Some of my prior blogs have discussed the use of Foam Rollers and more recently, the use of Trigger Point Performance tools, for Self Myofascial Release (SMR)
Self myofascial release techniques have become increasingly popular among athletes and fitness enthusiasts.
Therapists from many disciplines have embraced the use of myofascial release massage to reduce chronic pain and rehabilitate a range of injuries.
Myofascial Release (MFR) Performed by a Therapist
There are two key terms one should understand in order to appreciate how myofascial release works. These are fascia and trigger points.
Fascia is a specialized connective tissue that surrounding muscles, bones and joints and provides support and protection to the body. It consists of three layers – the superficial fascia, the deep fascia and the subserous fascia. Fascia is one of the 3 types of dense connective tissue (the others being ligaments and tendons) and it extends without interruption from the top of the head to the tip of the toes.
Fascia is usually seen as having a passive role in the body, transmitting mechanical tension, which is generated by muscle activity or external forces. There is some evidence suggesting that fascia may be able to actively contract in a smooth muscle-like manner and consequently influence muscles, nerves and the circulatory system.
Some research has shown that changes in the tone or structure of the fascia could have significant implications for athletic movements and performance. In addition, the occurrence of trigger points within fascia is thought to be correlated with increased risk of injury.
Trigger points are areas of muscle that are painful to palpation and are characterized by the presence of taut bands. Myofascial (muscle and fascia) tissue can become thick, tough and knotted.
Trigger Points can occur in muscle, the muscle-tendon junction and the bursa. Sometimes, trigger points can be accompanied by inflammation and if they remain long enough, they can replace healthy fascia with inelastic scar tissue.
Trigger points can alter the length and tension in muscles and ligaments and can result in weakness and imbalances.
Because trigger points in the fascia can restrict or alter the motion about a joint, it can lead to changes in the normal neural feedback to the central nervous system. Eventually, the neuromuscular system becomes less efficient, leading to premature fatigue, chronic pain and injury and less efficient motor skill performance.
What causes a trigger points?
Trigger Points can be caused by acute physical trauma, poor posture or movement mechanics, over training, inadequate rest between training sessions as well as nutritional factors.
Myofascial Release Treatments
In order to be effective, treatment needs to start with an accurate assessment.
An assessment includes:
- General movement screen
- Range of motion
- Muscle testing
Once the dysfunction is identified, MFR treatments should address both the fascia and muscles.
Treating the fascia
Direct myofascial release (or deep tissue work) is performed by engaging the myofascial tissue restrictive barrier, and then loading the tissue with a constant force until a release occurs.
Therapists use knuckles, elbows, or other tools to slowly stretch the restricted fascia by applying a few kilograms of force.
Direct myofascial release seeks for changes in the myofascial structures by stretching, elongation of fascia, or mobilising adhesive tissues.
The practitioner moves slowly through the layers of the fascia until the deep tissues are reached.
Trigger Point Release
Treating trigger points can be done through a variety of techniques. Some of the most effective include:
- Direct compression followed by stretching
- Pin and stretch
- Dry needling/acupuncture
Trigger point release has been theorized to work by normalizing the electrical potential of muscles and resetting the receptors responsible for maintaining muscle length and tension.
Addressing nutritional factors and prescribing corrective exercises are also essential for long term pain reduction/elimination and/or enhanced performance for athletes.