Monday, October 6, 2008

Myofascial Release - An Introduction for the Patient

Reg. No. A1.M9/08, S. 289/08
Chemmanampady, Medical College, Kottayam
Ph: 9846265331, 9846474873, 9048001452 E mail:
Myofascial Release is a relatively new addition to the armamentarium of the physical therapist. Because it is somewhat different from traditional physical therapy, many patients ask questions such as "What is it?" and "How does it work?" Myofascial Release is generally an extremely mild and gentle form of stretching that has a profound effect upon the body tissues. Because of its gentleness, many individuals wonder how it could possibly work. To help you understand, we are providing you with this article.
In SCeB CAPT ® our therapist are specialized in MFR and practicing most resent and proved Hands- On techniques through an approach called AJIMSHAW’s Approach ® & this is the identity and uniqueness of our clinic.
Our motto "SCeB CAPT® Care…….100% Cure……
Fascia (also called connective tissue) is a tissue system of the body to which relatively little attention has been given in the past. Fascia is composed of two types of fibers: A) Collagenous fibers which are very tough and have little stretch ability. B) Elastic fibers which are stretchable. From the functional point of view, the body fascia may be regarded as a continuous laminated sheet of connective tissue that extends without interruption from the top of the head to the tip of the toes. It surrounds and invades every other tissue and organ of the body, including nerves, vessels, muscle and bone. Fascia is denser in some areas than others. Dense fascia is easily recognizable (for example, the tough white membrane that we often find surrounding butchered meat).
When Fascia is Injured
Because fascia permeates all regions of the body and is all interconnected, when it scars and hardens in one area (following injury, inflammation, disease, surgery, etc.) it can put tension on adjacent pain-sensitive structures as well as on structures in far-away areas. Some patients have bizarre pain symptoms that appear to be unrelated to the original or primary complaint. These bizarre symptoms can now often be understood in relationship to our understanding of the fascial system.

Anatomy of Fascia
The majority of the fascia of the body is oriented vertically. There are, however, four major planes of fascia in the body that are oriented in more of a crosswise (or transverse) plane. These four transverse planes are extremely dense. They are called the pelvic diaphragm, respiratory diaphragm, thoracic inlet and cranial base. Frequently, all four of these transverse planes will become restricted when fascial adhesions occur in just about any part of the body. This is because this fascia of the body is all interconnected, and a restriction in one region can theoretically put a "drag" on the fascia in any other direction.
Treating Fascial Restrictions
The point of all the above information is to help you understand that, during myofascial release treatments, you may be treated in areas that you may not think are related to your condition. The trained therapist has a thorough understanding of the fascial system and will "release" the fascia in areas that he knows have a strong "drag" on your area of injury. This is, therefore, a whole body approach to treatment. A good example is the chronic low back pain patient; although the low back is primarily involved, the patient may also have significant discomfort in the neck. This is due to the gradual tightening of the muscles and especially of the fascia, as this tightness has crept its way up the back, eventually creating neck and head pain. Experience shows that optimal resolution of the low back pain requires release of the fascia of both the head and neck; if the neck tightness is not also released it will continue to apply a "drag" in the downward direction until fascial restriction and pain has again returned to the low back.
Muscle provides the-greatest bulk of our body’s soft tissue. Because all muscle is enveloped by and in grained with fascia, myofascial release is the term that has been given to the techniques that are used to relieve soft tissue from the abnormal grip of tight fascia. The type of myofascial release technique chosen by the therapist will depend upon where in your body the therapist finds the fascia restricted. If it is restricted in the back (more superficial than deep) he may apply a very gentle stretch on the skin across the back, with the use of two hands. If the thoracic inlet, deep transverse fascia is suspected of being restricted, the therapist may place one hand on the upper back and one over the collarbone area in front and apply extremely gentle pressure. Muscle tissue responds to a relatively firm stretch, but this is not the case with fascia. Remember the collagenous fibers of fascia are extremely tough and resistant to stretch. In fact, it is estimated that fascia has a tensile strength of as much as 2000 pounds per square inch. (No wonder when it tightens, it can cause pain). However, it has been shown that under a small amount of pressure (applied by a therapist’s hands) fascia will soften and begin to release when the pressure is sustained overtime. This can be likened to pulling on a piece of taffy with only a small, sustained pressure. Another important aspect of myofascial release techniques is holding the technique long enough. The therapeutic affect will begin to take place after holding a gentle stretch and following the tissue three-dimensionally with skilled, sensitive hands.
In general, acute cases will resolve with a few treatments. The longer the problem has been present, generally the longer it will take to resolve the problem. Many chronic conditions (that have developed over a period of years) may require three to four months of treatments to obtain optimal results.
Frequently there is increased pain for several hours to a day after treatment, followed by remarkable improvement. After, remarkable improvement is noted immediately during or after a treatment. Sometimes new pains in new areas will be experienced. There is sometimes a very light-headedness or a feeling of nausea. Sometimes a patient experiences a temporary emotion change. All of these are normal reactions of the body to the profound, but positive, changes that have occurred by releasing fascial restrictions. It is felt that release of tight issue is accompanied by release of trapped metabolic waste products into the surrounding tissue arid bloodstream. We highly recommend that you "flush your system" by drinking a lot of fluid during the course of your treatments, so that reactions like nausea and light headedness will remain minimal or nil. If patients have any questions or concerns that arise concerning myofascial release, they should be encouraged to discuss them with the therapist.
Some examples of our Successes
Case History—Chronic Low Back Pain
A 32-year-old construction worker was suffering from Chronic Low Back Pain with bilateral thigh pain. Five months after his continuous pain he was referred to physical therapy by his doctor for three weeks of treatment for chronic low back pain and bilateral thigh pain. He was treated with AJIMSHAW’s Approach for his condition. After just two treatments sessions itself there was no further leg pain and only mild low back pain with movement. After the completion of the course he no longer was having any pain and had returned to his job as a construction worker. Specific exercises and activity modifications were advised. Following up by telephone three months later, he reported having no problems with his back. He is very pleased with his ability to continue his strenuous job.
Case History- Fibromyalgia
A 18-year-old BDS student was suffering from chronic low back pain, neck pain, head ache, leg pain and arm pain, she was treated with AJIMSHAW’s Approach for one month. After the course he is totally pain free and energetic and doing well in her studies.
Case History- Cervical Spondylosis
A 48-year-old businessman was referred to our centre with a diagnosis of Cervical Spondylosis. He was having symptoms of radiating pain over both the arm, neck pain and head ache. He was given a 20 days program of AJIMSHAW’s Approach. Now he is spending a normal life without any discomfort on a 4 months follow up enquiry.

Case History- Carpal tunnel syndrome
A 55-year-old retired nurse/ house wife was suffering from tingling, numbness, pain along both the wrists. All studies (EMG, NCV) confirmed the diagnosis of Carpal tunnel syndrome. She received treatment for her neck, upper back, upper arm, fore arm and wrists. There were 18 sessions after that she didn’t have any tingling episodes and reported complete recovery.
Case History- Heel pain
A 28-year-old female (House Wife) visited SCeB CAPT® for her debilitating pain on right heel. She cannot walk properly, not able to use her feet for any force producing activities. The pain was particularly worse in the morning when she is getting up from the bed. She has undergone five days treatment at our centre. According to her 90% of her pain had vanished immediately after the first session. After two months enquiry she is doing well and the pain has never returned.
Case History- Shoulder Stiffness
A 70-year-old retired businessman, known diabetic and hypertensive, was referred to our centre for his left shoulder stiffness, severe pain particularly at night which is radiating to his upper arm too. He was given a 20 day program. After 10 days itself he had a very good relief and his shoulder activities returned back to 100%. A follow up after five months reported that he is having no complaint with his left arm.
Case History- Lower leg pain.
A 45-year-old government employee, was referred to our clinic with the complaints of pain in his both lower legs. Pain intensity is worse in the right than left. He cannot walk for long, cannot squat or cannot climb steps. He was given a 15 day program of AJIMSHAW’s Approach. Now all his discomfort had disappeared and is doing well.
Case History- Tennis Elbow
A 27-year-old computer professional was referred to our centre with a history of pain and weakness on his right elbow and hand. He was given a five day program. Now he is happy because he is not having any such complaints when using the mouse of the computer.
Case History- Head Ache
A 29-year-old university employee had visited our centre with a complaint of severe head ache for which she had tried almost all treatments. Her duties include prolonged sitting and computer use. We had given a course of AJIMSHAW’s Approach with Craniosacral Therapy and given some advices regarding how to use the daily activities correctly without harming the neck. Now she back to work with no such complaints afterwords.
Other conditions for which we are having successful track records are :-
Post Chickun gunia pain
Persistent body pain after severe accidents
Stroke rehabilitation
Spinal cord injury rehabilitation
Parkinsonism rehabilitation
Cerebral Palsy
Different types of arthritis
Knee Joint Pain and so on…….

1 comment:

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