Wellness Blog

Inna Evtoushenko, RMT, CLT

Restorative Massage & Lymphedema Therapy offers treatments to manage Lymphedema, reduce swelling, relieve pain, increase joint mobility, decrease muscle tension, promote healing and relaxation.

February 2020

ImpediMed welcomes NCCN’s updated breast cancer guidelines to provide early lymphoedema screening

Article Image

The National Comprehensive Care Network (NCCN) has updated its Guidelines for Breast Cancer regarding early detection and diagnosis of lymphoedema, which ImpediMed (ASX: IPD) hopes to take advantage of with its non-invasive bioimpedance spectrometry (BIS) test and Lymphoedema Prevention Program (LPP).

The update follows requests from Vanderbilt University School of Nursing, Lymphatic Education and Research Network and the American Society of Breast Surgeons Foundation to the NCCN to recommend early surveillance with ImpediMed’s BIS test.

This would enable detection of subclinical breast cancer-related lymphoedema. In turn, it would result in early intervention, which would reduce the need for complete decongestive physiotherapy.

May 2019


Several years ago we published the first article in a series under the general name “How Massage Heals The Body.” In these articles we reviewed modern scientific sources on what exact mechanisms Massage Therapy employs to deliver such powerful clinical results.

In issue #2, 2017 of JMS we published an article on the effect of MT on cell functions: “Stimulation Of Cellular Functions By Massage Therapy“: https://www.scienceofmassage.com/2017/05/how-massage-heals-the-body-part-v/

This article reviewed fascinating data on how mechanical pressure elicited on the soft tissues alters function of the tissues all the way to cellular metabolism and even gene expression. This article was based on our much earlier publication – textbook Therapeutic Massage. A Scientific Approach (2002).

November 2018

The Best Types of Cardio Workouts for Weight Loss

Article Image

If you’re like most guys, you do cardio to help you stay lean and show off the muscle gains you get from hitting the weights, aka “the usual workout routine.” And there’s absolutely nothing wrong with that.

But when it comes to which type of cardio is best for burning fat, you have to decide which lean body type you’re going for. “If you train like a distance runner, you’ll get a distance runner’s body: little muscle, very lean from lots of miles logged at relatively slower paces,” explains Chris Ryan, C.S.C.S., a physical trainer and the founder of Chris Ryan Fitness. “If you train like a sprinter—short, high-intensity workouts—you’ll get a sprinter’s body with muscle growth and fat loss.”

Here’s something we can all agree on: Intensity is paramount. As intensity rises, more calories get burned. That’s why high-intensity interval workouts are a great choice for getting shredded while maintaining (or even gaining) muscle.

October 2018

Does the brain really feel no pain?

Article Image

The brain has no nociceptors – the nerves that detect damage or threat of damage to our body and signal this to the spinal cord and brain. This has led to the belief that the brain feels no pain. A belief that has entered popular culture.

In the 2001 movie Hannibal, there is a gut-twisting scene in which the eponymous Hannibal Lecter cuts out part of the brain of an FBI agent who is fully awake, though drugged, and seated at a dinner table.

“See the brain itself feels no pain,” Lecter tells an aghast Clarice Starling. But if the brain feels no pain, what causes headaches?

June 2018

Multivitamins are not only ineffective, but dangerous

Article Image

For many years, when my doctor would ask what vitamins or supplements I consume on a regular basis, I would reply by saying "a multivitamin." Never once in all those years did she (or he; I’ve bounced around a bit) ask what type of vitamins were included in the cocktail. No question of percentages, minerals, vitamins—just a head nod and a mouse click.

A few years ago I stopped saying "multivitamin" because I stopped taking one, and he (or she) never asked why, recommended advice, anything. They simply unchecked the box.

For more than half of Americans—68 percent of adults over age 65—a multivitamin (among a few, or many, supplements) is part of the daily ritual. Overloading your body with five or ten times the recommended daily allowance of this or that vitamin is treated as folk wisdom. It’s such basic science that questioning it seems like a complete waste of a thought.

April 2018


Article Image

What is Carpal Tunnel Syndrome? Carpal tunnel syndrome is a condition characterized by tingling, numbness and pain in the hand and fingers (particularly the thumb, index, middle and ring fingers). These symptoms are often the result of median nerve irritation in the wrist or forearm.

Why Give Massage Therapy A Try? Massage therapy as a therapeutic intervention is being embraced by the medical community, it is simple to carry out, economical, and has very few side effects. One area that is being explored is the use of massage therapy for patients who suffer from carpal tunnel syndrome.

Randomized clinical trials have demonstrated that for some patients who suffer from carpal tunnel syndrome there is no significant differences in pain and functional outcomes at six and twelve months when surgical and conservative care are tested (Fernández-de-Las Peñas et al. 2017).

March 2018


Article Image

What is a Posterior pelvic tilt? A Posterior pelvic tilt is where the pelvis is rotated backwards from the ideal neutral position. This causes a rounding of the natural curve in the lower back. (… also referred to as a loss of lumbar lordosis) Note: If you would like to know more about the ideal pelvis position, check out this post: The correct pelvis position in sitting.

Having a posterior pelvic tilt WILL drastically effect the rest of your posture (even up into the upper back and neck!)… It is vital that you address your Posterior pelvic tilt as soon as possible. It may just be the one reason why you have so much pain and tightness in your body. When you have a Posterior pelvic tilt, there will be an associated flattening/curving of the lower back. So what? Why is this an issue?… You need your curve! It helps distribute the forces in your lower back more efficiently.

Without a natural curve in your lower back, you are at a higher risk of developing painful injuries such as disc bulges, nerve issues and muscular strains (… just to name a few) in your lumbar spine.

January 2018

Starting rehab early can speed
recovery from muscle injuries: study

Article Image

On a Tuesday in late October, Wayde van Niekerk headed into an operating room in Vail, Colo. The 25-year-old South African 400-metre runner, who shattered a 17-year-old world record en route to gold at the Rio Olympics in 2016, had torn his anterior cruciate ligament during a celebrity rugby match, putting his upcoming season – and perhaps his career – in jeopardy.

Two days later, he sent out an optimistic tweet: "Successful op done and dusted! Rehab already started. Ready for the hard work ahead."

Van Niekerk's vanishingly small post-injury rest period is typical of the aggressive return-to-play strategies practiced by professional athletes and sports teams. When every day on the sidelines represents lost dollars, there's strong incentive to hurry back from injury by starting rehab as soon as possible – despite the fact, says Monika Bayer, a postdoctoral researcher at the Institute of Sports Medicine Copenhagen in Denmark, that "there has been very little scientific evidence obtained through human clinical trials to support this approach."

January 2018

Should We Crush Tissue?

Recently, I have found myself reflecting back on some techniques and approaches that I have significantly changed my thought process and approach on. While it frustrates me that in the past I have made decisions and used techniques that are sub-optimal, I also believe that this evolution is an indication of improved treatment and training techniques over time and it also shows a personal commitment to finding the best solution to every problem, given what you know at the time. So, I do believe that it is a sign of a commitment to excellence, even though I wish I knew then what I know now.

One item that I have significantly changed my approach on over recent years is the idea of “crushing tissue” in an effort to improve movement quality. Not very long ago, I fell victim to the notion that “more is better” and that if I was going to change how people move, I needed to mechanically change and deform tissue with aggressive interventions with a ton of pressure. This includes deep massage, trigger point therapy, watching people sweat while they lie on a foam roll, bruising patients with IASTM, and dropping elbows whenever and wherever I saw fit. While I didn’t go to some of the extremes of other clinicians, I do know that many people “smash” tissue by doing things like walking on their patients or using very heavy weighted objects to “release tissue.”

I believe that these ideas stem from the following thought processes:

October 2017

A comprehensive guide to the new
science of treating lower back pain

A review of 80-plus studies upends the conventional wisdom.
Article Image

Cathryn Jakobson Ramin’s back pain started when she was 16, on the day she flew off her horse and landed on her right hip.

For the next four decades, Ramin says her back pain was like a small rodent nibbling at the base of her spine. The aching left her bedridden on some days and made it difficult to work, run a household, and raise her two boys.

By 2008, after Ramin had exhausted what seemed like all her options, she elected to have a “minimally invasive” nerve decompression procedure. But the $8,000 operation didn’t fix her back, either. The same pain remained, along with new neck aches.

September 2017

Massage Therapy for Headaches and Migraines

Article Image

Massage Therapy for Headaches

Massage therapy as a therapeutic intervention is being embraced by the medical community. This is in part because it is a non-pharmacological therapeutic intervention that is simple to carry out, economical, and has very few side effects (Busse et al. 2017).

Turns out that there is good supporting literature for the use of massage therapy for patients who suffer headaches (Ferragut-Garcías et al. 2016, Nahin et al. 2016, Varatharajan et al. 2016).

Structures to be aware of when treating headaches

A massage therapy treatment plan should be implemented based on patient-specific assessment findings and patient tolerance. Structures to keep in mind while assessing and treating patients suffering from cervicogenic headaches may include neurovascular structures and investing fascia of:

May 2017

Morning Back Pain
A thorough review of possible causes

Article Image

“I woke up with it” is an amazingly common description of how low back pain started. (And neck pain and headaches. And even more.1). Is sleeping dangerous? Probably not: waking up with back pain rarely indicates a serious problem. Both mornings and backs are unusually vulnerable to some common minor sources of pain.

Many people get their first acute episode of low back pain during the night, and the AM effect is also a dreaded part of chronic low back pain. Even many people who are more or less pain-free during the day may still experience routine and significant irritation and stiffness first thing in the morning.

Morning back pain is a tough problem to treat because most of it probably has several subtle chronic causes, but there may be some opportunities for treatment in changing the way we sleep.

April 2017

Trapped Cluneal Nerves
May Be Primary Reason of Certain Low Back Pain

Article Image

For many years, I used to think low back pain is a muscle or spine problem or pinched nerves in the spine. After having read much of the history of pain science and the research by Dr. Ronald Melzack, Dr. Patrick Wall, and Dr. Joel Katz (gate-control theory, neuromatrix theory, phantom pain), low back pain is much more than just “something is wrong with my tissues.” (1,2,3) Although psychosocial factors can affect pain intensity and the perception of pain in general,(4,5) sometimes low back pain can primarily be caused by biological factors, such as irritated or “entrapped” cluneal nerves.

Entrapment of these cutaneous nerves of the buttocks was once described as the tendency for the cluneal nerves to get entrapped where they pass through the fascia near the iliac crest. (6) However, Tubbs et al. stated that such entrapment is uncommon yet possible, and they did not find “no osteofibrous tunnels or obvious compression sites” that could cause these nerves to get “stuck” among 20 cadavers. (7) They suggested that more obvious and common causes of low back pain and leg pain should be ruled out before considering entrapped cluneal nerves be a possibility. “We found no anatomical variation between sex, age or side,” lead author Dr. Shane Tubbs told Massage & Fitness Magazine in an online interview.

However, Aota cited a few studies that yielded some evidence that “suggested entrapment of the penetrating nerves within or under the ligament is a potential cause for [low back pain] and peripartum pelvic pain” because “primary and secondary loops of the posterior sacral nerve plexus passed through or underneath the LPSL. (8,9,10) It appears that this is quite a controversial topic, especially so little is known about cluneal nerves and their role in contributing to pain.

March 2017

Touch Therapy And Physiological Effects
Of Psychological Stress

Article Image

We often underestimate the physiological effects of psychological stress. However our mind and body is one, in the sense that mind affects the body and body affects the mind. One does not act independent of the other. The following is a brief description of what happens to our bodies when they go through stress. It’s worth mentioning that the distinction of whether it is psychological or physiological stress is not very relevant as the physiological effects of either stresses are the same.

When we’re calm and at rest, our brain activates parasympathetic nervous, which keeps the blood pressure and heart rate at low normal levels. This system is often referred to as “rest and digest” system. It is responsible for body’s “housekeeping” activities such as digestion, nutrient absorption, and tissue regeneration.

When we’re stressed, physically or emotionally, our brain goes into fight-or-flight mode, activating sympathetic nervous system. Blood vessels constrict and the heart beats faster, raising blood pressure. Blood is diverted from temporarily nonessential organs to the heart and skeletal muscles. Blood glucose levels rise, which in turn signals for further release of hormones responsible for maintaining fight-or-flight response.

Chronically elevated blood pressure increases the risk of developing hypertension. Chronic hypertension strains the heart and damages arteries. Because the heart is forced to pump against greater resistance, it must work harder, resulting in heart enlargement. When the heart finally is strained beyond its capacity, it becomes weak and its walls become flabby, further compromising its function.

Corisol is one of the hormones that are released during stress, physical or emotional. Excessive levels of cortisol depresses immune system, cartilage and bone formation, disrupts cardiovascular, neural, and gastrointestinal function.

The neural disruption due to stress suppresses production of melatonin, the sleep hormone. Lack of sleep results in decreased nutrient absorption and tissue regeneration, which are some of the essential processes take place during sleep. Recent evidence suggests that melatonin controls production of protective antioxidants and detoxification molecules within our cells.

Stress, physical or emotional, also increases Basal Metabolic Rate (BMR). This metabolic rate is obtained when a person is in a postabsorptive state (has not eaten for at least 12 hours) and is mentally and physically relaxed in room temperature 20-25⁰C. Excessive BMR levels cause the body to catabolise stored fats and tissue proteins, resulting in weakened bones and muscles, including the heart.

Registered Massage Therapy is a very effective method to reduce physical and mental stress. Touch therapy calms the mind. A mind at rest activates parasympathetic nervous system which in turn reduces heart rate, blood pressure, enhances immune system, nutrient absorption, and tissue regeneration. Regular touch therapy is a very effective prophylactic measure to keep mind and body healthy and happy.