Saturday, 26 January 2013

Self Myo fascial foam rolling.

Myofascial Mobility Through Strategic Movement
by Anthony Carey Date Released : 19 Jun 2012

Performing self-myofascial release using a variety of tools is now a common strategy among fitness professionals, with the term “myofascial” denoting the inseparable connection between muscle and fascia. As our scientific knowledge base grows, our understanding of what occurs during the myofascial release process has also grown and matured. Building on that knowledge, this article will present a strategy of improving myofascial mobility through strategic movement.
The Science Behind Myofascia and Movement
Once ignored as irrelevant tissue, fascia has been a hot topic in orthopedically-related research and conferences in recent years. While other PTontheNet authors have covered much of the current research surrounding fascial anatomy and biomechanical properties, it’s still worthwhile to review some of the current research – ranging from embryological influences to biochemistry – that are most relevant to this article. The specific relevance of much of this information varies depending on one’s professional background and objectives. The fitness professional will be most interested in how we can positively influence the myofascial system using tools that clients can manipulate themselves in conjunction with movement.
Structurally, Van der Wal (2009) describes fascia into two mechanical/functional types:
  1. Fascia that separate and permit sliding and gliding of muscles (and tendons) against each other and against other structures. This is muscular fascia adjacent to spaces that are filled with loose areolar connective tissue (“sliding tissue”) and, sometimes, adipose tissue.
  2. Fascia that connects and transfers force. This is intermuscular and epimysial fascia that serve as areas of insertion for neighboring muscle fibers, which can mechanically couple bone and soft tissue.
It could be argued that in the areas of fitness and biomechanics, the interest in fascia has been more on the very important role of force transmission, stability and mechanical economy of the fascial network. Conversely, it could also be argued that the fields of orthopedic medicine and body work have centered more on the influence and intervention of a less than optimally functioning fascial system and its relationship to pain and dysfunction. Because all of the characteristics of fascia are interdependent during movement, training principles should reflect as much.
Klinger and Schleip (2004) showed in vitro that the stiffness of fascia is in part due to its water content. And when fascia is stretched or compressed, water is extruded from the tissue like wringing out a sponge. As the water content is lessened, the tissue becomes softer and more pliable. During this period there is also a relaxation of the arrangement of the collagen fibers. Within hours, the water returns to the tissue at a higher concentration than before with increased stiffness of the fascia. These results were confirmed in a more recent study in which they described a “super compensation” of increased water/stiffness hours after the stretch (Schleip et al., 2012). This means that the period following the extrusion of the water and prior to its refilling is a window of opportunity for better access to the elastic component of the muscle tissue, which can influence the alignment of the collagen fibers and mobilize joint motion. From the training perspective, this is the time when solid gains in mobility/flexibility can be achieved.
Tool-Assisted Self-Myofascial Release
The term “self-myofascial release” is applied to techniques done independently of a practitioner. Tools used for this process typically include foam rollers, other rollers of varying shapes, sizes, and textures, and balls. A common objective related to this work is to release “tight” tissue and/or improve flexibility. The mechanisms behind this can be thought of as both compressing and elongating simultaneously. This concept is clear when we use Tom Myer’s 2001 analogy of the human body being a fascial “bag.” Imagine applying pressure with your finger to a water balloon. The pressure compresses the balloon inwards. As it does this, the balloon’s fibers elongate against the increased outward pressure of the water. It also becomes obvious that you cannot affect one part of the balloon without affecting the whole.
Many manual practitioners and fitness professionals still consider the process of myofascial release to be purely a mechanical tissue response – that is, the pressure or stroking makes the tissue longer and/or softer by affecting the ground substance, adhesions, and crosslinks of the collagen fibers. This may be just a small part of the tissue response because there is an abundance of mechanoreceptors in the fascia, which means that fascia plays a critical role in proprioception and nociception (Yahia, 1992). And receptors in the fascia – such as the epimysium and deep fascia – far outnumber those around the joint (Cantu and Grodin, 2001). Paramount to this is that within these mechanoreceptors the majority of input comes from the interstitial receptors that are intimately connected to the autonomic nervous system (Schleip, 2003).
According to Schleip, stimulation of the intrafascial mechanoreceptors “leads to an altered proprioceptive input to the central nervous system, which then results in a changed tonus regulation of motor units associated with this tissue.” The result is relaxed, freer moving, more pliable tissue.
The autonomic nervous system has also shown to be influenced by oscillating and vibratory movements via the tonic vibratory reflex-TVR (Comeaux, 2011). One of the premises behind the role of the oscillations in the body’s neurophysiology is related to the abundance of rhythmical cycles found both inside and outside of the body. Physiologically, there are rhythms associated with functions such as the heartbeat, breathing, sleep cycles and hormonal cycles in women. Even one’s relaxed, self-regulated gait is rhythmical in nature following the reciprocation of the opposite sides of the upper and lower body utilizing stored elastic energy.
Many disciplines and techniques have utilized the effects of oscillation on the autonomic nervous system. It is a part of osteopathic techniques, joint mobilization, cranial sacral work, facilitated positional release, Trager work (psychophysical integration therapy), and Muscle Energy Technique, to name a few. One trait that is common to all of these techniques is that the patient/client is a passive participant minimizing gravitational forces while lying or sitting.
How Oscillating Motion Can Help Your Clients Move Better
One strategy of improving myofascial mobility during training sessions is to incorporate strategic, oscillating movements grounded in evidence-based principles along with the personal trainer’s personal experience. The neurophysiological pathways elicited through manual therapies mirror those elicited via rhythmical, oscillating movements. These movements prepare the body for more global myofascial mobilization movements.
Fascia adapts its fiber arrangement, length and density according to local demands (Findley, 2009). This follows Davis’ Law of soft tissue modeling. Along with this, both macro and micro trauma will have local effects on arrangement, length, and density with global influences on the body. Habitual postures, repetitive movement patterns and a musculoskeletal health history give us insight into the myofascial restrictions that influence the client’s movement patterns.
Critical Execution Points
Myofascial restrictions will limit motion at the joints. Stretching or mobilizing techniques that approach a joint’s barrier and stress the joint capsule (intimately tied to the intervening fascia) will discharge joint receptors that up-regulate increased muscle tonus around the joint. In addition, the threshold for discharge is likely to be lower in joints that have previously been damaged and not thoroughly rehabilitated or that have experienced degenerative changes. For example, an unstable ankle joint from a previous ankle sprain may respond to rapid, end range or close to end range loading with increased co-contraction of the peroneals, anterior tibialis, toe extensors and gastroc/soleus complex. Therefore, the movements suggested here work in a range below any barriers presented by the joints or myofascia.
Two key variables associated with the oscillatory motion are rhythm and amplitude.
  1. Rhythm relates to the tempo and timing of the movement. The movement should be continuous with no pause or delay at either end of the movement. A gentle, controlled momentum utilizing the stored elastic energy of the myofascial line(s) being addressed is used as part of the motion to produce a sense of “rocking.”
  2. Amplitude refers to the size of the oscillation created by both the range of motion in the direction of the barrier (tissue tension) as well as the return range of motion in which the tissue tension is disengaged. These movements should not approach the associated joint barrier and maximal tissue tension. Instead, the motion should have small amplitude in both the direction of tissue tension and in the direction where tension is removed.
Advantages of Movement-Based Myofascial Release
A physiological advantage to a client actively performing these movements in a gravitational field is the addition of heat and fluid exchange within the tissue created by the muscles associated with the movement (Ingber, 2003). Mechanically, more overall connective tissue can be influenced via movement. Huijing (2007) has shown myofascial force transmission between and within muscles, demonstrating connections between both synergistic and antagonist muscles. Within a muscle fiber, up to half of the total force generated by the muscle is transmitted to surrounding connective tissues rather than directly to the origin and insertion of the muscle fibers.
The overall objective of the oscillatory movements is to reduce myofascial tone so that the range of motion can gradually be improved through the targeted myofascial lines by increasing the amplitude of the movements. As tonus is decreased, the oscillations create a pumping action of the tissue. As range of motion is increased, fascial lines in parallel as well as in series are positively affected.
As the local amplitude of the movement can be increased, the progression would be to include engage more of the myofascial line by involving related anatomical segments. For example, if you were beginning with the oscillating motion focused on the anterior hip joint in the sagittal plane you would begin with anterior to posterior motion of the pelvis on the relatively fixed femur. To progress this, you would gradually incorporate motion of the thorax moving in opposition to the pelvis. Further progression would be incorporate shoulder flexion as a continuation of the anterior thorax, lengthening the myofascial line from hip to hand.
Returning to the ankle joint as the example, limited dorsiflexion is a common movement challenge for many clients. This can be due to myofascial restrictions from the plantar fascia to the hamstrings and/or over activity of the surrounding musculature due to instability-as in the case of chronic ankle sprains.
Oscillating Myofascial Release in Action
A popular technique to address this is through a kneeling lunge (shown below). With this maneuver, the knee is driven over the toes as the heel is kept on the floor. The goal is to move the knee to its maximal range (tissue barrier), progressively lengthening the tissue over time.

Kneeling Lunge

An alternate approach is to use the same positioning, but instead of taking the knee to its maximal range over the toes, a shorter range of motion is reached.  Within this shorter range, we use oscillatory movement, moving into and out of dorsiflexion. As the mechanoreceptors in and around the joint down-regulate activity, the amplitude can be increased, which subsequently increases the range of motion.
A challenge with this strategy is that its success or failure is not immediately observable by you, the personal trainer. Instead, it relies upon the kinesthetic awareness of your client and their ability to sense the reduction in resistance from the tissue and systematically increase the amplitude of oscillations as the body becomes receptive to the movement. One common error is for the client to increase the amplitude prematurely and approach the joint barrier.
The video below provides additional examples of movement-based myofascial release techniques you can use with your clients:

Strategic movement can be an adjunct or complimentary strategy your client uses for self-myofascial release in combination with tool assisted devices on the fitness floor. Both forms of myofascial release will benefit the client as will manual treatments by a trained therapist.
If we can agree that the body is in fact a rhythmic structure, then with oscillating movements you are creating rhythm where rhythm is not present due to myofascial restriction. By following a philosophy of “ask – don’t tell the body,” you can work with the body versus against it to actively improve function of the myofascial system.
Cantu, R.I., & Grodin, A.J. (2001). Myofascial Manipulation: Theory and Clinical Application.Austin, TX: PRO-ED, Inc.
Comeaux, Z. (2011). Dynamic fascial release and the role of mechanical/vibrational assist devices in manual therapies. Journal of Bodywork & Movement Therapies 15, 35 e 41.
Findley, T. (2009). International Journal of Therapeutic Massage and Bodywork, 2(3): 4-9.
Huijing, P.A. (2007). Epimuscular myofascial force transmission between antagonistic and synergistic muscles can explain movement limitation in spastic paresis. Electromyography and Kinesiology, 17(6): 708–724.
Ingber, D.E. (2003). Tensegrity II. How structural networks influence cellular information processing networks. Journal of Cell Science, 116: 1397-1408.
Klinger, W., Schleip, R., & Zorn, A. (2004, Nov.). European Fascia Research Project Report. 5th World Congress Low Back and Pelvic Pain, Melbourne, Australia.
Myers, T.  (2001).  Anatomy Trains:  Myofascial Meridians for Manual and Movement Therapists.  New York, NY:  Churchill Livingston.
Schleip, R. (2003). Fascial plasticity – a new neurobiological explanation. Journal of Bodywork and Movement Therapies 7(1):11-19 and 7(2):104-116.
Schleip, R., Klingler, W., & Lehmann-Horn F. (2005). Active fascial contractility: fascia may be able to contract in a smooth muscle-like manner and thereby influence musculoskeletal dynamics.Medical Hypotheses, 65: 273–277.
Schleip, R., Duerselen, L., Vleeming, A., Naylor, I., Lehmann-Horn, F., Zorn, A., Jaeger, H., & Klinger, W. (2012). Strain hardening of fascia: Static stretching of dense fibrous connective tissues can induce a temporary stiffness increase accompanied by enhanced matrix hydration.Journal of Bodywork & Movement Therapies, 19: 94-100.
Stecco, C., Gagey, O., Belloni, A., et al. (2007). Anatomy of the deep fascia of the upper limb. Second part: study of innervation. Morphologie, 91: 38–43.
van der Wal, J. (2009). Connective Tissue Architecture and Proprioception. International Journal of Therapeutic Massage and Bodywork, 2(4).
Yahia, L. et al. (1992). Sensory innervation of human thoracolumbar fascia. Acta Orthopaedica Scandinavica 63(2): 195-197.

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