Myofascial Release
Myofascial Release
Just what is myofascial release and what does it do?
I’ve read of how others generally define myofascial release, such as: Myofascial release is an alternative medicine therapy that claims to treat skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation, and stimulating the stretch reflex in muscles. Of course there’s this one too: Myofascial release is a type of physical therapy often used to treat myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder caused by sensitivity and tightness in your myofascial tissues. These tissues surround and support the muscles throughout your body. The pain usually originates from specific points within your myofascial tissues called “trigger points.” Or this one, Myofascial release focuses on reducing pain by easing the tension and tightness in the trigger points. It’s not always easy to understand what trigger point is responsible for the pain. Localizing pain to a specific trigger point is very difficult. For that reason, myofascial release is often used over a broad area of muscle and tissue rather than at single points.
None of the above actually tell you what myofascial is, or what it does.
First thing to know; Myofascial Release is just as generic a term as is massage. Many forms of myofascial release, many philosophies about what it is and they’re all accurate. However, we’ll start at the beginning with helping you understand what it is. Just as fascia runs through the body in different depths, there are many forms of myofascial release that have been touted as the ‘best’, yet, most only work on superficial connections. This can make us feel good for a little while but require ongoing work.
Myofascial Pain Syndrome / Compressed Joints
Myofascial pain syndrome; the best description I know of is this. You’ve complained of being in pain since…. Pick a date or event… you tell your doctor. You wind up with an MRI and the doctor tells you everything is fine. Fascia is stuck. Its wanting attention, and that’s where I come in.
What Fascia Does
What this fascia does is act as the ‘lubricant’ that allows organs and other muscles to move without sticking to each other. It’s a connective tissue, which has a beginning and ending with room to move in between. This tissue is around each muscle fiber, around each muscle, around each muscle bundle (IE the quads, the ham strings) it runs in layers through the body in a pattern connecting your body together to allow you to have physical definition and function. This connective tissue is what gives your human form definition. It holds skin to the body, it locks muscles when they’ve been injured, it gets stuck when you frown too often… hence the mouth and eye lines.
How does Fascia get stuck?
Fascia may become adhered when there is scarring from an injury or surgery and when you are dehydrated the fascia starts to shrink up causing muscles to have limited mobility, limited motility and pain.
What causes lower back pain?
In many cases, low back pain is associated with spondylosis, a general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
Most of the low back pain is mechanical in nature. Some examples of mechanical causes of low back pain include:
- Sprains and strains account for most acute back pain. Sprains are caused by overstretching or tearing ligaments, and strains are tears in tendon or muscle. Both can occur from twisting or lifting something improperly, lifting something too heavy, or overstretching. Such movements may also trigger spasms in back muscles, which can also be painful.
- Intervertebral disc degeneration is one of the most common mechanical causes of low back pain, and it occurs when the usually rubbery discs lose integrity as a normal process of aging. In a healthy back, intervertebral discs provide height and allow bending, flexion, and torsion of the lower back. As the discs deteriorate, they lose their cushioning ability.
- Herniated or ruptured discs can occur when the intervertebral discs become compressed and bulge outward (herniation) or rupture, causing low back pain.
- Radiculopathy is a condition caused by compression, inflammation and/or injury to a spinal nerve root. Pressure on the nerve root results in pain, numbness, or a tingling sensation that travels or radiates to other areas of the body that are served by that nerve. Radiculopathy may occur when spinal stenosis or a herniated or ruptured disc compresses the nerve root.
- Sciatica is a form of radiculopathy caused by compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and the adjacent bone, the symptoms may involve not only pain, but numbness and muscle weakness in the leg because of interrupted nerve signaling. The condition may also be caused by a tumor or cyst that presses on the sciatic nerve or its roots.
- Spondylolisthesis is a condition in which a vertebra of the lower spine slips out of place, pinching the nerves exiting the spinal column.
- A traumatic injury, such as from playing sports, car accidents, or a fall can injure tendons, ligaments or muscle resulting in low back pain. Traumatic injury may also cause the spine to become overly compressed, which in turn can cause an intervertebral disc to rupture or herniate, exerting pressure on any of the nerves rooted to the spinal cord. When spinal nerves become compressed and irritated, back pain and sciatica may result.
- Spinal stenosis is a narrowing of the spinal column that puts pressure on the spinal cord and nerves that can cause pain or numbness with walking and over time leads to leg weakness and sensory loss.
- Skeletal irregularities include scoliosis, a curvature of the spine that does not usually cause pain until middle age; lordosis, an abnormally accentuated arch in the lower back; and other congenital anomalies of the spine.
Other underlying conditions that predispose people to low back pain include:
- Inflammatory diseases of the joints such as arthritis, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae, can also cause low back pain. Spondylitis is also called spondyloarthritis or spondyloarthropathy.
- Osteoporosis is a metabolic bone disease marked by a progressive decrease in bone density and strength, which can lead to painful fractures of the vertebrae.
- Endometriosis is the buildup of uterine tissue in places outside the uterus.
- Fibromyalgia, a chronic pain syndrome involving widespread muscle pain and fatigue.
I must add, that the most common reason I find for low back pains in my clients are stuck psoas muscles. These are the core muscles that support the low back, attaching from mid thoracic/lumbar junction (T12) and connecting at the lesser trochanter of the hip. Often, when lifting a person tries to turn at the same time; this causes the psoas muscles to grip and hold on and refuse to let go. This compresses the lumbar region of the spine. Symptoms include not being able to stand up straight, not be comfortable lying down, walking up stairs or up hills, trying to stand from a seated position, shoulders being pulled forward, taking a deep breath may be difficult, urinating can be difficult. So many other things as well!
Shoulder Pain
The thing with shoulders is to be precise in detailing the pain. What it feels like, where you feel it, and does it occur with specific motions. This helps isolate the muscles that are at work causing this pain. There are a lot of muscles involved in the shoulder, rotator cuff, upper arm, upper back, neck ALL of which is considered part of the shoulder! I may want to start at your hip, bringing tissue up to your shoulder. Your upper back, rhomboids, scapula, levators, scalenes etc.… your deltoid, biceps, triceps and so many other muscles are a part of what makes the shoulder move that we must work each of these starting with the most superficial working to the deeper. There may be some inflammation which normally resolves in a day. You can toss a ball again, play frisbee, raise your hand, put on your shirt, roll over in bed without having to use your other hand to move your arm out of your way and so much more!
Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
Who is at risk for rotator cuff injuries?
Rotator cuff injuries can be acute or degenerative.
Acute injuries usually occur from one incident. These can be caused by lifting objects that are too heavy, falling, or having the shoulder forced into an awkward position. Young people are more likely to experience this type of rotator cuff injury.
Degenerative injuries are due to long-term overuse. People most at risk for these injuries include:
- athletes, particularly tennis players, baseball players, rowers, and wrestlers
- people with jobs that require repetitive lifting, such as painters and carpenters
- people above 40 years of age
The rotator cuff is a group of four muscles and tendons that help stabilize the shoulder. They also aid in movement. Every time you move your shoulder, you are using your rotator cuff to stabilize and help move the joint.
The rotator cuff is a commonly injured area. The most common injuries are strains, tendinitis, and bursitis.
What causes a rotator cuff injury?
Rotator cuff injuries can range from mild to severe. They tend to fall into one of three categories.
Tendinitis is an injury caused by overuse of the rotator cuff. This causes it to become inflamed. Tennis players, who use an overhead serve and painters who reach upward to do their jobs commonly experience this injury.
Bursitis is another common rotator cuff injury. It’s caused by inflammation of the bursa. These are fluid-filled sacs that sit between the rotator cuff tendons and the underlying bone.
Rotator cuff strains or tears are caused by overuse or acute injury. The tendons that connect muscles to bones can overstretch (strain) or tear, partially or completely. The rotator cuff can also strain or tear after a fall, a car accident, or another sudden injury. These injuries typically cause intense and immediate pain.
What are the symptoms of rotator cuff injury?
Not all rotator cuff injuries cause pain. Some are the result of degenerative conditions, meaning the rotator cuff could be damaged for months or years before symptoms start to appear.
Common rotator cuff injury symptoms include:
- avoiding certain activities because they cause pain
- difficulty achieving full range of shoulder motion
- difficulty sleeping on the affected shoulder
- pain or tenderness when reaching overhead
- pain in the shoulder, especially at night
- progressive weakness of the shoulder
- trouble reaching behind the back
Bursitis? Pain on the side of your hip is more likely from tendinitis, tight muscles, or another condition.
Much like the shoulders, LOTS of muscles are at work to create the hip joint stabilization you require. There are the gluteal muscles,
the rotators, the inguinal attachment, the psoas family, and the lower abdominal muscles, iliotibial band and the adductors. The thigh may be wound more circular and need to be unwound. Your thoracic region may be compressed, pulling at your hip/thigh muscles. The femur may be compressed into the pelvis. This tends to happen when falling on one’s knees; the femur gets jammed up into the pelvis making walking very difficult. Again, going through the layers we get in deep and make space in that joint. This is where we frequently must release the psoas groups.
Hip bursitis — an inflammation between your thighbone and nearby tendons — is commonly diagnosed when patients have pain on the outer side of the hip. However, several other conditions can cause similar pain, and require different treatments. “Doctors often assume that pain on the outer side of the hip is due to bursitis. But 90% of the time, it’s not bursitis,” says Dr. Lauren Elson, a physiatrist with Harvard-affiliated Massachusetts General Hospital.
What’s causing the pain?
Tendinitis. This is an inflammation of the tendons (fibrous bands of tissue) that connect the gluteal muscles in your buttocks to the hip bone.
Overuse injury. When you walk or run, weak hip and buttock muscles can tighten and irritate the iliotibial (IT) band — a long band of connective tissue that runs from the knee to the hip. It merges with the gluteal muscles to stabilize the leg.
Tight muscles in the buttocks and hip. If the gluteal muscles and IT band are too tight, they pull at the thighbone where they attach, and that causes pain on the side.
Spine problems. The body isn’t always smart in recognizing where the pain is coming from, and spine arthritis, a pinched nerve, or bones in the spine rubbing together can create pain in the side of your hip.
My Knees hurt – Dealing with Knee Pain
Knees are much like the hinge on your gate or door at home. They are designed to move in one direction and they do it wonderfully when not damaged. The abductors and adductors attach below the knee to help with stability. This can cause the knee to lose space, to be ‘jammed’ and to hurt when attempting to walk. The lower muscles of the leg can be at play and weight is also a consideration. Do you walk often, do you exercise, are you at a computer all day? Here again, we look at the psoas family, the ankles, the hip muscles. We can unwind, we can lengthen and strengthen the muscles of this joint. We can make room for your knees to work painlessly so that you can stretch and exercise.
Could It Be Your Back Causing Your Knee Pain?
An important thing to understand is that what hurts is not necessarily the problem, but a symptom of the problem. For knees, the first thing to consider if knee pain isn’t the result of traumatic injury is, are issues in your back causing your knee pain?
How Are the Knee and the Back Connected?
Your back houses the nerves that drive the muscles around the knees. Hence, a problem with a nerve in your back can impact how those muscles work. Low-level nerve irritation usually isn’t noticed by patients as back or leg pain. It just causes the muscles to misfire, destroying the otherwise needed protection for the knee joint.
Knee Pain Accompanied by Back Pain
If you have acute or chronic knee pain, mentally scan for other pains or discomforts that accompany in your body. The pains may seem completely unrelated, consider them anyway. Back pain can be related to knee pain simply based on the phenomenon of referred pain. The nerves to the lower extremities branch directly off the lower spine. It’s easy to see how a pinched nerve, perhaps due to a bulging lumbar disc in the lower back, could direct pain down that nerve branch and into the knee especially if you sit a lot and don’t get up to move around or walk. If you sit a lot, and you have both back and knee pain, it’s possible the knee pain is due to your back. You might not even consider your back discomfort to be pain. It may just be a little tense or tight. It could be very mild, but don’t discount it. Before deciding on a major knee surgery, your surgeon and you owe it to yourself to have even the mildest back discomfort investigated to determine if it’s your back causing your knee pain. This is where myofascial dysfunction is often seen.
Tightness in the Hamstrings
When the hamstrings become tight, painful, or inflamed, this will impact how the knee joint works. Have you ever seen people in the gym every day using a foam roller to massage and relax their hamstrings? These people can never seem to get permanently rid of the tightness. If this is you, there’s a reason this is happening, and it’s not good for your knees. The L5 nerve travels from the lumbar spine and down the outside hamstring muscle to power the biceps femoris. Hamstring pain or tightness that won’t go away despite repeated stretching is one of the first signs in the lower extremity that there could be a nerve issue in your back causing knee pain. Not only is the knee affected directly by the nerve but also by the adjustments you might make in how you move to compensate for the stressed hamstring. After a few weeks of hamstring tightness, the meniscus will begin to suffer, and your body will attempt to repair it by mobilizing the stem cells in your knee and other inflammatory cells in the body. Since the trauma will be constant and ongoing, the cells’ efforts will be futile, and the swelling will live there until the root cause is addressed.
Bunion Formation
When there is a problem in the back, this can cause the stabilizing muscles of the foot to weaken and lead to bunions. You might wonder what in the world bunions have to do with your back; however, bunions can be a direct result of back issues, and where there are bunions and back issues, there is probably knee pain. The L5 spinal nerve goes to the muscles that help support the inside of the foot, while the S1 nerve goes to muscles that support the outside of the foot. When the nerve is stressed or injured, the muscles that support the outside of the foot as you walk, run, or stand won’t be able to do their job. This will cause the foot to pronate, forcing a misalignment in the main tendon and leading to an unnatural tilting of the big toe joint. This tilting of the toe joint creates pressure in the joint, where bunions, or bone spurs, can form. When you develop a bunion, it’s important to find its source. There’s a good chance your back is the culprit. It won’t do you any good to just treat your knee pain with a knee stem cell injection if it’s an issue in your back causing your knee pain. It may provide some slight temporary relief, but it won’t fix your problem.
I have a stiff Neck or Neck Pain and I get headaches
Your neck consists of so many muscles! Relaxing the neck is easy, releasing the fascia takes more work. Often, we start at the rib cage / diaphragm, working our way up the sternum, clavicles and cervical spine. 7 vertebras all with tiny muscles and ligaments in addition to the big muscles requiring individual attention. We can eliminate headaches, neck strain, and give you the ability to turn your head to look over your shoulder when you’re driving!
I feel like I’m getting a hunched back
When muscles pull your shoulders, ribs and head forward it does mean your abdominal and low back muscles are challenged. They can be released, your diaphragm can be released and relaxed, your rib cage lifted which brings back your shoulders and head to assist in eliminating the feeling of being a hunchback.
I think I have arthritis
Another thing, people tell me is that they think it’s “their’ arthritis causing the pain, because a doctor told them they had arthritis. No tests were run to prove it, the doctor just made a statement. IF you DON’T have Rheumatoid Arthritis or Osteo Arthritis STOP TELLING YOURSELF YOU DO!!! You have compressed joints! Let’s decompress them! Let’s change how you think about your health to help you be healthier!
What to expect from a first session with Zach
You’re apprehensive, uncertain of what to expect. You’ve heard horror stories from people from experiences they’ve had receiving treatments from various people. First, you’re going to fill out a simple intake form with some standard information on it. Then we’re going to talk about what’s happening for you, how you think it began, how your day to day life is being affected and what goals you want to get from our session. Then we’re going to have you in the minimal amount of clothing you are comfortable in, so I can look at your structure, your walk, your movement and look at what your body is telling me about what’s happening for you. I’m going to mark up a graph on an intake sheet and show you what I’m looking at. I’ll show you in the mirror too, if you want to look. I’ll discuss with you what I would like to do so you get to be informed. You and I agree on a course of action and we get busy. Yes, it’s true I play rock n roll music when I’m working on folks.
How to plan out follow up visits.
I seldom tell people they must see me, or that they must see me X number of times over the next X amount of time. When I do its usually because there is so much to accomplish that we’re better off maintaining a schedule until you are where you want to be health wise! This means, you take my card and when you’re ready for a follow up session, you either phone me, text me or phone the office. Visits for follow ups are 15 minutes, 30 minutes or one hour. You tell me what you’ll want based on what appointment you make.
Whether it’s your elbow, wrists, fingers/thumbs/toes, feet, ankles, knees, hips, low back, mid back, upper back, forearms, upper arms, shoulders, neck, head; we can make space, we can eliminate pain, we can make movement easier and we can give you the life you’ve wanted to lead!
Some people come in for work because they just plain old like this form of body work over regular massages. It helps them relax as well as feel energized.
I have the belief that you have the right to have more knowledge of how to heal yourself and require minimal visits for bodywork.
My goal is this: I want to see you as seldom as possible over this next 25 years (I’ll retire then). I want at least a 60% improvement from our first session with the goal being:
- A) Decreased pain to no pain
- B) Improved range of motion
- C) Improved feeling of balance and comfort in your body.
Whether the problem is shoulder, back, neck, hip, feet or anything between your skull and your toes We can probably resolve it or get you on the road to much improved health, movement, strength, range of motion etc.
FAQs Myofasical Release
What is myofascial release?
It’s using the hands, forearms, elbows to lengthen shortened fascia, to shorten sprained ligaments, to unwind wound up muscles and tissues, to create space where you are compressed, to balance your pelvis, to lift your ribcage, to release the adhesions in your neck and upper shoulders, in your feet and everything in between. It’s a manual manipulation using the hands which can sense tissue changes, adhesions, hot spots. It’s using body weight and height to lean into the tissue in the direction you want it to move into. Its opening the limitations you have that are causing you pain and other frustrations.
When I work with client’s we get to discuss life; past and present as well as future. Discussion is great because there again, you’re releasing beliefs about the pain or the restrictions you’ve been experiencing. The spoken word is very powerful. You speak of what you are thinking as we work in a specific area and believe it or not, you’re letting out limitation and restrictions you possibly hadn’t realized even existed! This helps the fascia release, helps you heal, helps you feel much improved and much more positive.
Myofascial release is a generic term for a few different types of massage and muscle manipulation available. It covers a plethora of options and ‘massage’ forms available. Myo-fascia means muscle-tissue, it is the connective tissue that surrounds each muscle fiber in a muscle. Another layer surrounds the muscle. Another layer surrounds the muscle bundle and it surrounds your organs. It is the tissue that allows your body to move freely and painlessly when it is hydrated and healthy. To release fascia depends on the individual and their needs. Using fingers, hands, forearms, elbows we are able to be specific about a layer or area where fascia needs to be separated from that which it is stuck to. Sometimes its fascia to fascia, sometimes its fascia to bone. Some is point specific using finger tips, some is more of a shield using the palm of the hand. The depth required depends on how deep the fascia is stuck in your body, however, one should always work superficially first, working through the layers so as not to miss the layer where it is stuck. Fascia might be stuck due to an injury or a surgery, scarring or, from an emotional trauma. Myofascia work can be used anyplace on the body.
Does myofascial work hurt?
When you’re in pain, there may be pain removing that pain. The thing is, it’s releasing the pain you’ve been in, it’s not causing additional pain. Within a couple of minutes, no more pain and you’re in shock wondering what happened. Fascial release happened. Set it free, set free the issues that live in the tissue!
Why do I cry or feel so emotional when I hurt?
Pain can be attached to emotions. When there is sustained pain in your body there is usually an emotional attachment or reasoning for that pain. It’s serving some purpose in your life whether it’s to keep you from doing something you claim you want to do but are afraid to do, or to get others to stop expecting more from you. It’s your excuse, it’s your out… and when you’re finally ready to stop doing those things and really want to get on with your life, I take those obstacles away through fascial manipulation myofascial work.
Will myofascial work bruise me?
Side effects; bruising may occur. Normally it means we’ve gone deeper than the body was prepared to allow, sometimes it means you had a lot of adhesion there. Consider that dehydration, lack of appropriate supplementation or nutrition all play roles in how well you recover. My experience has been that no one’s ever stayed bruised long or regretted bruising. Increase water consumption. Water is the secret weapon of being healthy. The quality and quantity of water you ingest is vital in your brain function, eye sight, how your teeth are, your blood pressure, pulse, muscle use, mobility, generic aches and pain. Drink your water! The rule is simple, take ½ your body weight in ounces of water each day. For example, if you weigh 150 lbs., drink 75 ounces of water daily. If you are sweating a lot, drink more! Filtered, healthy water. Add electrolytes, lemon or lime juice, cucumber, mint, lemonade (splash)…. But drink the water!
What is the difference between deep tissue massage and myofascial release?
Massage is to move fluids whether that is lymph or blood. Massage done properly, only goes in one direction focusing on not only moving fluid but relaxing tense muscles on the entire body. You may use a cross fiber / friction movement on point specific areas. Myofascial release can be to lengthen the muscles, to release the connective tissue, to open joints and make room where they are compressed. Other times, it is used to shorten muscles, tendons, ligaments to assist in getting through a sprain faster etc. It is not the whole body in one session as is a massage.
What do you wear to myofascial release?
My clients wear the least amount of clothing they are comfortable in as we need to assess their structure, posture and movement limitations in order to truly know where to make the releases.
Is foam rolling myofascial release?
Not really, however it can release superficial layers.
Have you ever thought about how our organs are able to stay in place, exactly where they need to be? There is a stretchy webbing, or connective tissue, inside of our bodies called fascia that runs from head to toe around our organs and our muscles. We are learning more and more about this tissue, the role it plays in our health, and how to keep it healthy so you can feel your best.
In this episode, we dive into:
- Dr. Bhat’s background and education (4:18)
- What is fascia? (12:16)
- Discovering fascia is an organ with an important function (18:41)
- Addressing nutrition to keep fascia healthy (20:30)
- Fascia and digestion (27:32)
- Does your fascia affect your brain health? (30:38)
- How has technology impacted our fascia? (35:12)
- Sitting properly in a chair and desk work (42:00)
- Fascial release at home (46:46)
- Finding root causes to help fascia (49:30)
- Emotions stored in the body (54:33)
- Where to find Dr. Bhat online (1:01:13)
