#1 – There’s more to the story than muscles and bones
Bones give us stability and muscles allow us to move, right? What if there was a third body system that is more stabilising than bones and more dynamic than muscles, yet has been overlooked?
Surrounding every muscle, bone, and cell of our body, is a web-like connective tissue called fascia. This dynamic, fluid-filled whole-body system, through which everything else integrates, is responsible for giving us our shape, posture and stability.1
Like flexible steel cables attached to the muscles, bones and organs throughout our entire body, fascia has the tensile strength of up to 2000 pounds per square inch – that is similar to a horse standing on a 20-cent piece!2 When it gets tight, it changes the position of our bones, squeezes muscles, elicits pressure on organs and pinches nerves — ultimately causing pain.
If the problem isn’t resolved by treating the bones or muscles, the fascial system should be another avenue of investigation. Interestingly, fascia is invisible to the medical profession as is doesn’t show up on standard ultrasound, MRI, and CT scans. Therefore, the dynamic web that envelops us head-to-toe, front-to-back is often unexplored by traditional physios. Why? The modern understanding of fascia is under-recognised in their university education. Thanks to new scientific methods, including micro-videography of live human fascia3, researchers are now able to see the importance of a system previously believed to be merely ‘packing material’ or ‘insulation’.
#2 – Your pain is not a strength problem.
How many times have you gone to the physio with neck pain, back pain, shoulder pain, or headaches and been given strengthening exercises to do at home with a stretchy band? Looking at the big picture, we discover that what looks like muscle weakness is often due to fascial restrictions. For example, a person who has slumped posture in sitting or standing with shoulders rolled forward, will often present with weakness in the muscles in between the shoulder blades.4 Thus, the physio will conclude that strengthening those muscles will pull the shoulders back out of the slumped position and eliminate the pain a patient is experiencing. Clinically, we often find that once the tightness through the front of the neck and chest is released, the patient can now automatically sit upright and the slouched posture is gone. Re-testing muscle strength, we find that the muscles in between the shoulder blades have good strength without doing any strengthening exercises! How can this be? Muscles that are chronically in an overstretched position can’t exert their full power and therefore present as ‘weak’.
When a person is no longer victim to tension, drag and pull from the front of the body, then the muscles in the back of the body are positioned properly and able to function at maximal power. Therefore, to prescribe strengthening exercises without looking beyond the symptoms, leaves a person ‘strengthening’ muscles that are already spasming, full of trigger points, and working hard to counterbalance the forces at play in the front of the body. Common to many patients, this type of exercising without first releasing tight fascial tissue often leads to symptoms getting worse.
#3 – “No pain, no gain” is a myth
“It’s gotta hurt to get better.” “Pain is good for you.” “If it hurts, something is really happening.” Naturally we do everything to avoid pain, but what about when a practitioner is treating us and says pain is a good thing? We’re left to grit our teeth and suppress our natural reaction to do whatever we can to stop the pain — sometimes wiggling and squirming under their pressure with tears leaking out of the corners of our eyes.
Pain is a life-saving signal that is necessary to keep us safe. It alerts us that something is wrong or gives us the message to stop or take a break. Therefore, ignoring this signal can compound our problems. Tissue being elbowed, knuckled, or ground to bits is quite painful, and so it should be! There are approximately 10 times the sensory nerve endings in the fascia for every one sensory nerve ending in the muscle.5 Thus, fascia plays a major role in helping us perceive where we are in space and sense our inner tissue in ways not fully appreciated previously.6 Experiencing injurious pain sensations during treatment is indicative of the tissue being forced. However well-intentioned it may be, forcing the connective tissue apart can lead to thickening and scarring as the body braces against this routine micro-trauma.7
There is another way to elicit change, healing, and the opening of tight tissue, and that is through sustained, gentle pressures. This way, changes can be made without traumatising or re-injuring the tissue by allowing the tension to dissolve naturally.8 It doesn’t have to hurt to get better, and the body really wants to be as free and relaxed as you do – it’s a matter of learning how.
Joni Edmunds is an American-trained physio who specialises in myofascial release treatment following the John F. Barnes approach. She’s passionate about sharing with Australia’s pain-sufferers this gentle, natural form of hands-on treatment that has been useful for treating unresolved issues such as endometriosis complications, chronic tendonitis, unexplained migraines, and symptoms associated with longstanding diagnoses such as chronic fatigue syndrome, fibromyalgia, and myofascial pain syndrome. For more information, or to contact Joni, please visit www.perthmfr.com.au.
References
- Schleip R. Fascial plasticity–a new neurobiological explanation. Bodywork and Movement Therapies. 2003;7(2): 104-116.
- Kyoto, J., Tensile Strength of Fascia, Prefector Medical U., 69:484-488, 1961.
- Guimberteau JC. Strolling Under the Skin [DVD]. France: ADF Video Productions;2005.
- Darnell MW. A Proposed Chronology of Events for Forward Head Posture. J Craniomandibular Practice. 1983;1(4): 49-54.
- Kandel E. Essentials of Neural Science and Behavior. 1995; New York: Appleton and Lange.
- Barnes JF. Massage Magazine. Therapeutic Insight: The Myofascial Release Perspective—50 Years Ago. 6 Dec 2010. Available at http://www.massagemag.com/therapeutic-insight-the-myofascial-release-perspective50-years-ago-8329 Accessed August 6 2014.
- Stauber, W, et al. Fibrosis and intercellular collagen connections from four weeks of muscle strains. Muscle & Nerve.1996;19:423-430.
- O’Connell, Judith. Bioelectric responsiveness of fascia: A model for understanding the effects of manipulation. Techniques in Orthopedics. 2003; 18: 67-73.
Joni Edmunds, DPT graduated from Pennsylvania State University with a Bachelor’s degree in 2002. She completed her post-graduate work at Gannon University in 2004, receiving her Master’s and Doctorate degrees in 2004 and 2008 in physical therapy.
She began utilizing the myofascial release techniques and principles with patients after completing the Myofascial Release I Seminar in 2005. Joni continues to repeat John Barnes’ Myofascial Release Seminars and is an assistant instructor for Myofascial Release Seminars in North America.