Self-Myofascial Release

A movement compensation leads to inflammatory responses in tissues that get overstressed, and if left unchecked can result in excessive calcium and fat deposits (Patterson). These excesses and deposits cause joints to move off axis and contractile tissues to work much harder to attain the ranges of motion crucial to sports movement.

Self-myofascial release techniques (SMRT), is a safe and effective hands-on technique that involves applying gentle, sustained pressure into the myofascial connective tissue restrictions to eliminate pain and restore motion. Two key terms to review, so you appreciate how SMRT acts favorably on the body are fascia and trigger points.

Fascia is a general term used to describe the connective tissues of the body. A sample of fascia is the shiny stuff that covers and divides your T-bone steak into those little compartments before you cook it. These dense connective tissue sheets play an essential role as force transmitters in human posture and movement regulation. Collagen is the primary structural component of fascia and is proportionally stronger than a steel cable allowing a maximum distribution of load with a minimal framework. However, when this tissue becomes dysfunctional — referred to as knots, ropes, gristle, adhesions, and scar tissue — they can be a significant cause of movement restriction and pain.

Keyterm: Collagen is the most abundant protein in your body. It is the major component of connective tissues that make up several body parts, including tendons, ligaments, skin, and muscles.

Myofascial pain syndrome (MPS) is a chronic pain disorder. In this condition, pressure on sensitive points in your muscles called trigger points (TP) are painful to palpation (touch) and get designated by the presence of taut bands. By association, myofascial trigger points are to MPS as pimples are to acne. TP in fascia restricts and alter joint motion that disrupts regular neural feedback to the central nervous system. The disruption impacts mechanical efficiency causing premature fatigue, chronic pain, less efficient motor skill performance, and potential injury. Trigger points get produced by acute physical trauma, poor posture or movement mechanics, limited rest between training sessions, and nutritional factors.

Training and sport put soft tissues under tremendous tension and stiffness — part of the game. Therefore, SMRT is an easy way an athlete can alleviate trigger points and soft tissue restrictions. To perform SMRT exercises, you will need a foam roll which comes in a variety of options and shapes.

• Rollers – Great for overall use on larger muscle groups.
• Foam Roller – This is the original myofascial release tool. It comes in different densities. Typically the blue/white ones are softer, and the black one is firmer.
• PVC Roller – More firm than the foam type and easily made at home. Great to have when your muscles need more pressure with a firmer surface.
• The Grid – The TP Therapy Company produces this roller at 5 inches in diameter to target more into the muscles. It’s easily portable as well.
• Quad Roller – Great for targeting the legs and calves by use of a small rod covered with light padding attached to two wheels.
• Rumble Roller – The same base as a regular roller, but has tiny ridges that cover the entire roller to give precise pressure to the muscle tissue.
• Balls – Typically used on smaller muscle groups to reach areas that are less accessible with a roller. Depending on what muscles need attention, choose a size and density that will quickly get into the troubled regions. Other small sports ball options include golf, tennis, lacrosse, softball or even a medicine ball work best on your feet, calves, glutes, lower back, and shoulders.
• Manual Resistance – If you do not have a roller or any sports balls, your own hands or elbow can do the trick on specific areas. For example, try applying pressure to your thigh by use of your elbow. It’s a simple way to release trigger points and learn where tension is in your body.

To begin the SMRT exercise, roll on relaxed muscle until a trigger point is found (painful area). Hold for 30-seconds or 10-deep breaths to reduce any tense reflexes caused by discomfort. You want to count or breath until you feel the pain of the trigger point fade somewhat. If the pain doesn’t fade, readjust and try again by applying less pressure or use a softer roller. Holding your position and counting and breathing is critical. Instead, if you roll around, you will be wasting time. That’s the equivalent to bouncing while you stretch and it doesn’t work. Wherever you feel the most tenderness is where you want to count longer because those are the areas you need the most work and will benefit the most from SMRT.

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SMRT Patterning involves bending and extending joint in isolation. When a TP gets located, flex the joint through a full range-of-motion at a pace of 6-seconds up and down (concentric and eccentric) for 30-seconds or 10-deep breaths. Similar as before, you want to count or breath until you feel the pain fade somewhat. Readjust and try again by applying less pressure or a softer roller. The advantage of SMRT Patterning is that it allows you to practice the exact (or close to the accurate) movement that is trying to be improved. Furthermore, it creates a healthy neurological relationship while addressing tissue motion.

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Performing SMRT exercises is relatively easy to administer, but there is a simple way to ensure you are doing it correctly. Perform a movement before SMRT exercise and then perform the same action afterward and note if making changes:

• Pain reduction
• Feeling of ease and smoothness in motion
• Increased range of motion
• Reduced inflammation

SMRT Bibliography

1. Scanlon, V.C., and Sanders, T. Essentials of anatomy and physiology, 3rd edition. Canada: F.A. Davis Company. 2002
2. Schleip R, Klingler W, Lehmann-Horn F. Active fascial contractility: Fascia may be able to contract in a smooth muscle-like manner and thereby influence musculoskeletal dynamics. Med Hypotheses. 65(2):273-7. 2005
3. Borg, S. et al. Trigger points and tender points. One and the same? Does injection treatment help? Rheum. Dis. Clinics of North America. 22(2). 1996
4. Vecchiet, L., Giamberardino, M.A., Saggini, R. Myofascial pain syndromes: clinical and pathophysiological aspects. Clin J Pain. 7 Suppl 1:S16-22. 1991
5. Saggini, R., Giamberardino, M.A., Gatteschi, L., Vecchiet, L. Myofascial pain syndrome of the peroneus longus: biomechanical approach. Clin J Pain. Mar;12(1):30-7. 1996
6. Hanten, W.P., Olson, S.L., Butts, N.L., Nowicki, A.L. Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points. Phys Ther. Oct;80(10):997-1003. 2000
7. Hanten, W.P. et al. Effects of active head retraction with retraction/extension and occipital release on the pressure pain threshold of cervical and scapular trigger points. Physiotherapy Theory and Practice. 13(4). 1997
8. Hou CR, Tsai LC, Cheng KF, Chung KC, Hong CZ. Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity. Arch Phys Med Rehabil. Oct;83(10):1406-14. 2002
9. Patternson, M. The Journal of the American Osteopathic Association, September 2015, Vol. 115, 534-535. doi:10.7556/jaoa.2015.110