Myofascial massage is a type of massage that acts on the connective tissue to loosen adhesions and restore normal elasticity.
Skeletal muscle pain usually comes from the fascia, but this is still unknown to most doctors.
When examining a patient, the doctor often does not check the radius of movement and limits himself to ordering a series of unnecessary examinations: first an X-ray, then ultrasound or magnetic resonance imaging, then electromyography, etc.
If the doctor were to perform a thorough physical examination, in some cases he would only recommend physiotherapy treatment to the patient.
The medical examination is crucial and myofascial treatment is definitely not a treatment that cures everything, but if indicated, it can eliminate the causes of the pain. The latest research in the field of orthopedics, rheumatology, physical medicine and osteopathy agree that the “fascia” can cause symptoms such as: pain, loss of strength and movement.
There are different methods of treating fascia: physiotherapists perform stretching and possibly Rolfing, or a technique that has a profound effect on the soft tissue of the body.
Fascial manipulation was introduced by Luigi Stecco, who created an innovative and effective way to treat these disorders.
Fascia is simply the connective tissue, which is mainly composed of collagen fibers.
This tissue is found everywhere in the body: in tendons, ligaments, epidermis and tendon sheaths, as well as in muscles, bones, organs and intestines; it occupies 70% of body weight.
Anatomical examinations show that there are different layers of connective tissue in the body: subcutaneous tissue and fascia (which can be superficial or deep-lying).
The fascia is a very plastic tissue, easily it can become denser and wrinkled.
Muscle fibers run inside the connective tissue scaffold, which continues into the tendon.
The most important thing is that the deep fascia of one muscle continues in the fascia of the other muscles and in the bones.
Excessive tension of the fascia of one muscle is transferred to the muscles and skeleton in other areas of the body.
There are connections between different fascia of connective tissue, such as between agonists and antagonists. For example, the muscles that raise the arm are affected by the muscles that lower the arm and vice versa.
The second link runs along the vertical line, that is, the muscles that raise the arm work synchronously with those that raise the elbows, shoulder, hand and fingers.
Finally, there is a spiral connection, i.e. it connects the front area of a joint with the rear area of the nearby joint.
This connection affects a whole limb, for example, the anterior internal fascia of the hand, finds its continuation in the fascia:
- the posterior outside of the elbow;
- the front inside of the arm;
- the posterior outside of the shoulder blade.
A muscle can end in a muscle septum, or in a fascial structure that connects it to the antagonist. So when the first one contracts, the tension developed on the common connective tissue stretches the other muscle. For example, if the arm flexor (biceps) contracts, the extensor (triceps) relaxes.
In the fascia there are many organs of the nervous system (muscle spindles and the Golgi tendon organs), which serve to send information about contraction, relaxation and length of the muscle to the brain. There are also the “Pacini” bodies, which transmit nervous signals only when pressure is applied to a zone.
This explains the importance of fascia in motor coordination. The connective tissue contains parallel-oriented collagen fibers that connect to other muscles in a vertical line.
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Why does fascia cause the symptoms?
The term myofascial unit refers to: all muscles that serve to move a bone in one direction. For example, to raise the humerus are used: biceps brachii muscle, brachialis muscle and deltoid anterior muscle.
The myofascial unit also includes the connection of joints, bones and connective tissue. When lifting the arm, the shoulder blade, collarbone and the following joints are also included:
- shoulder joint (acromioclavicular joint);
- shoulder blade-thorax joint (scapulothoracic joint);
- sternum-collarbone-joint (sternoclavicular joint);
- Shoulder joint (glenohumeral joint).
There are two different points that are crucial for understanding this method:
- The perception center (CP) is the painful point;
- The coordination center (CC) is the point at which the muscle forces that perform the movement of a bone converge.
Abnormal collagen bridges may form in the coordination center due to inflammation, adhesions, poor posture, or trauma that form an increase in density or a “step” in connective tissue, similar to a patch on a garment.
Many “coordination centers” correspond to those of acupuncture.
Appendectomy is a traumatic and stressful event for connective tissue, like all surgical procedures.
The surgical incision has caused changes in the connective tissue of the abdominal muscles and hip flexor muscles.
There are structures called spindles that measure the length of muscle fibers and transmit the data to the nervous system. Others are called Golgi tendon organs. They report to the spinal cord when the muscle is contracted.
In the human body, for each muscle, there are 3 layers of connective tissue that work together to perform complex movements by bundling muscle tension in one point (coordination center).
The nervous system recognizes that the coordination center is tensing and sends an impulse to the muscles to contract, thus beginning the pull on the bones that causes the movement.
If the connective tissue is too dense at this point, it is not possible to transfer the tension to the muscle spindles, which then cannot activate and, consequently, cannot stimulate contraction of all the necessary muscles for this movement.
The result is that the muscle pull on the joint comes from only some muscles, but not from all.
The structures that form the joints are pulled abnormally because only part of the muscle fibers contract.
The joint structure receives abnormal impulses and responds by producing pain.
The partial action of muscles and connective tissue leads to a loss of strength, movement and coordination. It is possible to feel pain in the antagonist. For example, hardening in the triceps (back of the arm) could cause pain in the front of the shoulder and prevent the arm from being lifted forward.
How is fascia massage performed?
The fascia therapist must understand all existing and past complaints in each area of the body.
Often patients are perplexed by the questions I ask because a person with shoulder pain expects the physical therapist to evaluate only the shoulder blade and arm.
It is possible that an ankle sprain 15 years ago now causes low back pain or periarthritis of the shoulder.
You have to perform all possible operations, bone fractures, dislocations, tooth extractions, cramps, etc. , which can leave hardening of the fascia behind and cause pain even after years.
The second part of the evaluation includes all movement tests of the painful joint, adjacent joints and joints that may have caused the pain.
After that, all points that need to be examined on the basis of the indications of the muscle examination are scanned to look for hardening and pain radiation.
The radiation is not mandatory, but often, when a coordination center is treated, which is linked to these complaints, one feels an “electric shock” in another part of the body. If this is the zone that usually hurts, then treatment begins at this coordination center.
Often patients ask me if I treat “overlapping” or “exposed” nerves because it is very uncomfortable.
Treatment consists of rubbing your ankle or elbow over the point likely to be responsible for the pain.
The manipulation causes friction and heat, which leads to the dissolution of the abnormal collagen bridges. Immediately afterwards, the patient is asked to repeat the painful motor tests to see if there are any differences.
Usually, an improvement occurs immediately. In rare cases, the person concerned does not feel better until the following days. It may happen that the patient feels well for a few days, but after that the previous pain returns. This is a good sign, which only means that the cause of the pain and hardening is tension at other points. On two subsequent days after the treatment, it is possible that the treated points hurt. But this is only a temporary effect.
Can myofascial treatment cure cephalgia or headaches?
It is important to know that increased collagen bridges can cause symptoms that affect the head: headache or cephalgia, migraine, dizziness, tinnitus, feeling of eye heaviness, problems chewing and swallowing, feeling of lump in the throat, etc.
How many patients spend the days visiting specialists without getting a solution for their symptoms?
Although the causes of the complaints can be very many and many of them are the competence of neurologists or other doctors, a common cause is the tension of muscles and fascia, which affects the functioning of internal organs, joints (for example, those of the jaw) or muscles (for example, those of the eye) and causes pain and malfunctions.
One thinks of the physiotherapist only in case of muscle pain of the skeleton, but forgets that the head also consists of many muscles that are located on the skull bones.
How many people laugh asymmetrically by lifting one side of the lips more?
In this case, adhesions are found:
- in the muscles above the side where the lip rises higher;
- in the lower fascia of the side where the lip remains further down.
What causes the cracking when opening the mouth or moving the jaw sideways?
One of the main causes is fascial tension, which hinders movement.
Why do you feel a lump in your throat or have difficulty swallowing?
Possible causes of the problem include the muscles of the hyoid bone or the masticatory muscle (masseter) with which one “grits one’s teeth”.
If there is an indication, myofascial treatment eliminates tension of connective tissue by freeing movements or releasing stiffness that causes the symptoms around the eyes, headaches or chewing difficulties.
