Last week, we featured “Part 1: Foam Rolling NOT Myo Fascia Release” where we looked one end of the debate regarding foam rolling for myo fascia release; where our focus was to look who foam rolling should be applied based on a client’s particual tissue make up. Meaning, the difference between tissue tone or muscle knots vs tissue fibrosis and scar tissue.
Foam rolling is a form of self-myofascial release that is commonly used by fitness and health professionals across the globe. However, it is still a relatively new field of research. The study of the areas of fascia, myofascial release, self-myofascial release and myofascial trigger points are also still young and quickly developing; therefore depending on how, what, when and where you apply these techniques are up for discussion. As I mentioned in my previous post, it really boils down to the the understanding of both tissue composition and the “WHY.”
Why are you prescribing these tools? Do you understand the difference between tone, tightness, tension and fibrotic tissue/scar tissue? Have you considered manual therapy over self release techniques? If a client has tone and you are looking to prepare the clients tissue for movement, the roller can be effective, but has temporary lasting effects. If the client has significant mobility and tissue adhesions the roller will not be enough to break down fibrotic tissue and thus you will get the results you want, nor will your client.
Any discussion of self-myofascial release first has to present some background to research into fascia and the vast interconnected matrix. The purpose of today’s post is to look at how foam rolling, can indeed by beneficial to a client’s tissue health, when used appropriately.
First, let’s jus review the fascia system; fascia is connective tissue that wraps around all of our muscles and is heavily interconnected with muscular function, communication and our nervous system. It has 3 integral layers (visceral, deep and superficial) putting it in it’s simplest terms. It is also a continuous sheet all around the body, which means when we alter it’s composition in one area, it can effect movement in other areas of the body.
Tight fascia and fibrotic tissue affects the whole organism. Structural imbalance causes overall and specific increased rates of nervous stimulation. These cause increased muscle tonicity, trigger points and somatic-visceral referrals into the organs.
Myofascial trigger points are more usually defined as “tender spots in discrete, taut bands of hardened muscle that produce local and referred pain” (Bron, 2012). A commonly-held hypothesis about myofascial trigger points is that they are caused when motor endplates release excessive acetylcholine, leading to localized sarcomere shortening and consequently very short muscle fibers in one particular area (e.g. Hong, 1998).
According to the standard definition provided by the Journal of Bodywork and Movement Therapies (LeMoon, 2008), fascia is responsible for:
- Maintaining structural integrity
- Providing support and protection
- Acting as a shock absorber
- Plays a role in hemodynamic and biochemical processes
- Provides the matrix permitting intercellular communication
- Functions as the body’s first line of defense against pathogenic agents and infections
- Creates an environment for tissue repair post-injury
How Can Self Myo Fascial Release(SMR) Benefit Tissue:
In general, a myofascial release technique is intended to address localized tension and tone , but most people describe it as “fascia rlease” when in actuality a better way to educate clients, is to use “tissue release,” because we are affecting more than just the fascia itself. SMR traditionally focuses on the neural and fascial systems in the body that can be negatively influenced by poor posture, repetitive motions, or dysfunctional movements.
There is research that explains that these mechanically stressful actions are recognized as an injury by the body, initiating a repair process called the Cumulative Injury Cycle. This cycle follows a path of inflammation, muscle spasm, and the development of soft tissue adhesions that can lead to altered neuromuscular control and muscle imbalance. The adhesions reduce the elasticity of the soft tissues and can eventually cause a permanent change in the soft tissue structure, referred to as Davis’s Law. SMR focuses on alleviating these adhesions (also known as “trigger points” or “knots”) to restore optimal muscle motion and function.
Literature often seems to me to be slightly confusing regarding whether muscle tissue, fascia itself or a combination of both is being treated by the various techniques. I tend to lean towards “tissue release,” vs “fascia release.” Most often we prescribe these tools not only to “release fascia,” but to prep muscles to improve mobility in a joint, or perhaps extensibility in muscle tissue (called tightness).
Let’s Talk Hydration:
Outside of blood, connective tissue houses the majority of our fluid state. Other, more intricate and vastly important systems (nervous, vascular, and circulatory, etc…) rely on the fluid in this system to function efficiently. If the Extracellular Matrix (ECM), which is the fluids and it’s components of connective tissue that support, protect, and connect all of the cells it surrounds loses even 2% of its water content, it would cause every cell, structure, and system it surrounds to lose efficiency. This exhausts the body, makes it work harder daily and ultimately taps out your energy, ages you faster, and is the catalyst for most chronic pain.If we become dehydrated the body will prioritorize so that essential organs will remain hydrated.
Connective tissue (fascia) will be one of the first to dehydrate leading to adhesions and fixotrophia. For example, researchers have noted that since 67% of the volume of fascial tissues is made up of water and that the application of load squeezes water out of the structures, fascia may therefore lack water in certain areas. The application of external force may therefore be required in order to redistribute water and rehydrate the tissues. Using tools like the roller , the magic stick and slow, application of pressure can improve translation of nutrients and water into and out of tissue.
James Oshman Phd. in his book ‘Energy Medicine’ cites research which shows that a 10% increase in hydration will result in a million -fold increase in conduction of impulses through the tissues such as collagen. This means our work could potentially be a whole lot more effective if we could get our clients more hydrated.
Gil Hedley, who is renowned for his work with cadavers and fascia mentions quite frequently in his Integral Anatomy Series, that using myo fascia tools and manual therapy are important to movement and the pliability of tissue to maintain the sliding properties of fascia and muscle.
The discussion is new, our fields of research in these areas are new, and there still so much we do not know about the fascia, tissue and this interconnected matrix.
KISS Principle: Keep it simple…
- SMR & Foam Rolling Techniques: good for reduces tone, improving hydration and temporary release of tense “tissue.” (notice I did not say just fasica, let’s think tissue – fascia and muscle)
- For Fibrotic Tissue, Scar Tissue and Acute Adhesions: for best results, seek hands on professional treatment for long-term sustainable effects. Offer client’s self management tools to empower them to manage their health, but ensure they recognize the difference and benefits, to both used together.
- The Concise Book of Neuromuscular Therapy: A Trigger Point Manual – By John Sharkey
- NASM Essentials of Corrective Exercise Training – edited by Micheal Clark, Scott Lucett, National Academy of Sports Medicine
- Integral Anatomy Series – Gil Hedley
- MELT Method – http://www.meltmethod.com/category/tags/connective-tissue
- Energy Medicine – by James Oshman Phd
- John Forsyth – RMT, Central Lonsdale Massage Therapy Clinic & Massage and Therapy Center Vancouver