Myofascial Release: What Are We Doing/How Does This Work?
 
Through the course of treatment, you will probably hear your therapist mention the terms fascia, connective tissue, scar tissue, adhesions or lesions. These are all words for the exact same thing: the tissue that contains, adheres to and shapes every structure in your body. It surrounds every muscle fiber (cell), every bundle of fibers, and every muscle belly, as well as tendons and ligaments. This tissue lies between muscles, muscles and nerves, and muscles and vascular tissue (arteries and veins). In some places it appears as a fuzzy gauze, others plastic wrap-like sheaths, and still others thick binding straps.
 
Your body is producing connective tissue continuously, particularly when you sleep. In the case of an acute injury like a muscle strain or tear, the body lays this tissue down to stabilize the area while it heals. But it isn’t necessary to have an injury for excess fascia to be formed; even a slight oxygen deficit produced in muscular tissue by continual contraction is enough to trigger the cascade of chemical reactions that creates it. Think of spending long hours doing any repetitive task, be it a sports movement, manual labor, or typing all day at a desk with a rounded posture and forearm muscles endlessly working. Do these activities day in, day out without break, corrective exercise, stretching or proper hydration and it becomes not a matter of if adhesions will occur, but when.
 
So what’s wrong with your body using fascia to reinforce muscular tissue? In and of itself, nothing, and it is in fact a necessary process. The problem arises when the tissue, whether through injury or overuse, is not moved through its full range of motion. At this point, scar tissue can inhibit the muscle from fully lengthening or contracting properly. Constrictions allow even less blood into the area, contributing to trigger points. Nerves become entrapped. Lesions develop between muscles, preventing them from sliding past one another, and their attachment points to joints become strained. Further, bound tissue in one structure of the body can cause multiple compensations in other areas, causing overstress in muscles, tendons, ligaments and joints that may be far removed from the original cause. The end result? Diminished function, atrophy, decreased range of motion and pain.
 
The good news is that this tissue responds well to manual therapy. Fascia tends to be malleable, and much like stretching a plastic sheet, once lengthened it tends to retain its shape. By putting tension into adhesions and moving the affected area through a full range of motion, the therapist can mechanically “break up” problem areas and restore function. Releasing these tissues can be painful, but this is a temporary condition with benefits far exceeding momentary discomfort. 
 
All this does not mean, however, that if a client continues to practice the same habits that caused the issue in the first place that the problem won’t reappear. One hour a week with your LMT cannot outweigh the 167 other hours in that week without some effort on your part. Proper stretching, corrective exercise, modifying activities, movements and workstations to allow for good posture, sleep habits and hydration are all key in the healing process. But together with manual therapy, making these changes will contribute to very successful treatment outcomes and a permanent end to pain and loss of function.
 
By B.A. Martens, LMT