reduction of pain, improved circulation and lymphatic flow. In layman’s term it is a form of therapeutic stretching that associates with the nervous system.
MET is designed to have the patient participate, or actively engaged in performing isometric muscle contractions against the therapist’s resistance, in a controlled direction and position.
Types of muscle energy technique commonly used are as follows:
Post-isometric relaxation (PIR) – is to isometrically contract a muscle against resistance which is over-facilitated (excessively favoured by the nervous system to contract), followed by a brief period of relaxation (to lower neural input to that muscle).
The purpose of this technique is to stretch the muscle into a range that was previously not available and restore ideal range of motion of an over facilitated or an agonist muscle. (Prime moving muscles that produce most of the force)
Reciprocal inhibition (RI) – similar to PIR, this technique assists in contracting the antagonist muscle (works opposite to the prime moving muscles)
Muscles are designed to work in groups, in an agonist/antagonist manner; RI’s treatment approach is to ensure the antagonist muscle inhibits (switches off) from the nervous system. Similar to PIR, it is an alternative method to stretch the muscle into better range of motion if PIR may not be applicable, or too painful to use.
Isotonic MET – to facilitate weakened muscles by concentric (shortening) and eccentric (elongating) methods.
MET in general is a very gentle technique and changes are made in a subtle but precise manner. The participant must be alert and aware of small changes to feel the benefits of this approach.
Joint mobilisation
Joint mobilisation is a type of manual therapy where skeletal joints are passively moved for the purpose of achieving a therapeutic effect such as decreasing pain, increasing range of motion and induce reflex muscle relaxation. (Lebert 2020)
It is classified into five grades of motion (grade 1-5), each different grade are believed to produce selective activation of different mechanoreceptors in the joint. In manual therapy, mechanoreceptor pathways communicate with the central nervous system, and are influenced by touch, pressure, movement, or any physical stimuli.
Myotherapy treatment is focused on gentle, grades 1-4 joint movement to achieve optimal movement and pain relief. Grade 5 mobilisation is often referred to high thrust osteopathic or chiropractic adjustments.
Recent research, however have demonstrated that general approach to joint mobilisation is as effective as specific one. (de Oliveira et al., 2020; McCarthy et al., 2019)
Joint mobilisation is often indicative of hypomobile joint dysfunction, also known as subluxation or misalignment.
Cupping therapy
Modern cupping therapy is often carried out with the use of plastic suction cups and a hand pump to create the vacuum. This vacuum effect draws the superficial layers of the muscle in a tensile force, which can be left in one site or moved along the tissue. Cups are designed in various diameter and suction intensity and can be adjusted depending on client’s sensitivity and reaction.
An evidence based approach, known as functional release cupping, has a focus on fascial release (layer that supports the muscle) and movement patterns associated with it to assist in changes in range of motion.
Cupping therapy is an add-on technique and is indicative for overall musculoskeletal tension, poor circulation, tender spots, tight fascia, overuse injuries and toxicity in the body. Bruising is often seen and commonly perceived to be painful, however it can be understood as an indication where toxins or blockages are drawn to the surface via the skin.