Tuesday, June 1, 2010

What's self myofascial release?

A few posts ago I discussed the merits of trigger point massage therapy.  If a trip to the massage therapist isn't possible, here's another option: self myofascial release technique (SMRT).  It sounds technical, but it isn't all that difficult to practice.  We've been using foam rollers for SMRT in our group exercise class.  Unfortunately, we haven't really had a chance to discuss the mechanics and benefits of this technique. So, why is SMRT helpful? The key is our body's fascia.

Just what is fascia? It's a thin sheath of tough connective tissue. It spreads throughout the body without interruption, from head to toe, in what I think of as a web. Fascia covers and separates different layers of tissue. It also encloses muscles. When an imbalance occurs in the fascia, pain usually results.

Remember the discussion of trigger point massage a few posts ago? It mentions how often times the pain we feel in one location isn't always at the actual site of injury. This is called referred pain. It's important to trace our pain to its source, or trigger point, in order to treat the cause of the pain and not just the symptom.
Dr. Michael Leahy's diagram  is a great illustration of what happens when we develop a trigger point. He calls the process the Cumulative Injury Cycle. I like that he begins the cycle with the term overwork. This word can describe injuries, repetitive motion or prolonged inactivity. It might seem contrary to use the word "overwork" to describe  prolonged inactivity.  However, if you think about sitting at a computer in one position for hours at a time it's easy to see how this could be a type of overwork for our muscles.

Let's take a closer look at overwork in the form of a soft tissue injury like a sprain or strain. Treatment at the acute phase of injury is usually with the RICE (rest, ice, compression, elevation) prescription. Then we'll typically follow this up with strengthening and stretching rehabilitation exercises. In a perfect situation the injury will heal and not cause us any chronic issues. Unfortunately, this is not the norm. 

Sometimes muscle imbalances can result from the injury. These imbalances are compounded by unequal tension in the body's fascia. Internal swelling occurs, blood flow is restricted to the area and scar tissue, or adhesions, form. Adhesions are also referred to as trigger points.  These result when localized areas of muscle and fascia bind together. Adhesions can change a muscle's ability to contract or lengthen. Pain can result.

What about Dr. Leahy's Cumulative Injury Cycle as it relates to other overwork, like repetitive motions or inactivity? These also can cause chronic muscle strain, imbalance and adhesions. Regardless of the cause, in order to break up these adhesions some form of deep tissue or trigger point massage is helpful. This is where you and the foam roller come in.

Basically here's what you do:
  • use your body weight to provide direct pressure to an area of concern, while rolling back and forth on the muscle/fascia. 
  • Once you find the trigger point, which is typically the area of greatest discomfort, you hold the pressure on that spot for 30-90 seconds or until you feel the discomfort subside. 
  • You need to work within your pain tolerance by applying less or more of your body weight on the roller and holding for more or less time. Focusing the pressure on this trigger point will help to break up adhesions. This will allow the muscle to return to its normal ability to contract or lengthen. The end result is less or no pain. It's not a magic bullet, but it helps.

In my next post I'll talk about the mechanics of SMRT and will post some illustrations of a few of the positions. I'll also include suggestions for rollers and other tools to use for your SMRT.

Happy rolling.

Complimentary Therapies in Rehabilitation, Carol M. Davies
The Myofascial Release Manual, Carol Manheim

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