Myofascial Release


Fascia – what is it?

Fascia are sheets of connective tissue that wrap around every, and penetrate into, every organ and structure in the body. Anatomically they are regarded as separate entities, and named appropriately:

If tension patterns exist within us (and not just necessarily in the muscles) it can pull our centre of gravity backwards or forwards (usually the latter). If this happens it pulls us in front of our centre of gravity; then the back muscles have to work overtime to help maintain our erect posture, with consequent chronic tension patterns as a result. People frequently attend a practitioner with a ‘tight back’ for a massage, and it works; but the ‘primary lesion’ of fascial tension remains unaddressed, so it will recur again and again

The function of Myofascial Release is to address the tension carried in the fascia and allow it to release. This can be a slow process, depending upon the person and the amount of time it has been allowed to establish itself.


- Perimysium – around muscle
- Periosteum – around bone
- Perineurium – around nerves
- Peritoneum – around the gut
- Dura mater – around the brain and spinal cord
- Pleura – around lung

It wraps around muscles and separates them. In skeletal muscle, a ‘normal’ muscle consists of a collection of muscle fibres held together by connective tissue (endomysium). This is wrapped up in more connective tissue (perimysium), with a sheath of connective tissue around several groups of muscles (epimysium), and all this connective tissue extends at the ends as tendons and attaches on the connective tissue of the bone via the enveloping periosteum. It acts as a foundation for layers of cells (e.g. the basement membrane of epithelia, like skin). It secures organs within the body; it protects and supports the nerves and blood vessels, and it allows freedom of movement where necessary (e.g. heart, lungs and gut). The most important thing to remember is that it has a 3 dimensional structure down to a cellular level.


Seeing fascia in this way introduces a different way of looking at the body; not just in terms of organs, bones and muscles, but in terms of compartments in which other tissues grow (in our embryological development).It creates spaces (compartments), sacs and tubes in which these other tissues can develop and function. Hence it provides not only a supportive framework, but also a web that connects all these other tissues together and so, indirectly, a secondary route of communication; this manifesting as referred or remote pain, i.e. pain elsewhere in the body, even a long way away from the point of origin of the pain.

Fascia can be very thin and delicate, like the pleura around the lung and peritoneum, around the gut; or thick and robust like the ligamentum nuchae in the neck, thoracolumbar fascia in the low back, or dura mater around the brain and spinal cord, and ligaments. It can be ‘mobile’ and flexible like the peritoneum enveloping the gut or basement membranes of epithelia, or ‘fixed’ like the periosteum, stuck to the surface of bone.

MYOFASCIAL PAIN is any pain that manifests in any of these structures.
Other possible names for this could be:
- Fibrositis
- Fibromyalgia
- Chronic benign intractable pain syndrome
- Repetitive strain injuries

Irrespective of what it is called, it manifests as a broad umbrella of conditions: from the symptom free, to the mild and irritating and even severe pain that can be disabling.
Generally speaking, I have found the body is quick to react to a trauma, but slow to relax following it, so a ‘learned pattern’ appears. If any tension stays for a period of time, it becomes chronic; this period of time is variable depending upon the person. People may say, “It started last week”. However, when I put my hands on them I feel that it has been there for a lot longer than that; but they are telling me the truth as they perceive it – it started last week. I feel this reflects the variable within us all, which I call the ‘coping zone’.

The coping zone is that ‘area’ within us that copes with things. You could see this coping zone as physical, emotional, or energetic. I see it rather like the body trying to cope with everything that we encounter; everything is potentially a trauma. We can have a wealth of ‘things’ going on inside us, but all the time it remains inside the ‘coping zone’ we don’t know it’s there; it doesn’t get in the way, we can do everything we need to do, we feel OK. Only when it goes beyond or outside the ‘coping zone’ do we know it is there. Now it does get in the way; now we can’t do all that we want; it causes us suffering. It is only now we seek attention for it.


Healthy tissue has a compliant, elastic, fluid, quality about it. It moves out of the way when pressure is applied to it. This is the nature of healthy tissue; they can ‘flow’ within themselves and between each other.

Tension is a feeling of tightness. It is felt both subjectively, by the person or by palpation and is frequently a reaction of the body to something; be it trauma, disease, dysfunction or otherwise.

When chronic tension appears, the tissues lose their elastic, compliant and fluid quality. Normal muscle tissue is both contractile and elastic, but the fascia is the tissue that carries the tension. In chronic situations and muscle tension, the fascia thickens; not just through and around the muscle, but right up to the surface resulting in thickening and reduced elasticity and mobility of the skin. It feels fixed and leathery; at first touch feeling hard and resistant and painful to the patient. It fixes the length of a muscle and reduces its elasticity. It can also ‘get in the way’ the muscle fibres contracting and create alteration of muscle activity.

Symptoms:

Causes
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