Massage Rx

PERIMENOPAUSE & PAIN: IT’S NOT JUST “GETTING OLDER.”

Have your joints suddenly started aching? Tendons become more irritable? Recovery feels slower? Or has shoulder pain appeared seemingly out of nowhere?

The menopausal transition may be part of the picture.

Changing oestrogen levels can influence tissues and systems involved in:

🦴 Bone health
💪 Muscle mass and strength
🧬 Collagen and connective tissue
🦵 Tendon biology
🔥 Inflammatory signalling
🧠 Pain processing

Conditions such as frozen shoulder, rotator cuff-related pain and some tendinopathies are also particularly relevant during midlife.

But there’s an important distinction:

Menopause doesn’t automatically cause these conditions — and pain doesn’t necessarily mean your joints or tendons are deteriorating.

Pain is multifactorial.

Hormonal changes can interact with training load, sleep, stress, muscle strength, body composition, previous injury and overall health.

And that changes how we should approach treatment.

The answer usually isn’t to stop exercising and protect everything.

It’s about:

🏋️ Building strength progressively
📈 Managing load intelligently
🥩 Eating enough protein and supporting bone health
😴 Prioritising recovery and sleep
🤲 Treating pain where appropriate
🧠 Understanding pain rather than fearing movement

Most importantly, your body remains adaptable through perimenopause and beyond.

Hormones may change.
Recovery may change.
Your approach may need to change.

But you can still become stronger, fitter and more resilient.

As an Advanced Manual Therapist, Clinical Nutritionist, Sports Nutritionist and Health Coach, this is exactly where I believe combining good assessment, manual therapy, progressive exercise, nutrition and pain education can be incredibly valuable.

👉 Swipe through for the science.

Strong through perimenopause. Strong beyond menopause.

💥 BETA-ALANINE: DOES IT ACTUALLY WORK?

Yes — but when it works depends heavily on what you’re training for.

Beta-alanine increases carnosine inside skeletal muscle. Carnosine helps buffer hydrogen ions (H⁺) during intense exercise, helping maintain muscle pH as fatigue develops.

Research suggests the greatest benefit is during demanding efforts lasting roughly 30 seconds to 10 minutes.

That makes it particularly interesting for:

🔥 CrossFit-style conditioning
🏃 Hard intervals
🚣 Rowing
🚴 High-intensity cycling
🏋️ High-rep training
⚡ Some HYROX-type efforts

But it isn’t a universal performance enhancer.

For 1RM strength, hypertrophy alone, low-intensity exercise or very short sprints, the case is much less compelling.

😳 WHAT ABOUT THE TINGLING?

That’s called paresthesia. It’s generally temporary and harmless.

Importantly:

More tingling ≠ better performance.

The benefit comes from building muscle carnosine over time — not from feeling the supplement “kick in”.

🥄 HOW MUCH?

Around 3.2–6.4 g/day, consistently over several weeks.

Smaller divided doses can reduce tingling, and timing around your workout isn’t particularly important.

🎯 THE TAKE-HOME

Creatine → rapid energy availability, strength & power

Beta-alanine → buffering & fatigue resistance during certain high-intensity efforts

Different supplements. Different physiology. Different jobs.

As an Advanced Manual Therapist, Clinical Nutritionist, Sports Nutritionist and Health Coach, I’m a big believer in matching supplementation to the individual, their training and the evidence — rather than the hype.

Train smart. Supplement strategically.

HEADACHES & TMJD — COULD YOUR JAW BE PART OF THE PUZZLE? 🧠🦷

Headaches are complex, and they don’t always originate where you feel the pain.

For some people, temporomandibular disorders (TMD/TMJD), jaw-muscle pain and headaches can overlap — particularly when headaches occur alongside jaw pain, clenching or grinding, painful chewing, restricted jaw movement or tenderness around the temporalis and masseter muscles.

So how can the jaw contribute to pain felt in the head?

🔹 Convergence–projection
Nociceptive information from the jaw, face, head and upper cervical region can converge within shared trigeminal/trigeminocervical pathways. This helps explain why the nervous system may sometimes perceive pain away from the tissue contributing to it.

🔹 Myofascial referred pain
Sensitive areas within the masticatory muscles can reproduce pain elsewhere. The temporalis, for example, can refer toward the temple, forehead, eye and upper teeth, while the masseter can produce referral into areas of the jaw, face, teeth and head.

🔹 Sensitisation
When pain persists, the nervous system can become increasingly responsive, potentially amplifying symptoms and expanding the area in which pain is experienced.

Importantly, this does not mean every headache comes from the TMJ.

Migraine, tension-type headache and other headache disorders have multiple potential mechanisms and contributors. But when headaches consistently occur alongside jaw symptoms, the temporomandibular system deserves to be assessed.

My approach is therefore broader than simply “releasing trigger points.”

I assess the TMJ, masticatory muscles, cervical region, movement and loading capacity, relevant lifestyle factors and pain mechanisms to determine what may actually be contributing to the individual presentation.

🎯 Find the drivers. Treat the system. Improve the outcome.

Hamilton TMJ Solutions × MassageRx
Advanced Manual Therapy | TMJ Assessment & Treatment | Rehabilitation | Pain Science

Ankle sprain rehab: treatment is only part of the picture 🦶

An ankle sprain can look simple, but good rehabilitation involves much more than waiting for the pain and swelling to disappear.

In my clinic, I like to combine three important pieces of the recovery process:

🔹 Manual therapy — helping restore comfortable joint movement, address surrounding soft-tissue restrictions and reduce symptoms where appropriate.

🔹 Progressive exercise rehabilitation — rebuilding mobility, calf and ankle strength, proprioception, balance, control and eventually the ability to tolerate running, jumping and change of direction.

🔹 Pain science education — helping you understand what you’re feeling, what is safe to load, and why some discomfort during rehabilitation doesn’t automatically mean you’re causing further damage.

It’s the combination of all three where the magic happens.

Manual therapy can help create a window where movement feels easier — but we then need to use that window.

Exercise builds the physical capacity.

Education builds confidence and reduces fear around movement and loading.

And importantly, rehabilitation shouldn’t simply stop when the ankle “doesn’t hurt anymore.” The later stages of rehab matter if we want to restore strength, balance and confidence and reduce the risk of ongoing instability or another sprain.

The goal isn’t just a pain-free ankle.

It’s an ankle you can trust again.

Swipe through 👉 for my 3-phase approach to ankle sprain rehabilitation.

General education only. Ankle injuries vary considerably and should be individually assessed when appropriate.

💪🧠 CREATINE: NOT JUST FOR BUILDING MUSCLE

Creatine monohydrate is one of the most researched supplements in sports nutrition — and the evidence now extends well beyond gym performance.

Research supports creatine for:

💪 Strength & lean muscle
⚡ High-intensity performance
🏋️ Training adaptations
👨‍🦳 Maintaining muscle and function as we age
🧠 Potential cognitive benefits

The brain uses the creatine–phosphocreatine system for cellular energy too.

Emerging research suggests supplementation may support aspects of memory, attention and processing speed, with particularly interesting implications for ageing and periods of increased cognitive demand.

But an important distinction:

👉 Creatine is not proven to prevent dementia or cognitive decline. The research is promising, but still developing.

🫘 WHAT ABOUT YOUR KIDNEYS?

Another common myth.

Current evidence does not show that recommended creatine supplementation damages healthy kidneys.

Creatine can slightly increase blood creatinine, which may affect creatinine-based kidney test results without necessarily indicating kidney damage.

🥄 HOW MUCH?

For most healthy adults:

3–5 g creatine monohydrate daily.

Loading is optional. Timing isn’t particularly important.

Consistency is.

And as we move through our 40s, 50s and beyond, maintaining muscle, strength, physical function and brain health becomes increasingly important.

Creatine isn’t magic — and it doesn’t replace good nutrition, resistance training, sleep or an active lifestyle.

But it’s inexpensive, well researched and increasingly difficult to dismiss as simply a “bodybuilding supplement.”

As a qualified Health Coach, Sports Nutritionist and Clinical Nutritionist, I’m particularly interested in using nutrition and evidence-based supplementation to support both performance and long-term health.

👉 Swipe through for the science.

💥 DOMS: IT’S NOT JUST “MICROTEARS”

For years, delayed-onset muscle soreness (DOMS) was commonly explained as:

Exercise → microscopic muscle tears → inflammation → pain.

But our current understanding is much more interesting. 🧠

DOMS appears to involve a temporary sensitisation of sensory nerves within and around exercised muscle, particularly after unfamiliar or demanding exercise.

Eccentric (lengthening) contractions are especially good at triggering it — think lowering weights, downhill running, lunges, negatives and unfamiliar high-volume training.

🔬 So why does it hurt?

Exercise triggers biological signalling involving mediators such as bradykinin, prostaglandins, NGF and GDNF.

These processes can make sensory nerve endings more sensitive, effectively lowering your mechanical pain threshold.

That’s why DOMS hurts when you:

👉 contract
👉 stretch
👉 press
👉 load
👉 move the muscle

⏰ And why is it delayed?

Because this biochemical signalling and nerve sensitisation take time to develop.

Soreness commonly becomes noticeable hours after exercise and may peak around 24–72 hours later.

And no… it’s not lactic acid. Lactate has largely cleared long before DOMS reaches its peak.

🔁 Why are you usually less sore next time?

The repeated-bout effect.

Your muscles, connective tissues and nervous system adapt to the stimulus, meaning the same workout can produce significantly less soreness next time.

Most importantly:

❌ More soreness ≠ more muscle growth
❌ More soreness ≠ more muscle damage
❌ More soreness ≠ a better workout
❌ No soreness ≠ an ineffective workout

DOMS often tells us more about how unfamiliar the stimulus was than how effective your training was.

🎯 Train smart. Recover well. Let adaptation do its job.

Save this one for the next time stairs become your enemy after leg day. 😬

👣 Heel pain isn’t always “plantar fasciitis.” It may actually be plantar fasciopathy.

If your first few steps in the morning are painful, or standing and walking become increasingly uncomfortable throughout the day, you’re not alone.

Current research shows that persistent plantar heel pain is often due to changes within the plantar fascia, not simply ongoing inflammation. That’s why successful treatment is about more than just rest or stretching.

At MassageRx, we combine an evidence-informed approach that may include:

⚡ Shockwave Therapy
🔴 High-Intensity Class IV Laser Therapy
🪡 Advanced Dry Needling
🤲 Manual Therapy
🏃 Progressive Rehabilitation

Each treatment plays a different role, but the goal is always the same: reduce pain, improve tissue capacity and help you get back to the activities you enjoy.

There isn’t a single “magic treatment.” The best outcomes come from an accurate assessment, identifying the factors contributing to your heel pain, and building a personalised rehabilitation plan.

If heel pain has been holding you back, we’d love to help.

📍 MassageRx – Advanced Manual Therapy
Hamilton, New Zealand

🏃‍♂️ Pain high in your hamstring that won’t go away? It could be proximal hamstring tendinopathy.

This common tendon injury affects runners, CrossFit athletes, lifters, cyclists and anyone who regularly loads their hamstrings.

The good news? Research shows that tendons respond best to the right treatment combined with progressive rehabilitation—not simply rest.

At MassageRx, treatment may include:

⚡ Shockwave Therapy
🔴 High-Intensity Class IV Laser Therapy
🪡 Advanced Dry Needling
🏋️ Progressive Rehabilitation

Each treatment has a different role. Together, they’re designed to reduce pain, improve tendon health, restore strength and help you return to the activities you enjoy.

No single treatment is a magic fix. The best results come from an accurate assessment, a personalised treatment plan and progressive loading based on your goals.

If persistent hamstring pain is limiting your training or everyday life, we’d love to help.

📍 MassageRx – Advanced Manual Therapy
Hamilton, NZ

🎾 Tennis Elbow or Golfer’s Elbow? You don’t have to live with persistent pain.

Despite their names, these conditions don’t just affect tennis players and golfers. They’re common overuse tendon injuries seen in tradespeople, office workers, CrossFit athletes, gym-goers, parents, and anyone performing repetitive gripping or lifting.

For years these injuries were thought to be primarily inflammatory. We now know they’re usually tendinopathies—meaning changes within the tendon itself that reduce its ability to tolerate load.

That’s why treatment needs to go beyond simply masking pain.

Current research supports both Extracorporeal Shockwave Therapy (ESWT) and High-Intensity Class IV Laser Therapy as evidence-based treatment options for many people with persistent elbow tendinopathy. Studies have shown improvements in pain, function and grip strength, particularly when these treatments are combined with an appropriate rehabilitation programme.

At MassageRx, treatment doesn’t stop at the machine.

Every treatment plan is built around:
✔ Comprehensive assessment
✔ Hands-on therapy where appropriate
✔ High-performance Shockwave Therapy
✔ High-Intensity Class IV Laser Therapy
✔ Progressive strengthening and rehabilitation
✔ Education and load management

While research hasn’t yet shown that combining shockwave and laser is superior to using either treatment alone, both have good evidence individually and may complement each other as part of an individualised treatment programme.

If you’ve been dealing with elbow pain for weeks—or even months—it may be time for a different approach.

📍 MassageRx – Advanced Manual Therapy
Hamilton, New Zealand

📩 Send a message or book online if you’d like to find out whether this approach may be suitable for your condition.

⸻

References (selected):
• Recent systematic reviews support ESWT for lateral epicondylopathy.
• Meta-analyses support high-intensity laser therapy for improving pain and upper-limb function in chronic lateral epicondylopathy.

🩸 PRP (Platelet-Rich Plasma) injections are one of the treatments I’m asked about most—but it’s probably time to clarify something…

I don’t perform PRP injections.

So why create a post about them?

Because my role is to help people understand what the current research actually says, so they can make informed decisions alongside their healthcare team.

Whether PRP is appropriate depends on many factors, including your diagnosis, the severity of your condition, your goals, your overall health, and whether other treatment options have been explored. Those are conversations that should always be had with your treating specialist or the clinician performing the injection.

This carousel isn’t intended to tell you whether you should or shouldn’t have PRP.

Instead, it’s a summary of what the current research and systematic reviews tell us:

✅ Which conditions have the strongest evidence
✅ How PRP is thought to work
✅ What benefits are realistic to expect
✅ Where the evidence is still limited
✅ The importance of rehabilitation and appropriate patient selection

One of the biggest take-home messages from the research is that PRP isn’t a miracle cure—but for the right patient, with the right condition, and as part of a well-planned rehabilitation programme, it may provide meaningful improvements in pain and function.

As always, my goal is to help people separate evidence from hype and make informed healthcare decisions based on the best available science.

Have you had PRP injections? What was your experience? I’d love to hear your thoughts in the comments.