MYO My! What is that?
When patients come to the practice for massage, they present with lots of different issues, with really varied underlying causes. So, I need to use a range of different techniques to get to the root of their individual problems. One of the most effective methods that I use is the little understood technique of Myofascial Release. But what is it, exactly?
Well, myofascia is the network of webbing in your body that holds, stabilises and connects muscles, bones, organs, skin and blood vessels. Imagine it as a pliable, protective body suit that covers you from head to toe.
The myofascial tissue is made up of water, collagen for flexibility and strength, hyaluronic acid for lubrication and elastin for elasticity.
There are 3 types of fascia
Superficial fascia lies under the skin and connects to the rest of the body, bones, muscle and organs. It is the common layer affected when you accidentally cut yourself or have lacerations. This layer helps maintain a constant body temperature.
Deep fascia is a more dense and stronger layer that helps support and protect muscles, holds our bones in place and covers tendons, ligaments and blood vessels that run throughout the body. This layer acts like a guard, protecting it from injury and from bacteria getting through the skin, to prevent infection from spreading to the muscles. If you strain or tear a ligament this is the layer you will feel it in as it’s full of nerve and pain sensors which send the signals back to the brain.
Visceral fascia is even deeper than the first two layers mentioned above. This fascia surrounds our internal organs to protect and hold them in place, alongside the nerves and blood vessels that keep them functioning. It keeps our heart beating, lungs inflating and deflating and the digestive system moving to remove waste and toxins from the body.
Myofascial Dysfunction
The fascia can become dysfunctional through bad posture, accidents, injury, repetitive movements and emotional or physical traumas.
The body can record and imprint these traumas in the tissue, which can cause the fascia to shorten and put pressure on muscles, nerves and the vascular structures.
Symptoms of Myofascial Dysfunction
Here are a few indicators that can show the fascia is not functioning well
Deep, aching muscle pain
Fatigue
Muscle spasms
Difficulty getting to sleep / broken sleep
Tender muscle knots
What is Myofascial Release?
This is a hands-on therapy to help treat pain and dysfunction. It involves holding pressure, skin rolling, stretching and lengthening the fascia to help breakdown adhesions in the tissue. When the tightened areas release, it can assist in restoring mobility and increase circulation and blood flow to the area, which aids the healing process and helps the lymphatic drainage. Certain areas - depending on tension and sensitivity - can be uncomfortable.
Case Study 1
A little while back, I had a patient come in with a very tight neck and shoulders, down to just below midback. They were suffering from horrible daily headaches.
They were having to take painkiller tablets every day, which eased the symptoms to a certain degree but didn’t fix it. Their background for work was physically demanding and unfortunately they had also suffered a close bereavement recently and they were having to manage their emotional stress and all the important paperwork. The combination of everything took its toll and that's when they finally came in for help. As they were feeling quite fragile, we started very gently stretching the back muscles (trapezius, rhomboids, infraspinatus) and holding each one for 2 to 4 minutes until I felt some sort of ‘give’ in the muscle. Not all of the muscle would release, so it was a case of leaving it for a few minutes before coming back to it.
Muscles of the back and neck involved in these case studies.
Eventually the muscles started responding well and I was able to feel a nice stretch without a lot of restriction. We communicated throughout the treatment to make sure they were okay. They had a few intense weekly treatments like this, each one feeling better and better and noticing their headaches were less frequent and intense – no more painkiller tablets! As they were feeling the improvements, I also introduced some deep tissue massage to release some of the stubborn knots. For general well-being this patient now comes in every 4 to 6 weeks for a top-up treatment.
Case Study 2
This patient was in her mid-20’s and had been working from home for the past few years. Initially her work set-up wasn’t the best, she would use the laptop at the dining table, then move to the sofa and finish her working day at the kitchen breakfast bar.
All these different sitting positions and height levels of the laptop caused her to have rounded shoulders and her head and neck to tilt down, making her slouch. Eventually, she got a proper standing desk to help counteract some of the above, but unfortunately the damage was already done. Her upper back, neck and shoulders were very tight and she was struggling to sleep at night because she wasn’t able to get comfortable. Her work productivity was down, so she was not keeping up to date with deadlines, which made her anxiety flare up.
Realising how bad everything was, her husband suggested that she book in for treatment. During the consultation, I could see how much she was struggling just to try and find a comfortable sitting position. We started treatment by gently stretching from the top of her back to the base of her spine, making sure she was taking deep breaths in and out. Then, coming from different angles, I did some skin rolling to the muscles of her neck and upper back (levator scapulae, trapezius, rhomboids, infraspinatus and erector spinae). This helped to further warm up the muscles and fascia and also work out where the main tension areas were. To finish, I asked her to lay on her back so that I could do some neck stretches and hold pressure on the sub-occipital areas at the base of the skull.
She had two more intense myofascial release sessions and by the third one, we incorporated some deep tissue massage to help break down some of the deeper trigger points in her shoulders and between her blades. She’s had a good response to treatment and - for maintenance - she comes every 6 to 7 weeks. She has also joined a yoga class once a week and does daily walks (30 to 40 minutes).
How to look after your fascia
Exercise: Doing gentle exercise can help keep the fascia supple and reduce the risk of it tightening up. Daily stretches are great, especially in the morning as the body and muscles will feel tight.
Eat well, drink well: Eating a balanced diet with lots of fruits and vegetables will provide good vitamins and minerals. Drink plenty of water to stay hydrated, remember the average body is 60% water. Aim for 6-8 glasses a day.
Relax: Find ways to relax such as reading, listening to music, audio books or a podcast, meditation, talk to a friend. It can be anything that helps you decompress.
Sleep: This is so important for physical and mental well-being. During sleep our body heals and repairs muscle. It also relieves stress and improves concentration. It supports the immune system to prevent infection and disease. Aim for 7 to 8 hours each night.
These aftercare steps are a very important part of the massage process. The effectiveness of the Myofascial Release will last much longer if you can make time to follow these simple steps in between your treatments. This, along with regular ‘maintenance’ massage can help prevent issues from returning.
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