* HICAPS is not available at this time for HCF members, however clients with HCF can still claim their rebate by submitting directly to HCF the receipt that is provided upon full payment of their account. You must have Remedial Massage cover as part of your Health Fund package to receive rebates through HICAPS or direct means. See "Availability, Rates & Other Info" for more details on how to claim Health Fund rebates.

Wow, it's the end of the year already! (It seems like every year flies by faster and faster...) 
It has been a busy year for me, setting up my own practice and getting it running, so I haven't been as good about blogging as I had hoped I would be. (I admit it's kind of a sad effort, really, with only 2 main articles in the past year!) But I'm hoping that next year I'll be able to get into a more frequent and regular schedule, as I have heaps of ideas for blog topics, and even an idea for a vlog (video blog) series! So be sure to check back here (or follow me on Facebook or Twitter) to keep tabs on what's happening at the clinic, as well as for some new informational blog articles. In the meantime, here's a wrap-up on this past year, with a brief look ahead for the new year:

Many thanks to all of my wonderful clients this past year, who have helped make the first year in my own clinic such a fantastic and rewarding experience! This year could not have been a success without you! It is a scary thing to venture out on your own in the world of small business, and I greatly appreciate all of the support and loyalty you have shown me. Additionally, in such a hyper-competitve field such as Massage Therapy, word of mouth is always the best form of advertisement, so I deeply appreciate the confidence you have shown me by recommending me to your co-workers, family members and friends. I hope that everyone has a safe and relaxing holiday season, and I look forward to continuing to ... into the coming year.
  

I will be closing the clinic for two weeks over the Christmas & New Year holiday season. The last day for an appointment this year is Friday, 23 December 2013; the clinic will re-open in the new year, on Monday, 6 January 2014.

In this busy time of the year, it can be easy to become so involved in work, family and friend commitments, that you forget about looking after yourself. And then suddenly your holidays are looming, and you realise that the niggly pain in your back isn't going to go away by itself - but when you try to book a Remedial Massage, there are no appointments available because everyone else has had the same idea! So I just want to gently remind everyone to book your massage now to avoid disappointment in the lead up to Christmas! Next week is already starting to book up, so if you want a particular day or time - book now! Appointments can be requested through this website by clicking on the button at the top of the page, or by ringing my mobile on 0405 792 425.
  

Next year, I will be making a slight change to my business hours, to keep up with current booking trends, as well as to give myself some time to do an end-of-week wrap up on business/clinic matters. My new hours, starting 6 January 2014 will be as follows:

(By Appointment Only)

• Mondays, 9.00am - 7.00pm
  
• Tuesdays, 9.00am - 7.00pm
  
• Wednesdays, 10.00am - 8.00pm
  
• Thursdays, 9.00am - 7.00pm
  
• Fridays, 9.00am - 4.30pm

Due to increasing operational costs, I will also be introducing a slight increase in my fees, however the new fees will not be effective until 1 February 2014. As always, HICAPS will be available for immediate processing of most Health Fund rebates (for now, HCF still does not participate in HICAPS for Remedial Massage, so members will need to manually claim their rebates back from HCF). Please CLICK HERE for more details on the new rates.

As mentioned in the introduction above, I am hoping to write a few more blogs in the coming year (in addition to an exciting - and hopefully very helpful - new YouTube series upon which I am currently working... but more on that later!). I have quite a few ideas for potential blog topics, however I would also like to hear from you as to which topics you would like to see covered in my blog. Is there a particular injury about which you are curious? Or did you really like my "Kunzea ambigua" article, and would like to see more blog articles profiling essential oils? Let me know by sending me a short email with your suggestions or comments!
  

Scientific Name:
Kunzea ambigua

Common Names:
White Cloud, White Kunzea, Tick Bush

Suitable to treat arthritis, muscular aches & pains, strains & sprains, and symptoms of flu.

Family: Myrtaceae;
Distribution: NE Tasmania, cooler coastal regions of Victoria and SE New South Wales;
Description: A hardy and adaptable shrub that can grow up to 5m tall &/or wide in sandy soils near the coast. Dark green, soft leaves are linear (lanceolate) in shape, and the long, thin branches carry a profusion of small, delicate, white (or very rarely, pink) flowers.

Oil Extraction Method: Steam distillation from aerial parts;
Aroma: Pleasant - if a little heady - with crisp, Eucalypt-like middle & top notes and earthy, herbaceous bottom notes;
Chemical Composition: Mostly mono- and sesqui-terpenes;
Application Method: Dilute in a topical oil blend or neat on the skin; Aromatic bath blend;
Cautions & Contra-indications: Generally, none. However, as with any oil, people with sensitive skin should do a patch test before using the oil in larger quantities.

This Australian Essential Oil is officially registered by the Australian Therapeutic Goods Administration (AUSTL 72143) for the following therapeutic uses:

• Temporary relief from pain associated with arthritis and rheumatism
• Relief from influenza symptoms
• Relief from muscular aches and pains
• Helps to relieve stress, nervous tension and mild anxiety

Additionally, this oil has been used anecdotally the following ways:

• As a disinfectant for a number of common, potentially disease-causing microorganisms, including Staphylococcus aureus, E. coli, Pseudomonas aeruginosa, and Candida albicans
• As a room deodoriser
• Temporary relief of the itching and pain of insect bites
• As a treatment for eczema, dermatitis and other skin irritations
• Relief from chillblains
• Temporary relief from headaches and migraines
• As an anti-inflammatory and to promote rapid repair of soft tissue injuries, such as strains and sprains

This is probably my favourite essential oil! My first experience with it was back in 2003, when I badly sprained my ankle. My husband and I were just about to go on holidays, and the only oil I had on hand was Kunzea. So, I applied 3-5 drops of the oil neat on my severely swollen and bruised ankle and foot, several times a day. Considering the grade of sprain that I had, the swelling and bruising cleared remarkably quickly! Even the physiotherapist whom I saw once I was back from holidays was amazed!

Clinically, I use this oil along with Manual Lymphatic Drainage techniques on clients that have inflammation with oedema (for example: corked thighs, ankle sprains, torn muscles), as well as on clients with trigger points, particularly in the Upper Trapezius and Levator Scapula muscles of the upper back and neck. I have found it to be a wonderful oil that I can use in small quantities neat on the skin, without any prior preparation, to help relieve the pain and inflammation of many soft tissue injuries, as well as a general muscle relaxant.

1. Guba, Ron (Ed.). "A New Australian Native." Essential News, v19. Essential Therapeutics, Hallam, Vic. 2006.

2. "Kunzea ambigua" - Australian National Botanic Gardens. Accessed on 03/04/13. 

3. "Kunzea ambigua (Sm) Druce" - PlantNET, Royal Botanic Gardens, Sydney. Accessed on 03/04/13.

4. Webb, Mark. Bush Sense: Australian essential oils and aromatic compounds. Griffin Press, Adelaide. 2000.

Edited on Fri, 17/10/14: Minor changes to link HTML codes & formatting.

 
Also known as: Runner's Knee; Patella Tracking Syndrome; Patellar Subluxation; ITB Syndrome

Patellofemoral Pain Syndrome (PFPS) is a common pain syndrome that is often experienced by cyclists, runners and people who walk for exercise. PFPS manifests as a minor to severe pain in the front of knee, often experienced as pain originating from the inside aspect of the knee or behind the patella, or kneecap. Sometimes this pain is associated with a "clicking" or "grinding" sound or sensation in the knee, as the knee is straightened or bent. Running, jumping, squatting, twisting or walking down stairs tends to make the pain worse, as does sitting for a long period of time with the knee in a flexed position - for example, at work or at a movie theatre. In severe or prolonged cases, swelling may be noticeable around the patella, and the sufferer may complain that he or she feels as though the knee is going to "give out" entirely.

PFPS is most often caused by an imbalance of muscle strength and soft tissue tension around the patella. Under normal circumstances as the knee is flexed and straightened, the patella glides centrally along the patellar groove - a bony groove located just beneath the patella, on the front (anterior) surface of the femur, or "thigh bone". However, improper running or walking biomechanics may, over time, create too much strength and tension in the Iliotibial Band (ITB), a thick band of fascia that runs along the outside of the thigh, as well as in the Vastus Lateralis, the most lateral (outside) muscle of the Quadriceps muscle group of the anterior thigh [See Fig A, above]. In conjunction with this, the Vastus Medialis (aka, "VMO") - the Quadriceps muscle on the inside (medial) aspect of the thigh - becomes weak. The result is too much lateral pull and not enough medial pull on the patella as the knee is straightened, causing instability in the knee as the patella is pulled up and slightly out of the patellar groove. Over time, this may lead to injury and inflammation of the soft tissue within the knee itself, such as irritation of the cartilage that lies underneath the patella.

If the pain in the knee is severe or particularly bothersome, then the most immediate thing to do is rest the injured knee. Avoid cycling or walking for long distances and running for any distance, and seek diagnosis by a physiotherapist, osteopath or other musculo-skeletal specialist. The therapist may decide to temporarily tape the knee, to provide support around the patella and keep it tracking properly. If inflammation is severe, you may notice some swelling in the knee. If this is the case, then application of an ice pack to the knee for 20 minutes several times a day may help to reduce the inflammation. (Always remember to wrap the ice pack in a light towel to avoid ice burns to the skin!) Additionally, application of an over-the-counter anti-inflammatory cream or gel, such as a gel containing ibuprofen, may be helpful, however avoid "warming" or "icy-hot" creams and gels, as these substances may actually increase inflammation. When in doubt, talk to your chemist for more information.

In the medium-term, exercises that specifically address the imbalance of tension around the patella will help to correct the position of this bone as the knee moves. Specifically, exercises that strengthen the VMO, as well as stretching the Quadriceps muscles in general, will assist in creating better muscle balance around the patella itself. Using a Foam Roller to release tension in both the ITB and Vastus Lateralis will help to reduce the lateral pull on the patella. Additionally, regular Hamstring stretches may help reduce the medial Hamstring tension that typically develops as a result of this muscular imbalance.

In the long-term, however, the biomechanical problems that have led to the muscle imbalance around the affected knee must be addressed in order to overcome this injury. Commonly, PFPS is associated with weakness in the Gluteus Maximus - the large muscle of the buttocks that ideally provides the main propulsion forward during a walking or running gait - as well as weakness in the Gluteus Medius - a smaller, deeper and slightly more lateral buttock muscle that is important for pelvic and hip stability. When these muscles are weak or firing out-of-sequence during a run or walk, the Quadriceps muscle will typically become overactive to compensate for this weakness, providing the propulsive movement forward instead of the Gluteal muscles. By strengthening these Gluteal muscles, the hips will be more stable and the Quadriceps will be less likely to be over-used for forward propulsion. Thus, the strain on the patella and knee is reduced. Additionally, addressing any foot biomechanical problems, such as pronating (dropping) arches, by appropriate lower leg and arch strengthening exercises, or by wearing corrective orthotics, will help to create a more efficient and stable gait, with less torsion at the knee.

Remedial Massage, when applied effectively to the appropriate muscular systems, acts to both treat and prevent occurrences of PFPS. When I do Remedial Massage Therapy for PFPS, I focus on releasing the unequal tension around the knee, thereby relieving the lateral pull on the patella. Typically, I employ Myofascial Release techniques to release the ITB, central and lateral Quadriceps, medial Hamstrings and the retinaculum - the dense band of fascia that wraps around the knee and encapsulates the patella. Deep Tissue Massage techniques may also be employed to these areas, as well as lighter, more stimulating massage to the VMO to encourage blood flow and nerve activation of this weaker Quadriceps muscle. I use Trigger Point Therapy to release any trigger points (small, painful "knots") in the Vastus Lateralis muscle. Additionally, Myofascial Release and Deep Tissue techniques may be used to release tension in the calves, buttocks and lower back to encourage a better, more biomechanically-efficient gait. If the there is a postural rotation in the pelvis, I utilise a special, advanced technique called Muscle Energy Technique to correct for this pelvic rotation, which in turn, helps to reduce the torsion through the knee. At the end of each session, I teach my clients how to strengthen their VMOs and Gluteal muscles, as well as how to stretch and release their ITB and Quadriceps. Ultimately, the effect of the massage treatment and exercise "homework" is to locally release the strain on the affected knee, as well as to treat the ultimate cause of this strain by correcting any problematic posture. This allows for a more efficient gait, and thus reduces the lateral pull on the patella.

The websites and video listed below give some general information on the causes and treatment protocols for PFPS:

• "Patellofemoral Pain Syndrome" on the MyDr Website: basic information about this injury.
  

• "Patellofemoral Pain Syndrome" on the PhysioAdvisor Website: more detailed information about this injury. 
  

• "Patellofemoral Pain Syndrome" on the Sydney Sports Medicine Centre Website: includes some exercises to help treat & avoid this injury. 
  

• "The Best Treatment for Patellofemoral Pain Syndrome" YouTube clip by Lisa Howell of Perfect Form Physio: great explanation of how PFPS is not simply a knee problem, but must include treatment of the underlying factors that are likely causing the muscular imbalance around the knee in the first place.
  

Exercises

Soon, I hope to upload my own videos to my YouTube Channel, demonstrating   the various exercises I advise for treatment and prevention of PFPS. Once I have these up, I will update this blog. Until then, however, check out these videos for some exercise tips:

• "Pilates Foam Roller - Myofascial release of outer thighs/ITB." YouTube video by Martina & Gemma of Perth-based Sense of Space Pilates Studio: demonstrates 3 alternative positions for releasing the ITB using a foam roller.
  

• "Pilates body - The Clam Exercise." YouTube video by Wayne Gordon of Sports Injury Clinic: demonstrates the basics of how to do the "Clam" exercise for strengthening the Gluteus Medius muscle.
  

Edited on Fri, 17/10/14: Minor changes to link HTML codes & formatting.

GOOD NEWS!

HICAPS is finally up and running for the clinic! What this means is that, provided you have the appropriate level of cover and that your Health Fund participates in the HICAPS program for Remedial Massage, you will be able to process your Health Fund Rebate on-the-spot, at the time of payment!


HOW IT WORKS:

Bring your Health Fund Card with you to your appointment. At the end of your consultation, I will swipe your Health Fund card through the HICAPS terminal and - voilà! - HICAPS will determine how much rebate you receive and credit it to your account! You may then use EFTPOS, VISA, MasterCard or cash to pay the remaining gap. It's simple!

Please note that your Health Fund card is required to take advantage of on-the-spot claiming with HICAPS, as the actual card must be swiped through the terminal to confer your rebate. Simply providing me with your specific details - such as your Health Fund account number - is not sufficient, as there is no scope within HICAPS to manually enter in your Health Fund details through the terminal's keypad.


HEALTH FUND REBATES:

Health Fund rebates vary, depending on the individual Health Fund and the specific plan you have with your Health Fund. The average rebate is between $25-40. To receive rebates for my services, you must have cover for Remedial Massage. I am a registered Remedial Massage Provider with nearly every Health Fund, so chances are excellent that, provided you have coverage for Remedial Massage, you will be able to claim a rebate for my services.


A NOTE ON HCF:

Some Health Funds - such as HCF - may participate in HICAPS for services such as dentistry, physiotherapy, etc., but not for Remedial Massage. In these instances, HICAPS on-the-spot claims cannot be made. However, you should still be able to manually claim your rebate from your Health Fund. Upon full payment of your account, you will be emailed a PDF receipt that will allow you to claim any rebate you may have owing from your Health Fund. Many Health Funds allow for online manual claims - check with your Health Fund for more details. For a complete list of Health Funds that participate in the HICAPS program for Remedial Massage, click HERE.