Posts filed under 'Myofascial Release'
Core strengthening is a popular treatment modality among physical therapists, as well as being popular in the mainstream of exercise. There have been a number of articles written critical of core strengthening (see The Myth of Core Stability). Based on my experience, one serious flaw has to do with tightness that most physical therapists pay little attention.
Tightness of the anterior (front) spinal and pelvic musculature can play a great role in back, sciatic, and pelvis pain. Shortness or tightness of the iliopsoas musculature can cause the lumbar spine to become drawn forward and downward. The psoas originates at the transverse process of L1-L5, with fascial slips into each of the lumbar discs. Tightness of one or both sides of the psoas and surrounding fascia can lead to commonly felt back pain and dysfunction. I find this a repeating theme among patients with back pain and one that I spend a great deal of time in education and treatment. Repeated exercise can lead to shortening of a muscle, if not properly stretched.
Some common symptoms that can result from shortness in this region are pain with prolonged standing, or standing while leaning forward (doing dishes), pain on rising to stand after sitting, especially when you are leaning forward (computer use or bleacher sitting), and lying flat on your back with the legs flat.
If the psoas and surrounding fascia is restricted, further strengthening these areas easily leads to further exacerbation of the back pain. This is what often results from core strengthening. The traditional medical model, including the traditional physical therapy model, pays little attention to these interplays. While your therapist may have put you on a general stretching program for your pain, the prescribed exercises seldom target the hip flexors. Strengthening the trunk and back to better support is a repeating theme among the patients I see who have not been helped (or have been hurt) by this approach to pain.
Myofascial release stresses identifying the restricted or shortened musculature and soft tissue that may be causing excessive strains on the body. In my Foundations in Myofascial Release Seminars™, I stress a unique deep model of evaluation as a part of Myofascial Release training. Without this proper type of evaluation, this tightness is often overlooked. Demand more of your therapist. Don’t settle for what each and every back pain patient receives. No two cases are alike, so why allow yourself to be treated by everyone else?
Walt Fritz, PT
www.MyofascialResource.com
August 25th, 2010
Miracles. I recently had an experience with a client that I wish to share. This client had been seeing a NUCCA chiropractor for approximately 15 years. For those who may not be familiar with NUCCA chiropractic, I would refer you to the NUCCA.org website. NUCCA emphasizes and focuses on C1 as the cause of issues throughout the body. Treatment is focused only on C1. My client felt that the NUCCA chiropractor had really helped him over the years, but with some reservations.
One thing that seems universal among NUCCA is that no one, beside the NUCCA chiropractor, should be allowed to touch the person’s neck, for fear of knocking the precise adjustments out. Additionally, this client had been warned to avoid hitting potholes with the car or jarring the neck or back in any manner. My client had developed a deep sense of fear that the alignment of C1 would be knocked out of place with the slightest incident.
This client, after numerous return visits to the chiropractor for check ups and re-adjustments after minor jarring, finally asked me to look at his neck. Tightness of the upper neck was evident and we proceeded with a few sessions of simple cervical lifts to release the sub-occipital region. He was doing quite well for a long period of time until a few weeks ago. He bumped his head and called to schedule a session. At the session he voiced his fear that this would send him into a few months of problems, as it had in the past. Prior occurances such as this required frequent re-visits to the chiropractor and much caution and guarding of the neck. At that session I simply performed a cervical lift to loosen the upper posterior cervical region and sent him on his way. He returned two weeks later calling me a miracle worker. While I appreciate the praise (and asked him to repeat it a few times!), I educated him further about the environment surrounding C1 and the need to keep things loose.After the previous session he had no symptoms at all, nor had any returned.
I tell this tale to ask why some health practitioners build so much fear into a client? I might be that they really believe that the precautions that they convey to the client are real. The cynic in me feels that it is a guaranteed method of maintaining repeat business. Make the client so fearful of any type of re-injury that they keep coming back, if nothing but for reassurance that they are OK. That’s what I love about the work that I do and teach. Get them moving again and get them out the door. Miracles.
Walt Fritz, PT
www.MyofascialResource.com
August 11th, 2010
I have some exciting news regarding the Myofascial Release Practitioner Directory on MyofascialResource.com. There is now no charge for a listing on this nationwide Myofascial Release and Bodywork Practitioner Listing. Therapists have had very good luck being found by potential patients and now is the time to add your practice. Simply go to the Sign Up page of my website, complete the form, and email it back to me. You can also send along a photo and/or logo for inclusion into the listing.
You can sign up here.
Walt Fritz, PT
www.MyofascialResource.com
August 9th, 2010
In my training as a physical therapist, pharmacology was required study. Traditional physical therapy comes in contact with many different medications for pain, inflammation, etc. As I began my Myofascial Release training, medications were viewed as maskers of symptoms and frowned upon.
Research published earlier this year shed light on a promising new treatment partner for fibromyalgia sufferers. Low-dose naltrexone has shown to be effective in reducing the symptoms (pain) of fibromyalgia. Published in 2009 by the scientific journal Pain Medicine, low-dose naltrexone produced a 30% reduction in symptoms vs use of a placebo. Given the very low side effects of this compounded medication, it merits inclusion into the treatment choices of fibromyalgia sufferers. Low-dose naltrexone is not a pain medication. It affects the body in different ways. You can read the full text versioin of this research paper on my website (#229).
Walt Fritz, PT
www.MyofascialResource.com
August 5th, 2010
Marketing your Myofascial Release (MFR) practice, or any type of practice, is about building a brand around you. I wrote an article a number of years ago that I cannot locate (after a number of computer changes) that talked to this fact. You, as an MT, PT, OT or whatever T you are, must decide what it is that you do and do well.
When I started my Myofascial Release practice, I pushed the words MYOFASCIAL RELEASE in all types of print advertising, as well as in verbal discussions about my work. I was going to convert every doctor and potential patient in my area of what Myofascial Release could do for them. But after a few years in practice, as my name and reputation spread, it was what I did that mattered more, not what modality I used.
The Pain Relief Center is the name of my practice in Rochester, NY. That pretty much explained to 99% of interested people what it was that I did. 1% would ask for Myofascial Release by name, and 1/10th of those 1% would ask who I was trained by. So my 2 minute elevator speech revolved around how I am very efficient at relieving pain. My 10 minute speech would talk about Myofascial Release a bit, but eyes tended to glaze over by that point. Once you are involved in the process of evaluating and treating, more attention is given to the specifics of MFR.
Brand yourself at what you do well. And what you do well should be patient directed. You may do MFR well, but to most people that message will not be heard. If it is pain relief you do well, create your brand around this fact. Know your market and know yourself. Promoting MFR, especially when you are promoting your teacher, may be wasted time and money on your part. It is YOU who needs to be in the forefront of your market.
Walt Fritz, PT
www.MyofascialResource.com
August 2nd, 2010
Who are the pioneers in the field of Myofascial Release? Or better put, who are those that created a shift in the way we view the body?
A look at the history of Myofascial Release, as well as the primary contributors, can be obtained on Wikipedia. But who represents the future?
I have a respect for the research and writings of Robert Schleip, Ph. D, who is a German fascia researcher and Rolfer. A case in point is his article, Fascial plasticity – a new neurobiological explanation: Part 1. While acknowledging the hypothetical nature of his work, he puts forth an explanation for the mechanism of fascial work from the basis of neurobiology.
When I put my hands on a client and feel changes, I have always had a mental picture of what was occurring, based on my learning. Schleip takes these same sensations and frames them in a new way. Since current research has failed to confirm the paradigm of mechanical explanation that I was taught as a means of validating fascial release, his theory draws from plausible explanations to come up with a logical framework. Sacred cows, whether they be in Myofascial Release or Craniosacral Therapy, can be changed.
So why does it matter? If what we are doing works, why should the explanation be so important? If Myofascial Release is to gain further credibility as an accepted modality, the science does matter. Will this change how we work? Quite possibly; finding the mechanism for change may lead to further advances in theory and technique.
Give Schleip’s article a read and let me know your thoughts.
Walt Fritz, PT
www.MyofascialResource.com
June 6th, 2010
I have created a new Group on the business networking site LinkedIn specifically for Myofascial Release Therapists. This is another opportunity to present your practice to the public, as well as to network with other MFR professionals.
Check it out here
Walt Fritz, PT
www.MyofascialResource.com
June 4th, 2010
A common aftermath of body work in general can be redness and itching of the skin. I have seen this especially evident in the trunk and ribcage area and can sometimes be rather pronounced. I was taught that this was a reaction to histamine released from the cells, creating an itching sensation. What have you been taught? Also, why does it seem more evident in the trunk vs other parts of the body?
I have a few good theories that I will share, but I invite your feedback.
Walt Fritz, PT
June 2nd, 2010
In my previous post, I talked about the importance of improving the mobility of the ribcage. I want to build on that by giving you some ideas for further increasing the flexibility and range of motion of the rib cage and beyond.
The seated respiratory diaphragm release is a technique many of us have been taught. This is an excellent way of releasing the three dimensional aspects of the diaphragm and proximity. You can take that concept one step further by performing a technique as shown here.
Motion test your client for limitations or pain. I will always work them in both directions, but you may wish to begin in the direction of ease. Be cautious of reports of light headedness or clammy skin, which can signal pressure in the area of the vagus nerve. Take them to a gentle end barrier and wait through successive releases. Repeat in the other direction.
This technique works well to improve intercostal soft tissue flexibility, anterior shoulder region tightness, and respiratory diaphragm restrictions.
How does this technique improve your effectiveness?
Walt Fritz, PT
www.MyofascialResource.com
Copyright 2010 by Walt Fritz, PT and www.MyofascialResource.com
Disclaimer: The information provided is intended for use in conjunction with a qualified health care professional. Please do not attempt these techniques yourself without proper instruction.
This information may be shared and/or included on your website, etc, as long as the article is printed in full, along with the source link.
June 1st, 2010
Much of Myofascial Release is about landscape. I look at posture to see deviations from mid line. I palpate tissue quality to determine tightness or restriction. I move into the rib cage to feel for areas that lack movement. These rib issues are what I want to address today.
Working into the osseous structures has always interested me. When learning this work, I felt that I had an adequate number of techniques to address rib cage tightness, but it was only through years of experimenting and noting the outcome that I learned the value of treating the rib cage.This is where landscape becomes important.
Think of the ways we treat those scapular or rhomboid knots that clients complain of. Treatments or modalities of all sorts may give some relief, but the pain returns. When was the last time you looked at and felt the landscape of the thoracic ribs?
In an ideal world, we are born with a landscape where the posterior rib cage gradually eases from shoulders to the lower trunk with a smooth, gradual sweep. There are no sharp peaks or valleys. With your client face down, you can view this while standing at their head. Global pressure into this area provides feedback of an equal give, all ribs and soft tissue flexing inward until you gradually reach the barrier. The thoracic spine matches this, with a smooth undulation toward the table. The scapula glides over this landscape in response to motion of the arm. The underside of the scapula finds no resitance from the smooth landscape underneath.
But, with normal or abnormal postural asymmetry, injury, scoliosis, or trauma, the rib cage often assumes a more craggy appearance, one where the landscape is interrupted by peaks or valleys of apparent tight ribs. The thoracic spine does not give equally to your pressure. The underside of the scapula is constantly irritated by the raised ribs, causing spams. The asymmetrical rib tension can force a rib head to misaligned at its junction with the spine.
Instead of staying on the surface and working the muscle or superficial fascia, move deeper into the rib cage. Engage the fascia and musculature of the intercostal regions. You most certainly will need to address pelvic torsions and tensions, but do not forget the landscape.
Walt Fritz, PT
www.MyofascialResource.com
May 12th, 2010
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