Myofascia – part 2

Last week I explained what myofascia is and how it can become restricted from, for example, poor posture.

How to identify Myofascial Restrictions?

It is important to acknowledge that it is difficult to diagnose myofascial restrictions as they do not show up on standard tests (x-rays, myelograms, CAT scans, electromyography etc).

Massage therapists utilise their palpation skills to find myofascial restrictions. For example fascial drag, this is a very light press & slow technique to allow the therapist to feel the restrictions in the fascia.

Who treats Myofascial Restrictions?

  1. Myofascial Release – Originated in the 1940’s. It is a specialised physical and manual therapy used for the effective treatment and rehabilitation of soft tissue and fascial tension and restrictions. John Barns a physical therapist based in the US is one of today’s leading lights in the world of myofascial release.
  2. Rolfing – Dr Ida Rolf, started working with client in the 1930’s and by the 1950’s was teaching her work under the name of Rolfing .   A physical therapy which aims to release stress patterns from the body.   It is normally to require a series of treatment often up to 10.
  3. Massage – massage therapists utilise direct and indirect technique to address Myofascial restrictions.

With indirect Myofascial techniques you apply pressure and wait of the fascial to release, when you meet restriction you stretch the fascia. With direct Myofascial techniques you drag the fascia to create a Chinese burn sensation.   Hence why in clinic I often rely on the gentler indirect Myofascial techniques even when I know my clients prefer deep pressure.

Related Posts

  • The hidden cause of lower back pain

    The psoas muscle is a very deep muscle that connects your torso to your legs.  It affects your posture and helps you to stabilise your spine.    In fact, whether you run, bike, dance, practice yoga, or just hang out on your couch, your psoas muscles are involved. A person suffering from IlioPsoas syndrome may have pain in the hip and thigh region, as well as hip stiffness and in some cases a clicking or snapping hip. Other signs which may indicate an unhappy psoas muscle are:

    1. Knee pain - if there is no obvious source then it may be your psoas muscle.
    2. Constipation - a tight psoas muscle can cause or contribute to constipation.
    3. Menstrual cramps - a tight psoas muscle can put pressure on reproductive organs contributing to menstrual cramps.
    The reason thatthe psoas is often the hidden cause of lower back pain in our clients is that prolonged periods of sitting cause the psoas muscle to contract.   A deep tissue or sports massage is the perfect way to release a tight psoas.

  • Cryotherapy

    We all know that sports stars take ice baths and I am often asked why they do it, and do I need to do it after I run.  So today I am going to answer that question. Cryotherapy is one of long accepted tools of a sports masseur.  If you have ever watched a football match on telly, you will have seen someone fall to the ground and the coach run on with a bucket of water and the magic sponge and the player then hopefully gets up and hobbles around before taking an active part in the game.  So the magic sponge, (the application of cold water to an injured area) is Cyrotherapy in its most basic form.  The local application of ice or cold water is beneficial because

    • It relieves pain
    • Reduces muscle spams (i.e. athletes take ice baths to avoid feeling stiff the next day)
    • When someone is injured it moderates inflammation
    Probably equally important to all those benefits is that the treatment is very convenient, inexpensive and effective. So to go back to the questions should I have an ice bath after training. If you have injured yourself during training you should definitely follow the RICE (Rest Ice Compression and Elevation) protocol
    • Rest - by which I mean avoid weight bearing activities and anything that causes pain for 24 - 48 hours.
    • Ice - Use either cold water or ice wrapped in a tea towel and apply for 2 - 20 minutes for 2-3 days then 3 times daily.    When applying ice you go through the cold, aching, burning and numbness sensation cycle, it is very important to stop at numbness to avoid burning yourself.
    • Compression  - use a compression bandage if necessary
    • Elevation - if the injury is to a limb, elevate it to help it heal.
    The only exception to using Ice for injuries is for people with a peripheral vascular disease e.g. diabetes, anyone who is hypersensitive or has a physiological aversion to cold if you are frail or if you have varicose veins in the injured area or  the injury is a broken bone. However, what if you haven't injured yourself, should you have an ice bath after training.    Taking an ice bath or sometimes a cold-water immersion is certainly now more popular amongst athletes than ever before.   The key reason is that as it reduces muscle tightness and soreness and it allows athletes to recover more quickly after intense training.   The big draw back is that is uncomfortable and not really scientifically proven.  My recommendation would be only to do it if you are training really intensively and you are not contraindicated (see above exceptions to using ice) and want to, as ice baths are optional.  For me the most important thing to prevent injury and allow you to recover quickly is a well designed training plan where you build up the intensity of the exercise slowly, with adequate warm up routine and a cool down routine and stretching. Remember if you do get injured or have tight muscles after training, a good masseur will be able to sort these out.    

  • Is reflexology or massage better at reducing stress or pain?

    While amongst my clients there is a clear preference for massage, I decided to investigate if there was any scientific evidence if massage was better than reflexology (or vice versa) at reducing pain and stress. In 2012 there was a small study comparing massage to reflexology on cancer survivors over the age of 75 living in a care home.  The study compared the effectiveness of 20 minutes of reflexology treatments against 20 minute Swedish massage by examining the impact on the patients stress levels, pain levels and mood.  Pre and post treatment levels of salivary cortisol, observed affect and pain were compared. Both reflexology and Swedish massage resulted in significant declines in salivary cortisol indicating a reduction in stress levels, reduced pain levels and improvements in mood.        So to go back to my original question, there is scientific evidence for both and I suggest you book the treatment you prefer. Hodgson N, Lafferty D (2012) Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evidence Based Complement Alternat Med. 2:456897