Self-Myofascial Release: Helpful or a Waste of Time?
The data seems to indicated “Meh” on Self-Myofascial Release.
You hear the term “self-myofascial release” a lot these days, but what is it and what does it do? Let’s talk about it.
Self-myofascial Release Defined
Self-myofascial release, or SMR, are the collection of techniques that involve the use of a firm density foam roller or massage roller device to purportedly effect change in the tension of the fascia, the body wide system o-f connective tissues that hold the body together.
Without fascia we’d be bag of skin filled with flesh with a bunch of bones sticking out in random directions!
So SMR is another way of saying foam rolling, but what does it purport to do?
Proponents of SMR tout many benefits: decreased pain, improved flexibility, among other benefits. But what does the data say?
According to a 2019 meta-analysis of research on self-myofascial release, SMR was found to be only negligibly effective on strength and flexibility during foam rolling prior to exercise, offering very short term increases in flexibility and jump. Post-rolling slightly decreased the severity of DOMS, or delayed onset muscle soreness, but had small effect on strength and flexibility.
What Works?
Myofascial Release Therapy as performed by a trained and experienced massage therapist is an effective, comfortable and safe bodywork therapy that can demonstrate positive results for many pain conditions, including for pre- and post-exercise events.
Paul Brown, CMT (that’s me!) has the training, experience and know-how to accomplish your pain and performance goals.
In a nutshell: fascia holds us together. Myofascial Release Therapy can help you: You Don’t Have to Hurt
Myofascial Release Therapy (MRT) is a type of massage that focuses on releasing tension in the fascia, the connective tissue that surrounds your muscles and organs. Myofascia is myo- = muscle, and fascia = connective tissue, specifically the connective tissue involving your muscles and tendons. MRT is a specific technique used in massage therapy to apply gentle pressure to the fascia to help it decrease tension and improve range of motion.
What is the fascia?
The fascia is a thin, elastic, web-like tissue that surrounds your muscles, organs, and bones. It is literally the glue that holds our body together. It forms our system of connective tissue, the tendons, ligaments, aponeurosises and fascial sheets. Without it, we would just be a blob of tissue on the ground with a bunch of bones sticking out! It also helps to transmit force throughout your body through its property of elasticity. As you can imagine, fascia is an important component of our bodies.
Composition of Fascia
Fascia is made up of two main components:
Collagen – this protein makes up the majority of material in fascia. It provides the basic structure of fascia. Collagen forms into thin sheets which surround and penetrate all other tissues in our bodies.
hyaluronic acid, which acts as a lubricant between the sheets of fascia, and it resists compression. This fluid can become glue-like and cause the facial sheets to adhere to each other, limiting range of motion and increasing pain.
When the fascia becomes tight or restricted, it can cause pain and limit your range of motion.
What is Myofascial Release Therapy
MRT is a hands-on treatment that uses a variety of techniques to release tension in the fascia. These techniques can include:
Longitudinal Release
Deep Transverse Friction
Passive and Active Stretching
Trigger point therapy
Client-active Pulse Therapy
Joint Mobilization
Sustained Cross-handed Holds
MRT can be used to treat a variety of conditions, including:
Typically, MFT is performed on a massage table that has been lowered more than it would normally be for a Swedish Massage. This is to ensure that the MT’s legs and hips can really provide more power to the hands.
How does Myofascial Release work
Myofascial release is a specific technique used in myofascial therapy to apply gentle pressure to the fascia to help it release tension. The therapist will use their hands to apply pressure to the fascia in a slow, sustained manner. This pressure helps to break up the adhesions and scar tissue that can cause the fascia to become tight.
Warm Up
Before performing the MFR strokes, it is necessary to warm up the tissues to be worked. This can be done with a couple of strokes: friction circles, tissue compression, or the dreaded skin rolling. I’m just joking about it being dreaded; some people actually enjoy it! (I’m not one of those people.) But after several minutes of warm-up strokes, the main action can take place.
Sustained Holds
A typical example of this technique is the sustained hold. There are a few ways of doing this: trigger point therapy, where direct perpendicular pressure is applied to the tender nodules until the soften and release; cross-handed hold, the therapist places each hand at the insertion points of a muscle and applies oblique, sustained pressure, which encourages the fascia to “unwind;” and eccentric holds, allowing muscles that mostly perform eccentric contractions to release into their shortened, relaxed state.
Longitudinal Release
As its name suggests, longitudinal release (LR) works with the direction of the muscle fibers, that is to say, lengthwise, or parallel to the muscle fibers. Hands are vaulted and stacked for stability and support, and a “slack-sink-stroke” technique is employed. Strokes are short but powerful, pressure should be at the perfect amount for client comfort. LR will bring about a lengthening of the affected muscle to help improve range of motion.
Deep Transverse Friction
The purpose of deep transverse friction is to reduce pain and adhesions through two strokes: slack-sink-stroke and sawing. These strokes are performed with increased pressure, but still at the client’s comfort level, perpendicular to the direction of muscle fibers.
Myofascial release can be a very effective treatment for a variety of conditions. It is often used in conjunction with other treatments, such as physical therapy, to help improve range of motion and reduce pain.
Benefits of myofascial therapy and release
This type of therapy can offer a number of benefits, including:
Reduced pain
Improved range of motion
Increased flexibility
Reduced inflammation
Improved* circulation
Reduced stress
Improved sleep
improved mood
Why choose me as your Myofascial Therapist?
You’ve come to the right place, as I’ve been a Myofascial Release Therapist since 2003. In fact, I’m a walking anatomy encyclopedia, in the best way. Given that, I use this knowledge to guide you through the process of MRT, by explaining what and why, and coaching your breath work. My unique approach to this style of massage is unmatched in this region and will achieve the results you seek. Come and see. You. Don’t. Have. To. Hurt.
What to expect during a myofascial therapy session
First things first: follow these massage prep suggestions – they will make your session a much more comfortable, relaxing and productive experience.
A typical myofascial therapy session will last for 30-90 minutes. During the session, I will assess your pain and range of motion. I will then use a variety of techniques to release tension in the fascia. We will work together in a collaborative manner to achieve your goals. You may feel some discomfort during the session, but it should not be severe.
Aftercare
After a myofascial therapy session, you shouldn’t feel soreness. But if you do, gentle stretching and movement like a 20 minute walk will help. An over the counter pain reliever like aspirin, acetaminophen, ibuprofen, or naproxen can help the next day, but is usually unnecessary.
Drink plenty of water, as this will help your body as it adjusts and rebalances itself to accommodate the changes in your body.
Make sure you get enough sleep, as this is the time your body needs to reset and repair.
Is myofascial therapy safe?
Myofascial therapy is generally safe for most people. However, it is important to talk to your doctor before starting treatment if you have any health conditions, such as:
The dreaded words no one wants to hear, “you’ve got a rotator cuff tear,” but what is that and what can be done about it? You don’t have to hurt.
What is the Rotator Cuff?
Rotator cuff muscles. Image by O. Chaigasame
The rotator cuff is comprised of four muscles that help the shoulder turn on various axises as well stabilize the ball and socket that is the glenohumeral joint. the four muscles are:
These densely textured muscles provide the majority of the torque for starting medial and lateral rotation, abduction, as well as continuing to provide a lesser amount of torque as the larger muscles that are the synergists take over the majority of the action. Additionally, they hold the head of humerus (the ball) in the glenoid fossa (the socket) to keep the joint stable. Without them, other muscles not as evolved for the job must be recruited to help. So you can see why they are so important, and the kinds of problems that emerge when they are injured.
Even when they are not performing their skeletal action, they are still eccentrically contracting for stability, so even when they aren’t acting, they’re acting! Such divas!
What is a rotator cuff tear?
A tear in the rotator cuff is an injury of the tendons that attaches the muscles to the head of the humerus. It can be a partial or complete tear. The most common injury is the supraspinatus tendon near to where it attaches to the humerus, then an infraspinatus tendon, then a dual supra- and infra- spinatus tear. Less common are tears of the teres minor and subscapularis.
Signs of a rotator cuff tear
Shoulder pain is the first sign, especially in the front of the shoulder; difficulty raising the arm and reaching behind are also signs. The pain will most likely be worsened during those actions. For me as a massage therapist, the torn tendon can, with careful touch, be palpated. And while MTs cannot diagnose, we can and should strongly advise seeking medical care.
Treatment of rotator cuff injuries
Depending on the severity of the tear, treatment can range from NSAIDS all the way up to surgery to repair the tendon, with physical therapy to retrain the shoulder.
How can massage help?
Massage can be a helpful and effective adjunct in the treatment of shoulder injuries. During the immediate post-operative period, light soothing massage can help reduce pain and anxiety, and some gentle full body joint mobilization will also deepen the relaxation process, which can help in making the perception of pain decrease. A calmer and more present-centered mind will help make the healing process more manageable, and massage can help make that happen. While the shoulder is early parts off the healing process, massage on that shoulder is contraindicated.
Massage is an important adjunct to physical therapy. Being in consultation with the patient’s PT is the best way to tailor your treatment strategy for them . The primary post-surgical massage treatment for rotator cuff tears is Myofasci al Release. Getting the fascia to release while physical therapy is happening will increase the effectiveness of the PT, and will help the tendons affected heal faster.
I really like listening to my clients, it feels important to let the space be about listening: to their breath, but also to the fascia. Very gentle effleurage, like a whisper, while listening to the superficial fascia: they are the herald of their brethren. If you listen really carefully with your twelve ears the superficial fascia will conspiratorially share their secrets.
They key is to work at the level of the strategic herald, while evaluating what that level is, and matching via therapeutic present-centeredness. I meet the client/patient where ever they are, don’t try to impose any particular therapeutic strategy, as their needs change from session to session.
You Don’t Have To Hurt
The best defense against a rotator cuff tear is self-care: rest, nutrition, stretching, strength training, and bodywork. And while I can’t ensure you get those first four items, I can provide the fifth: the best massage therapy in Sacramento. Because like I always say, “You don’t have to hurt”
Lower back pain: millions of people experience it every single day, and there are many potential causes, but one that is sometimes overlooked is the gluteus medius muscle, a broad swath of muscle on the lateral aspect of the hip.
What does the gluteus medius do?
The gluteus medius muscle is the most important muscle for hip abduction (opening the hip to the side), and less important in flexion, medial rotation, and lateral rotation. It is similar in function to the deltoid in the shoulder.
Signs of gluteus medius pain
A person might experience pain in the upper buttock and lower back when walking, laying on one’s back or affected side, or when slouching in a chair. “Lumbago,” as it used to be called, but now referred to as Lower Back Pain, is some of the most debilitating myofascial pains that we have, and can effect one’s mental health, especially in men, where depression is often an underlying cause of low back pain. LBP causes a drag on the US Economy, in the millions of dollars.
Gluteus Medius Massage
Massage can release tight gluteus medius muscles, with especially tight spots responding well to both ischemic compression and deep transverse friction. Get a massage!
Gluteus Medius Self-care
There are a number of good stretches that target the gluteus medius muscle:
Take Careof your Gluteus Medius…
and your Gluteus Medius Will Take Care of You!
So, you can see that there are many ways you can do stretch the gluteus medius muscle. But another effective method is my personal favorite: get a massage! When a muscle has been loosened up from the mechanical action of professionally applied therapeutic massage, it will be much more able to stretch and be pain-free!
Did you know that the most commonly injured rotator cuff muscle is
the small but mighty supraspinatus?
It’s true. Because of how the muscle is located on the body and in
relationship to the acromial clavicular joint and the humerus, it’s
often caught in a scissor-like pincing and can be torn pretty easily.
Also,
the supraspinatus can be the source of referred pain in the shoulder
and elbow, sometimes masking as lateral epicondylitis, or tennis
elbow. But as we will see, the tricksy supraspinatus is a naughty
culprit.
Signs
and Symptoms
Pain
in the front of the shoulder, the lateral epicondyle are both signs
that the supraspinatus muscle may be involved. Also, if you have
difficulty with tasks that involve holding the arms up, like riding a
bike, folding laundry, raking, or other activities, the supraspinatus
could be involved. Finally, if you hold your smartphone with the
hand of your affected arm, like playing pokemon go, for instance, or
lots of texting, the supraspinatus would be implicated. As you can
see, this a muscle that gets involved with a lot of actions!
Anatomy
As
you can see in the diagram, the supraspinatus originates in the
medial side of the supraspinus fossa, the “basin” at the top of
the scapula, directly superior to the spine of the scapula. From
there, it moves laterally, diving under the spine and clavicle at the
AC joint, where it attaches onto the greater tubercle of the humerus
bone. It’s action is the abduct the ball and socket joint of the
shoulder. Also, it helps stabilize the shoulder joint. So you can
see that the supraspinatus does a lot.
Referred
Pain Patterns
You
can see the referred pain patterns in red, and the corresponding
trigger points. The first illustration, the most lateral trigger
point causes a deep aching tenderness right at the point of the
trigger point. In the second, the trigger points in the muscle belly
can also cause the shoulder joint pain, but also the pain in the
lateral epicondyle, which is where the muscles of the back of the
forearm (posterior compartment) attach onto the outside of the upper
arm, just above the elbow. It can also have radiating pain from
shoulder toward elbow, or elbow toward wrist.
Treatment
The
best treatment for supraspinatus trigger points is deep focused
trigger point massage by a qualified massage therapist, physical
therapist, chiropractor, osteopath or physician. There are some self
treatments, but it can be difficult to access the muscle due to it’s
inconvenient location. But if you have a self-care tool like a
theracane or back knobber, you can get pinpoint pressure right where
it’s needed.
Of
course, a therapeutic bodyworker is also going to know the other
muscles that could potentially be involved with shoulder or elbow
pain, so if you can, book an appointment to get the thorough care you
deserve!
If you are experiencing shoulder or elbow pain, please call me at 916-534-8772 or book online anytime.
Ive been to alot of massage therapists and Paul is the absolute best its hard to find someone who does this with the same amount of attention and expertise.Whiterose Fortuna
The husband and I took Paul’s couples massage workshop for our date night! It was amazing! It was a completely new experience that was connective, interesting and fun. We learned techniques and got to apply those skillsets that made us realize just how much fun date night can be. Paul has a true passion for massage and appreciated his demonstrated genuine care throughout the session. He was not only excited to share his knowledge with us but incorporated his mastered knowledge of the body to help us understand how to give a professional massage to people we love the most. So glad we got to take this workshop. Enjoyed every moment.Cassandra Harris
Paul is wicked smart and is very knowledgeable about the body. And he totally geeks out over it! This makes his massages very effective! I’ve been getting massage for many years. Some really good. Some meh. I really enjoy deep tissue work. Paul is very effective!Nancy Johnston
Paul is a fantastic and knowledgeable massage therapist! He helped me by working out several areas of tension in my back and hips. I truly felt rejuvenated and considerably less tense after working with him.Caroline Basile
Paul knows how to work muscles I didn't know needed working.Timothy Koch
Thanks Paul very much for your superb service!! It hurt so good lol. I hope that we will get together soon. Great job and many more thanks!!Perry Trowbridge
Exceptionally knowledgeable when it came to addressing my long standing back issues and providing me the tools to help myself feel and stay better, besides being a great massage therapist.Bryan Sperrazza
A consummate professional. He loves and continually educates himself in the study of anatomy and massage therapy, and you'll feel it in all the best ways. Body, mind, and spirit. You won't be disappointed. I highly recommend.Steve Scott
