Home Care

People who suffer from chronic pain do not move properly.  The body at the same time is constantly healing itself.  It relies on proper motion to maintain the freedom of motion in all the place that need to move.  When people don't move properly or suffer trauma or injury their muscles tend to adhere to tissue restricting movement.   People tend to compensate for this lack of movement but the results are usually restricted range of movement and pain.

Muscles are covered with a sheath of connective tissue (fascia) that helps them glide over surrounding tissues.  This tissue can loose its pliability and stick to adjacent muscles, bones or ligaments.  Fascia also covers and separates most tissues in the body.  The specific fascia that covers muscles is referred to as myofascial tissue.  

Fascia is continually being created.  Without proper movement the facial fibers will cross link and and restrict movement or bind muscles and nerves creating pain.  After injuries this is especially true when large amount of fascia are formed as scar tissue.  These adhesions bind muscles to other tissues including other muscles, nerves, bones and more.  They inhibit the muscles from moving properly.   If nerves are adhered they are not free to slide past other tissues when they move or can become restricted.

Fascia responds to a gentle differential stretch but when you exceed the proper tension it does not release no matter how long you hold the tension.  It appears under light force (shear) to be thixotropic (more fluid over time, under shear).  You have to use just enough stretch to engage it but with more, it behaves like a dilantantic substance (like corn starch and water or silly putty) which is less fluid under sheer.  Most thixotrops will liquefy even more when the shear force or time increases.  It seems that fascia deforms under low shear but resists high sheer. 

The gel like fluid between the fibers called "ground substance" is thixotropic and the collagen fibers are dilantantic so that to stretch the fascia you need enough force to get it to move but not so much that the collagen fibers lock.  This is why you are able to break the weaker cross links and get more mobility yet the normal collagen fibers prevent more vigorous stretching from breaking the cross links.

Scar tissue is fascia with fibers that go every which way.  Breaking some of the fibers except those that are aligned in a useful direction converts the scar tissue to normal fascia.  In actuality you will never get perfectly aligned fibers but we can add more flexibility to scars tissue and remove adhesions to surrounding tissues.

Releasing myofascial adhesions is referred to as myofascial release.   

Using subtle but precise tension for myofascial release, relies on the body's own natural wisdom to determine the proper course of action.  The fascia comprise of a complex interconnected web within your body to support and protect soft tissues.  If the therapist attempts a release that  is not right, the release will not happen or the tension will reappear.  Sometimes we have to do things in a specific order that may be different from the normal order because the body to protecting an injury and problem. 

The most straight forward technique is to stretch a single muscle a the origin and insertion (each end).  If you stretch the muscle by itself you will create a differential stretch between that muscle and the surrounding tissue.    Hold the stretch until you feel it release or relax.  Typically this is only a few ounces.  It works best if you can accurately visualize the muscle.  Anatomy books help.

Stretching stressed muscles at the origin and insertion has the advantage that the golgi organ is located where the muscle and tendon join.  This is the muscle's strain gauge.  Putting pressure her can cause the muscle to relax because it feels that it is too tense.

Don't fret about thinking if this in totally mechanical terms.  What we perceive is a combination of rational and extra rational.  (maybe a bit of irrational as well)  The rational is easy to understand and cultivate but the extra-rational is direct perception.   Some call it intuitive.   If you treat a person in a logical manner from a totally rational perspective you will miss much of the person.  We are too complex to totally understand by breaking our observations into components and putting together a view of a person for the component parts.  There is much we how and can not explain why.  We need to restrict how we treat people to the rational when the consequences of a wrong decision are potentially harmful.  That is why medicine restricts itself to scientifically based treatment.

Because this type of work is safe, it benefits for a combinations of a studied approach and hunches.  If you feel that a stretch of this part in this direction came into you head for no explainable reason then maybe you are picking up on something that while you can not explain is non the less a valid thing to do.   The proof that this tough is valid is the outcome after trying it.

With experience you can learn to sense which hunches are good or not.  After a while you can learn to balance a systematic approach with what becomes an unspoken direct dialogue with the body.

If you want to try this with your partner you need to do so in a peer to peer relationship not one of therapist to patient.  It is the patient who is doing the healing and are not being "fixed".   It is a mutual exploration of the body.  The stretches and touch are to help the body understand how to heal itself.

Performance anxiety is the best way to insure that this does not work.  The pain especially if it is severe may create stress in both parties.  Often it is better to try this at first when the pain is less.   Patience, humor and playfulness are good.  Talking can also distract someone from getting too serious.  Rejoice in your successes understanding that if you don't succeed you are no worse  Often if you are not getting a response you are trying too hard.  You can work deep in the body with a very light touch.