More on Myofascial Release...

How MFR is Different from Traditional PT

Unlike traditional physical therapy, the myofascial approach does not emphasize strengthening the body.  MFR sees most pain syndromes, postural abnormalities, and restricted motion as a result of tightness, not weakness.  Additionally, at Quantum Therapy, PC, we do more than pay lip service to the term holistic.  The interconnectedness of fascia throughout the body is truly appreciated.  Shoulder pain could just be shoulder pain, but it could also stem from fascial restrictions elsewhere in the body that are affecting the joint mechanics of the shoulder.  Because the human body is so good at compensating, finding the root of the problem is not always as straightforward as it seems. 

 

A microscopic view of fascia 

 

Description of the fascial system

In order to understand the theory of the MFR approach and how it works, we need to become familiar with the fascial system. Only then can we fully appreciate the role of fascia in the healing process.  Simply put, fascia is connective tissue.  It is a three-dimensional, continuous web that surrounds and envelops all parts of the body. It provides stability and support while allowing for gliding and flexibility with movement. Fascia suspends organs, gives muscles shape, provides protective sheaths for nerves and blood vessels, and encases the brain and spinal cord in fluid.  Furthermore, it permeates throughout these structures down to the cellular level. The very walls of our cells are actually composed of fascia. Since fascia is a continuous structure, this means that every cell is connected to every other cell from head to toe!

For further clarification, it can be helpful to think of the fascial system as a tensegrity model.  Tensegrity (tension+integrity) refers to a structural principle of achitecture that describes a system made up of rigid, compressed struts and pretensioned cables.  The tension of the system is balanced in such a way that it provides optimal stability and strength under even high loads of stress.  However, it can fail if the tension equilibrium in the cables change or if a strut breaks. We can apply this model to the body (biotensegrity) where the cables are myofascia and the struts are bones. Our musculoskeletal system is in good equilibrium unless there is a change in the tension of our myofascia (or a bone breaks!).  The myofascial system is good at compensating for small changes over time, but eventually the balance is toppled and symptoms result.

A lot is still being discovered about the importance and role of fascia.  Some theorize that this complex web has a more critical role in communication between cells and storage of information.  As early as 1900, Dr. Andrew Still, a doctor of Osteopathy called fascia the "Container of the Mind"!

 

Tensegrity at work---tensioned cables are responsible for the stability and strength of this structure.

 

Origin of Fascial Restrictions

Things most people experience throughout life can cause fascial restrictions.  These include things like falls, car accidents, surgeries, childbirth, chronic infections and prolonged postures. Chronic stress, tension, and emotional trauma can also lead to physical tissue restrictions or bracing patterns in the body. Even though we may appear to heal from individual incidents, underlying fascial tightness or restriction can accumulate over time. These restrictions build up and overlap in a unique, individual pattern depending on our life experiences. Symptoms may appear seemingly out of nowhere that have origins in past injuries.

Superficial fascia of the forearm

 

How fascial restrictions result in symptoms

Fascia in its normal, healthy state is mobile and flexible while restricted fascia is dehydrated, stiff, and shortened.  Because fascia is contiguous with every part of our body, restrictions can have various and far-reaching effects.  The most obvious and common symptom is pain, due to compression on various pain sensitive structures in our body.  Other symptoms may accompany pain, depending on the specific structures involved.  For example, numbness and tingling may occur with involvement of nerves. Restricted range of motion, decreased flexibility, and postural changes occur with restrictions pulling on muscles and bones. Circulation of blood or lymph can be compromised if these vessels are compressed. Headaches/migraines can occur when there is tension in the fascia that surrounds the brain and spinal cord (the dural tube or meninges). Fascial restrictions can also affect the functioning of organs.  For example, restrictions or adhesions around the bladder can affect proper expansion/contraction properties leading to incontinence, frequency, etc.

Schematic diagram of fascia connecting skin to underlying muscle fiber.  Note the darker lines representing vessels and nerves running through. Healthy fascia allows for sliding and gliding between layers of tissue.

 

What MFR can treat

Diagnoses are simply labels for clusters of symptoms. They are a convenient way for the medical community to categorize disease and dysfunction. Treatment can then be prescribed based on what is believed to be the cause of that disease or disfunction. However, the role of the fascial system in evaluating the cause of symptoms is commonly minimized or missed entirely.  Why?  The importance of the fascial system is not taught in the traditional medical model.  Also, today’s diagnostic machines, such as MRI, X-RAY, and CT do not detect fascial problems.  This is important to consider if you are someone who has been told ‘nothing’ is wrong with you.  So, regardless of your diagnosis (or lack thereof!) MFR treatment may be the missing link in your recovery.

Web-like fascial strands stretched between muscle fibers

 

 

Pelvic dysfunction and MFR

People are often surprised to hear that "Women's Health" problems such as incontinence and various pelvic pain syndromes can be helped with MFR.  The pelvic bowl is composed of fascia, muscle, bone, nerves, etc, just like any other part of our body.  Internal (vaginal and rectal) myofascial techniques are a critical part of treatment for pelvic problems.  Vaginal or vulvar pain, coccyx pain, painful intercourse, and painful periods are a few examples of things that can be helped.  They are rarely discussed, undertreated, and yet surprisingly common. And while these problems are more common in women, men with pelvic pain can also be helped. 

These internal pelvic techniques can also be extremely helpful in treating other diagnoses and pain syndromes such as hip or low back pain, even headaches and jaw pain. As mentioned above, symptoms are often related to distant restrictions in seemingly unrelated areas of the body! 

 

Artistic rendition of muscles, tendons and fascia of the female pelvic bowl

 

 

A note on scars...

A surgical scar is the most obvious form of a fascial restriction.  Whether it is a longer incision, or laparoscopic holes, scars are the visible indicator of what lies beneath.  Not all scars are problematic, but if a scar is tender to deep touch, it is a sign that there could be adhesions to other tissues and structures beneath the skin.  By patiently holding deep pressure at or near the incision site, the fascia can release, lengthen and become more mobile.  I have witnessed dramatic improvement in range of motion and pain with release of even very old scars.  Some examples include: mastectomy/lumpectomy, breast reduction, c-section, appendectomy, episiotomy, and orthopedic scars.
 

             Pelvic adhesions surrounding the uterus

Quantum Therapy, PC

7929 SW 37th Avenue, Suite E

Portland, OR 97219

503-602-9197