Myofascial Release and Trigger Point Therapy at the Trauma Recovery Clinic
Myofascial Release (Muscle – Fascia – Release) is used for the release of fascia which has become stuck, hardened and dehydrated. Restricted fascia and soft tissues lead to often undiagnosed pain, exhaustion and immune system dysfunctions. Hardening of the fascia occurs in response to physical or emotional trauma.
MFR is necessary for recovery from all types of physical injuries and conditions such as sporting injuries, back and neck pain, whiplash, stress-related muscular tension and repetitive strain injuries. MFR is also used to release connective tissue adhesions which are involved in immune system dysfunctions such as Fibromyalgia, CFS, IBS and others. MFR is unparalleled in its ability to provide fundamental release from the pain and fatigue arising from physical adhesions often seen in:
• Chronic pain
• Neck and back pain
• Headaches and migraines
• Jaw problems, TMJ
• Whiplash and other trauma
• Frozen shoulder
• Sports injuries
• ‘Pulled muscles’ and muscle tears
• Scar tissue and other adhesions
• RSI, carpal tunnel syndrome
• Plantar fasciitis, heel spurs
• ‘Tendonitis’ and bursitis
• Undiagnosed or generalised pain
• Stress-related muscular tension
• Emotional stress and fatigue associated with physical trauma
• Myofascial Pain Syndrome
• Chronic Fatigue Syndrome
What is fascia?
Fascia is a tough membrane of varying thickness which envelops and separates everything in the body from whole muscle groups and bones down to each individual cell, providing protection and communication.
It is like a three-dimensional net, reaching right through the body, surrounding individual muscle fibres, tendons, ligaments, nerves, organs, lymph vessels, blood vessels and capillaries. Through the meninges and the dural tube fascia plays a crucial role in the central nervous system. Fascia has a tensile strength of around 2000lbs per square inch.
In the normal, hydrated, healthy state, fascia has the ability to stretch and move without restriction.
Because fascia is entirely continuous throughout the body, a restriction in one part will affect every other part.
Fascia and muscular pain
Each muscle fibre has a fascial binding, and so muscle and fascia are functionally linked. Injuries or imbalances in the muscular system will cause the fascia to tighten and dehydrate, and it is often restrictions in fascia which give rise to ‘muscle’ pain or ‘tendonitis’.
Fascia and other structures
Nerves and circulatory vessels all move through the body wrapped in fascial membranes. If fascia is stuck, it squeezes the structures it surrounds, inhibiting movement and circulation. If fascia is not moving freely the whole area will experience pressure, malnourishment and ultimately painful restriction in movement and at rest.
The Wider impact of fascial restrictions
Myofascial restrictions play a large part in pain syndromes. Fascia which is restricted can be extremely painful itself and cause surrounding fascia to harden protectively. Structures around restricted fascia cannot move without friction, compounding the problem.
Continuous overload of an area can then lead to compensatory restriction in other areas leading to total fascial restriction in which movement is almost impossible without extreme pain. This will not show up in any orthodox medical tests.
What happens when fascia gets ‘stuck’?
Fascia is composed mainly of collagen (40%) and lubricating ground substance. Both muscle with its fascial sheaths and ground substance are 70% water – fascia acts like a sponge. With physical and emotional trauma it dehydrates – water is pushed out – rendering it hard and gel-like, thus reducing the lubricant qualities of the ground substance between the collagen fibres and decreasing the distance between the fibres.
This leads to the collagen fibres shortening, thickening, and sticking together. This puts pressure on the adjacent structures. When this happens more collagen fibres are produced, to help take the strain, leading to more density of hard fascia in that area.
Fascia which is shortened and hard compresses capillaries and nerves, causing pain, imbalance and discomfort, and resulting in decreased cardiovascular flow which further compromises healing capability.
Myofascial Release brings about an increase of hydration of the ground substance, the collagen fibres and the whole of the fascial system. It increases the distance between the collagen fibres, and restores elasticity, allowing for further hydration and a decrease in compression around other structures.
The pain resulting from myofascial restriction is often described as deep, sharp, dull, burning, diffuse, heavy, or ‘like toothache’. Often it is difficult to pinpoint the exact location of the centre of pain and very often, if the cause is not treated and wider areas of fascia become affected, the pain can become generalized. Pain in the myofascial system is often referred pain, that is, the origin is in a seemingly unrelated, unaffected area. A myofascial practitioner will seek to treat the problem where it arises rather than where the symptoms emerge.
Myofascial Release techniques
Myofascial Release is the term referring to a collection of techniques for separating layers of fascia, releasing restrictions, restoring elasticity, conductivity and hydration. A Myofascial Release practitioner will use a variety of techniques including gross or ‘cross-hand’ stretches, focused stretches, skin rolling, ‘windmill’ or J-stretches, fascial glide, deep 3-dimensional stretches, following fascia layers in their direction of ease, pulls, focused rebounding, shaking or rocking, tender point treatment and trigger point release. Trigger point therapy is always accompanied by local fascial release, because if the fascia in the area of a trigger point has not been released, the trigger point is likely to return. Other muscle release techniques may well be used during the same session and tendons, ligaments, muscle tissue and fascia will all be treated where necessary, either concurrently or separately.
Trigger point therapy
Trigger points are areas of muscle fibres within a muscle, which the brain has decided need to be contracted – switched ‘on’ and shortened. They occur through accidents, falls, injuries, repetitive strain, overuse of muscles and poor posture. Trigger points cause a shortening of the muscle and refer pain to other areas of the body. ‘Active’ trigger points refer pain constantly, ‘latent’ trigger points can be triggered by seemingly innocuous movements or posture and become ‘active’. Active trigger points are often surrounded by other secondary trigger points which develop when the sufferer has tried to either strengthen or stretch the area to get rid of the pain or restriction. Attempts to strengthen or stretch will be unsuccessful until the trigger point, and the surrounding fascia, are released.
The pain that trigger points produce is similar to the pain of fascial restrictions – numbing, tingling, sharp, burning, deep, like toothache, dull, and other variations. Pain from trigger points can also move location from day to day or feel different from one day to the next.
At the Myofascial Release Clinic we will release the active (primary) trigger points which could be contributing to your pain, and also, most importantly, release the myofascial restrictions in the area. If the fascial restrictions and adhesions are not released, a trigger point in the muscle will return. We will also show you how to release trigger points yourself.
Craniosacral therapy is a type of Myofascial Release which focuses on the fascia through the central nervous system, releasing and balancing fascial sheets within the cranium, the meninges, and further down the spinal cord, the length of the dural tube. At the same time the craniosacral rhythm (the production and draining away of craniosacral fluid) is balanced and freed through gentle manipulation of the cranial bones. Although this is an extremely light touch technique, the therapist seldom applying more than 5g weight, corresponding roughly to a British 20p piece, all bony structures can be released and balanced this way.
Visceral manipulation is myofascial release around the viscera, the organs. With these exceedingly gentle techniques scar tissue and adhesions can be released, and organs given the space to move and function comfortably.
During myofascial release and craniosacral work the body often ‘unwinds’, going into spontaneous movement as the fascia and muscles release. The practitioner works with and is guided by this movement, supporting the body where needed and holding it when release is taking place. It is as if the body ‘needs’ to move in a particular way to unwind. If myofascial restriction was due to physical or emotional trauma or repetitive strain, the body tends to readopt the position it was in when the event(s) occurred, allowing tensions to be identified so that they can be cleared. Myofascial unwinding may be accompanied by emotions or memories.
Mind-body approaches to trauma
Specific approaches to help the mind-body heal from the effects of trauma. After traumatic events or low level prolonged duration stress the mind-body can respond with physiological changes including hypervigilance – being on ‘red alert’ all the time, panic attacks, palpitations, disturbed sleep, fatigue, and so on. We use a variety of approaches to allow the autonomic nervous system to re-regulate itself, let go of stress responses safely, find a new and healthy ‘normal’ setting and learn how to cope with current and future stress in a healthy way.
Reestablishing muscular balance through Pilates
Myofascial restrictions can lead to muscle imbalances as individual muscles and whole muscle groups are prevented from functioning fully because of myofascial pain, resulting in some becoming short and tight and others long and tight or atrophied. Weakness will occur in any case. It is therefore important to reestablish muscle balance when myofascial release has taken place. A specifically devised Pilates exercise programme, focusing on maintaining biomechanical balance and myofascial release, will reeducate the brain in correct muscle recruitment for each movement or postural hold. We show individual home stretches and can advise as to preferred Pilates teachers in Edinburgh and London.