I feel like one of the most important things about fascial release is that it is so general. The fascial system is continuous throughout the entire body down to the cellular level. Dysfunction in one area can cause symptoms in other areas. It assists in providing form but also allows for movement as well. There is the nervous system effect of Fascial Release and there is the actual shortening of the Fascial Tissue itself in some circumstances. Ultimately, in my experience, what I have experienced is inappropriate shortening of tissue that takes the body out of it’s most efficient positions causing limited range of motion of the body and can include reduced range of motion, weakness, pain and neurological symptoms to name a few.
Finding your center is such an important process as it is this place where you are centered and moving most efficiently. What can happen with shortened fascia is that it can send inappropriate messages to the brain that you are at end range of your motion, whether it be in the shoulder, neck, ribs, hips, low back to name a few. After a while, the brain will accept this reduced range of motion as being normal and a cycle can re-occur.
An example of this that has become common is due to our postural positions during the day, our heads are pulled forward and down and our shoulders are pulled forward and inward due to computer use/ phone use/ sitting at a desk/ driving ect. When we are in this position for long enough the tissues in the front of the neck and the front rib area will send information about position to the brain and eventually, the brain will assume that this less than optimal position is considered normal. Clinically, it causes the upper back and neck to work harder and to fatigue more quickly causing things like reduced shoulder range of motion with pain, burning pain between the shoulder blades, neck pain with reduced motion of the neck, jaw pain, numbness/tingling/pain down the arm to name a few. From a treatment perspective, my approach is to reduce the symptoms where they present but more importantly to make it easier for the client to bring their posture back to a place for the shoulders function better, the upper back and neck muscles don’t have to work so hard and the jaw is able to sit in a better place.
Here is a good test for you. Drop your breast bone down an inch and slouch forward. Bring your arms out to the side, bring them back down and then rotate your head from side to side and get a sense as to when your shoulders tighten and to how far your neck will rotate side to side. Then bring up your breast bone 2-3 inches. You will feel your shoulder blades come together as you move out of the slouch position. Then bring your arms out to the sides, bring them back down. Then rotate your head again. You should feel like your arms move higher up to the side and that your neck rotates more easily from side to side. This is the position that you should be in, where the shoulders and neck work better. Tight fascial pulls you out of this optimal position and makes it feel unnatural to try to get to. This is why Fascial Work is so important. It will help make it easier to find this optimal position where everything works more efficiently.
Often it’s difficult to properly describe the full effects of fascial release but in a nut shell, it help you go where your body will work better, be stronger, more mobile and suffer less symptoms. It’s my job to help you to get there.
With Deep Tissue Massage, the philosophy out there generally is deeper is better. Push hard, go deep. A teacher brought up a really important point about this type of treatment. They said “don’t think of the tissues as a one way system ie: the brain tells it what to do”. There are so many receptors in the tissues that also feed information to the brain. The connection is a two way system. If our work is too deep, too fast the brain may perceive this as a threat and tighten the muscles in response. In my teachers own words “if we think we can overcome a tight muscle by pressure that is too deep, we will probably lose that fight”. It seems to be a place of listening to the tissues. How much pressure will they allow us to use before beginning to tighten? The irony is, the more we listen and only use the appropriate pressure, the deeper we can get into a muscle or tissue. It will take a little bit longer but at the end the treatment was more effective and the patient leaves happy and not feeling like they were beaten up.
I have had instances where I can barely touch the tissue as it is too painful for the client. I only press to their tolerance, wait for the tissues to release, then go a little deeper to the edge of the patient’s tolerance again and repeat. It is amazing how the body will let us go to depths that would have been impossible in the beginning.
Be gentle and go deep.
In my previous post, I wrote about Joint Mobilizations and how great the course was. It reminded me of the important of what lies beneath the musculature. It is an essential tool for helping to determine why the muscles tighten in the first place. It is important that we look past just releasing the muscles to find underlying causes to help to good prevention strategies.
To review, a joint is the point where a moving bone attaches to another bone. Good examples of this are the shoulder joint, where the arm bone attaches to the outside of the shoulder blade, the hip joint where the leg bone attaches to the pelvic and the spine, which consists of 31 vertebral bones stacked on top of each other with a gelatinous disc between each. Whether it is a wrist/ elbow/ shoulder joint or a hip//knee/ankle joint or spinal joint, where is an inherent about of motion for each. We have evolved to a place where each joint in our body must move a certain amount. If that motion is limited the effect can be muscles being overworked or weakened, nerves may be compressed, tendons may be impinged resulting in reduced range of motion and/or pain.
As a result of the above, one of my primary treatment philosophies have evolved into simply assisting the joints in the body to achieve their full range of motion. That makes a body happy. If you have a sore shoulder, I look at reducing your symptoms but also determine if any of the joints in the shoulder complex are not functioning to their full capacity. The bones that move in the shoulder complex include the upper arm bone, the shoulder blade, the collar bone and the ribs surrounding the shoulder blade the upper 3 vertebrae of the midback. All of these must be functioning to assure that the shoulder can move fully and freely. This can apply to any joint from the feet to the top of the head. I have found that most of my success in treating pain, weakness, overworked muscles, nerve compressions come from just allowing the body to do what it can’t. Once it can do this, then it’s capacity to heal improves dramatically. Any correction of a joint done in a treatment will tend to last for a while but exercises are also given to maintain and improve the effects from the treatment. It’s the importance of including the patient in the treatment so they understand why the symptoms are occurring and empowers them to be part of their success.
With improving the function of the spine, I have found my greatest success is using a more Osteopathic approach. Without the surrounding soft tissue (muscles/ ligament/ fascia) the spine would collapse so it’s integrity, function, strength and position is determined by the tension of the surrounding tissue. So we look balancing the tension of the tissue that surrounds the spine and ensures that there is proper support available for it. The Osteopathic approach has been so good on this level in that is so gentle yet effective.
Allow the body to move as it is designed to do. Be strong, mobile and your body will be happy.
I took a really good course last weekend that covered Joint Play. This is a really important part of everything from injury prevention to rehabilitation. A joint is the place where two bones meet and one of the bones moves around the other in it’s intended range of motion. A great example is the shoulder joint. The main shoulder joint is where the top of the arm bone attaches to the outside of the shoulder blade. As the arm moves around the socket at the outer part of the shoulder blade, there needs to be small motion that occurs inside the shoulder joint. That is the joint play. If the end of the arm bone is the ball and the edge of the shoulder blade is the socket, good joint play range of motion ensures that the ball stays within the socket space no matter where the arms moves to. If that small motion isn’t there, the arm movement will stop and reach the end of it’s range prematurely and can mimic Frozen Shoulder. It’s like a hinge in a door that doesn’t move well, so the door doesn’t close. It feels like it catches or pinches causing local shoulder pain that can begin to travel causing neck, rib pain and headaches. A lot of my success with treating the shoulder is just returning that small essential motion in the joint. These small motions can occur in the jaw (TMJ), the spine, shoulders, elbows, wrists, hip, Sacroiliac joint, knees, feet to name a few. Each of these joints have their own movements and often any limitations can be restored. The treatment for restoring joint mobility is a little different from standardized massage therapy as the treatment is very regionalized but I feel like it is such a crucial part of getting to the cause of dysfunction/discomfort. There is always treatment to the surrounding muscle tissue, especially the symptomatic one in addition to the joint play treatment. I remember one teacher saying that if you have a painful/tired muscle, look to see what joint they move. For example, if you have a sore biceps muscle on your arm, I look at the shoulder and elbow movement. If someone has a sore front leg muscle, I look at the hip and the knee joint. It’s not well known that the ribs are also very mobile during torso and arm movement and breathing, and in our society, the ribs are commonly stiff and can benefit from mobilization. Very often, I have found that treating just the tight muscle may feel good for a shorter period of time, but can return if there is an involvement in the surrounding joints.
Having said all that, there is opportunity for pain to refer away from where the joint is not functioning properly. Neck joints in the spine can cause pain down the arms or produce headaches. Low back spine joints can refer pain into the hip or down the leg and mimic Sciatica. A stiff joint in the foot can produce pain that goes up the leg. There is a thought out there that you find the pain but look for the cause elsewhere.
Having joint play in my treatment tool box has vastly reduced pain and dysfunction with patients, increasing functionality and improving daily activities. It is a gentle treatment and follows with the Osteopathic process, which often reveals very good results. Be gentle and the body will let you do more. As always, the patient’s success is partly what we do in the treatments, but just as much, it is important for the patient to be involved so they can continue to improve at home with stretches, exercises and movement/posture changes. It continues with the philosphy that we were designed to move a certain way and very often dysfunction can occur when we don’t.