Stretching vs myofascial release

[Edoardo Roberto Cagnola]

I'm following the stretch courses and they are great. Before I used to follow my own stretch protocol (that was very inefficient compared to the courses) in which I also implemented some myofascial release self massage with a tennis ball. Today I saw my ball and I decided to give it a try after all these months. It wasn't nearly as painful as it used to be, which suprised me. Is there a correlation between the two? Does one make the other unnecessary? If not, do you think that it is worth implementing this kind of massages in our regimen?

Thank you for your attention

[Chris Garay]

Hi Edoardo,

 

Great question. Hopefully Wes, Mark, Cory, or Coach will chime in. In my view, correct stretching can change the elasticity of the fascia, at least temporarily if not long-term. When you say that the self-myofascial work was not nearly as painful after the stretching, then I'm guessing that you are storing less neuromuscular tension in those areas than beforehand.

 

I think myofascial release has its benefits, but it is important to realize that you will still need to stretch in order to gain flexibility. Working with a qualified and educated manual therapist seems to be the best bet here. When that option is unavailable, then perhaps that is where self-myofascial work such as tennis balls or foam rollers come into play.

 

Stretch well,

Chris

[Alessandro Mainente]

PNF has some benefits very similar to fascial release if done correctly, this is my primarily stretching technique. you can pass days, weeks and months understand what is the exercises for you, the number of contractions and the number of series. in therms of relaxation the titin is equally relaxed in soleus muscles of a rat by pressure and fascial release but also with alternated contraction (withe elettric stimulation) and relaxation with springs.

[Edoardo Roberto Cagnola]

Thanks guys, a lot of food for thought here!

Stretching, finally done right (thanks Coach), as done and will do wonders for me as far as lengthening my muscles. I was looking into this massages more as a form of "recovery helper", kind of like ice baths, if that makes any sense

[Wesley Tan]

What a great topic you have brought up Edoardo!

 

I love it! There is definitely a correlation to how tender or sore muscles feel and how much tension they are holding. By tension I refer to the degree of muscle tone a muscle(s) has, which can be thought of as a continuing force to resist stretching even when the muscle is not actively contracting. 

 

So plainly speaking and simplifying the topic greatly, the more relaxed a muscle is the less painful it will feel when pressure is applied to it. I see this everyday in the patients I treat. Some are extremely tender and sensitive, and this refers to areas they may not usually feel pain in, where as others feel only pressure and hardly any pain, to the same degree of applied pressure.

 

There is a an innate bond to what we feel and how we move, between your sensory and motor sides of your nervous system. Two major centres in the brain, the primary motor cortex and sensory cortex lay alongside each other and are in a continual state of information exchange and adaptation.

 

For motor neurons, you have those that start in the brain, Upper motor neurons, and those that start in the spinal cord, lower motor neurons. The upper motor neurons synapse with the lower ones which then go on to innervate the muscles directly. One of the roles of the upper motor neurons is to actually inhibit the activity of the lower motor neuron, which when activated causes contraction of motor units within a muscle. In certain brain lesions such as  those caused by a stroke or with cerebral palsy, one of the symptoms is spastic paralysis. Besides losing voluntary control of the muscles, the muscles remain in a state of contraction as the lower mortor neurons have no inhibition from above (the brain). These muscles are very tender and extremely sensitive to pain when massaged or stretched. I site this here because this is a clear example of how chronically tight muscles become very sensitive.

 

Besides the obvious lack of movement, there is also a breakdown between the sensory and movement sides of the nervous system. Stretching and/or massage/myofascual release provide a much necessary dialogue between the motor and sensory sides of the nervous system. I believe this is crucial for healthy tissues. I like using an analogy of the mind and body having a relationship like family. When you don't use a body region properly, or to put it another way, neglect that part for some time, when you eventually use it it complains like hell! Once your mind and that body part have reacquainted themselves sufficiently and dialogue is once again open and honest, it feels much better.

 

Another interesting fact is regarding the innervation of fascia itself. It has been shown to contain a large amount of free nerve endings, some of which are believed to be involved in the perception of pain but others that are involved in the control of local blood flow. When stimulated they can create dilatation of capillaries (through neural reflexes) boosting local blood flow and of course promoting tissue health. Under stimulated tissues therefor have a reduced amount of blood flow and all the metabolic complications associated.

 

Sorry to digress and go overboard a wee bit, but I love this stuff, thinking about the magic of physiology that goes on silently without us even being aware of it! 

 

Stretch regularly, massage yourself and even better treat yourself to regular massages or treatments too.

 

Wes

[Keilani Gutierrez]

What a great topic you have brought up Edoardo!

 

I love it! There is definitely a correlation to how tender or sore muscles feel and how much tension they are holding. By tension I refer to the degree of muscle tone a muscle(s) has, which can be thought of as a continuing force to resist stretching even when the muscle is not actively contracting. 

 

So plainly speaking and simplifying the topic greatly, the more relaxed a muscle is the less painful it will feel when pressure is applied to it. I see this everyday in the patients I treat. Some are extremely tender and sensitive, and this refers to areas they may not usually feel pain in, where as others feel only pressure and hardly any pain, to the same degree of applied pressure.

 

There is a an innate bond to what we feel and how we move, between your sensory and motor sides of your nervous system. Two major centres in the brain, the primary motor cortex and sensory cortex lay alongside each other and are in a continual state of information exchange and adaptation.

 

For motor neurons, you have those that start in the brain, Upper motor neurons, and those that start in the spinal cord, lower motor neurons. The upper motor neurons synapse with the lower ones which then go on to innervate the muscles directly. One of the roles of the upper motor neurons is to actually inhibit the activity of the lower motor neuron, which when activated causes contraction of motor units within a muscle. In certain brain lesions such as  those caused by a stroke or with cerebral palsy, one of the symptoms is spastic paralysis. Besides losing voluntary control of the muscles, the muscles remain in a state of contraction as the lower mortor neurons have no inhibition from above (the brain). These muscles are very tender and extremely sensitive to pain when massaged or stretched. I site this here because this is a clear example of how chronically tight muscles become very sensitive.

 

Besides the obvious lack of movement, there is also a breakdown between the sensory and movement sides of the nervous system. Stretching and/or massage/myofascual release provide a much necessary dialogue between the motor and sensory sides of the nervous system. I believe this is crucial for healthy tissues. I like using an analogy of the mind and body having a relationship like family. When you don't use a body region properly, or to put it another way, neglect that part for some time, when you eventually use it it complains like hell! Once your mind and that body part have reacquainted themselves sufficiently and dialogue is once again open and honest, it feels much better.

 

Another interesting fact is regarding the innervation of fascia itself. It has been shown to contain a large amount of free nerve endings, some of which are believed to be involved in the perception of pain but others that are involved in the control of local blood flow. When stimulated they can create dilatation of capillaries (through neural reflexes) boosting local blood flow and of course promoting tissue health. Under stimulated tissues therefor have a reduced amount of blood flow and all the metabolic complications associated.

 

Sorry to digress and go overboard a wee bit, but I love this stuff, thinking about the magic of physiology that goes on silently without us even being aware of it! 

 

Stretch regularly, massage yourself and even better treat yourself to regular massages or treatments too.

 

Wes

a gem amongst the mobility forum. definitely saving this bit of info in my word doc of goodies.

gracias, Wes!

[Edoardo Roberto Cagnola]

Wow, that was amazing! Thank you so much Wes, I think a lot of people will love this "digression" of yours

[Xabier Errea Mayo]

On 7/7/2015 at 8:07 PM, Wesley Tan said:

What a great topic you have brought up Edoardo!

 

I love it! There is definitely a correlation to how tender or sore muscles feel and how much tension they are holding. By tension I refer to the degree of muscle tone a muscle(s) has, which can be thought of as a continuing force to resist stretching even when the muscle is not actively contracting. 

 

So plainly speaking and simplifying the topic greatly, the more relaxed a muscle is the less painful it will feel when pressure is applied to it. I see this everyday in the patients I treat. Some are extremely tender and sensitive, and this refers to areas they may not usually feel pain in, where as others feel only pressure and hardly any pain, to the same degree of applied pressure.

 

There is a an innate bond to what we feel and how we move, between your sensory and motor sides of your nervous system. Two major centres in the brain, the primary motor cortex and sensory cortex lay alongside each other and are in a continual state of information exchange and adaptation.

 

For motor neurons, you have those that start in the brain, Upper motor neurons, and those that start in the spinal cord, lower motor neurons. The upper motor neurons synapse with the lower ones which then go on to innervate the muscles directly. One of the roles of the upper motor neurons is to actually inhibit the activity of the lower motor neuron, which when activated causes contraction of motor units within a muscle. In certain brain lesions such as  those caused by a stroke or with cerebral palsy, one of the symptoms is spastic paralysis. Besides losing voluntary control of the muscles, the muscles remain in a state of contraction as the lower mortor neurons have no inhibition from above (the brain). These muscles are very tender and extremely sensitive to pain when massaged or stretched. I site this here because this is a clear example of how chronically tight muscles become very sensitive.

 

Besides the obvious lack of movement, there is also a breakdown between the sensory and movement sides of the nervous system. Stretching and/or massage/myofascual release provide a much necessary dialogue between the motor and sensory sides of the nervous system. I believe this is crucial for healthy tissues. I like using an analogy of the mind and body having a relationship like family. When you don't use a body region properly, or to put it another way, neglect that part for some time, when you eventually use it it complains like hell! Once your mind and that body part have reacquainted themselves sufficiently and dialogue is once again open and honest, it feels much better.

 

Another interesting fact is regarding the innervation of fascia itself. It has been shown to contain a large amount of free nerve endings, some of which are believed to be involved in the perception of pain but others that are involved in the control of local blood flow. When stimulated they can create dilatation of capillaries (through neural reflexes) boosting local blood flow and of course promoting tissue health. Under stimulated tissues therefor have a reduced amount of blood flow and all the metabolic complications associated.

 

Sorry to digress and go overboard a wee bit, but I love this stuff, thinking about the magic of physiology that goes on silently without us even being aware of it! 

 

Stretch regularly, massage yourself and even better treat yourself to regular massages or treatments too.

 

Wes

Do you advice going to the physiotherapist regularly? If so, how often?

I asks this because I've been working on 4 Days Foundation + 2 HS + 3 Days stretching for a year now and last week I developed a contracture on the lower back. I can't attribute this to any change on workout intensity nor new exercise inclusion on my schedule, so I assume It could be just fatigue...I have an appointment at the end of the week to get a proper check, but just wondering the origin of all this and how to prevent it, since I've had to decrease workout intensity and avoid exercises involving pike position

Thanks in advance

Xabi

 

[Wesley Tan]

Xabi,

The tightness in the lower back is definitely a reflex to another deeper structure of the spine that you have irritated/injured. Pain on flexion is 9 times out of 10 caused by some form of disc compression and associated complications. Minor disc bulges, small annular tears, ligament strains deep within the spine can and will produce quite strong muscular contractions via pain reflexes. 

I know this from seeing it in my patients and having experienced it myself numerous times. I have strained my lower back 2 times in the last 12 months. Each time taking around 3-4 weeks to feel back to myself again (that's 2 months of missed training) and on each occasion it has been from doing too much!

I have quite a busy work schedule and sometimes things come up during my week where I have to adapt my training days. Both my recent back injuries had been from me spending too much time in the gym in one session, over working movements like pancake and pike. 

My educated guess is you have sustained a very similar injury. My advice is to back off, don't stretch the back out into painful ranges and give it time to settle. When you do begin to work the pike again make sure you try to keep your spine long APT as much as you can!!!!

I would recommend some form of massage to aid in relaxation and recovery alongside training, if you can at least once a month. If you see physio make sure they are hands on and offer massage and soft tissue work. here in the UK many physios are not so hands on and instead prescribe exercise and/or use infra-red and ultra-sound. I personally believe there is no better tool at working the body than a pair of trained hands 

[Xabier Errea Mayo]

Hi Wes,

Many thanks for the detailed reply, that scared me a bit tbh!   I'll check with my physiotherapist on Fri and establish a rehab protocol.

All the best

Xabi

[Ryan Bailey]

48 minutes ago, Wesley Tan said:

here in the UK many physios are not so hands on and instead prescribe exercise and/or use infra-red and ultra-sound.

This is unfortunate.

I want to also add both stretch and myofascial work are not always mutually exclusive.

My post graduate residency was in PNF manual therapy (Kaiser Vallejo Rehabilitation Center where PNF originated); physical therapy with patients who had upper motor neuron pathology (Spinal cord, stroke, brain injury). With hypertonic structures we use deep soft tissue work in the context of progressive, manual PNF therapy. (PNF is not just stretching by the way, and for those trained in PNF, contract relax is also a small component). I agree with Wes regarding the benefit of hands on practitioner when appropriate. I am just a big fan of movement with any soft tissue work.  That is why for me, I primarily use Stretch series and weighted mobility over my own soft tissue treatments. I find the blood flow combined with coordination of movement to be very productive.

[Wesley Tan]

Hey Ryan,

Don't get me wrong, i'm sure there are plenty physios here that do use their hands but on the whole it is far outweighed by prescribed exercise protocols. 

I agree also that using exercise gets great results and has profound effects and I frequently get my patients to perform certain drills/progressions. However, this is always after and informed by what my hands have felt and discovered. Palpation is a powerful tool that can detect a myriad of details; bony positions, soft tissue restrictions, temperature, tone, reflexes, capillary action, ranges of motions etc and this can be done with movement as you say. Unfortunately, palpation is a skill that has becone less practiced in medicine in general. It's no longer common for family practitioners tobget their hands on you anymore, which is a real shame.

 

 

 

[Ryan Bailey]

I totally get what you are saying Wes and enjoyed reading the above posts.

I was responding to your observation of ultrasound and exercise you see done by physios in the UK.

I also see this a lot in the US as well. It is just one of those treatment combinations we cringe at in my field. I respect your comments regarding practice of palpation and hands on care and agree it is beginning to become a bit of a lost art in medicine in general. Didn't want to distract too much from the previous posts. Good luck Xabier with the physio.

[Greg McDonald]

@Wesley Tan and @Ryan Bailey, where I live (Quebec), there is a distinction between physiotherapists and osteopaths.  Do osteopaths general favour the hands-on soft tissue work you're describing?

[Ryan Bailey]

Greg, good question (How are those calves feeling by the way?)

but its getting a bit into the weeds here depending on training, background, residency training, and continent one lives on of course.  There is definitely a distinction:

In the US, I went to a physical therapy graduate school (7 years total including the undergrad schooling) with osteopathic emphasis (Then additional heavy, manual therapy residency following 2 year primary physical therapist at an international learning hospital for manual PNF therapy with neurological conditions. The PNF group I trained under is responsible for establishing all the approved international hands on PNF education).  

My buddies who graduated in the other program, Doctors of Osteopathic Medicine, DO, practice as fully licensed physicians similar to a Doctor of Medicine, MD's, however, "some" utilize the traditional hands on, I would say "whole body" approach via their training. Then again, some absolutely do not... and  wish to practice as a hands off physician. I am not sure how this relates to other countries, or Wes's background but I have been very interested. 

[Wesley Tan]

In the UK, Osteopathy has remained a separate profession apart from the medical establishment, so the education establishments have also remained separate. In the UK Osteopathy is a profession that had an Act passed in Parliament in the 90's, whch saw the formation of the General Osteopathic Council, which means we have strict governance of the profession similar to teh medical profession. It maintains levels of educational courses and practice.

In the US I think Ryan is right, Osteopathy got consumed by the medical establishment shortly after Dr Andrew Taylor Still died. Since then I believe Osteopathy in the States has turned more towards typical medical practice.

In Canada, I believe your laws are a little bit more lax concerning the governing of the profession (this was the case 5 years ago although things may have changed now). I think there are some schools in Canada who might not have the same standards as others and so produce Osteopaths altogether different. 

Nice background Ryan, very interesting what you have done!

[Greg McDonald]

Thanks for the replies, @Wesley Tan and @Ryan Bailey (the calves are right as rain BTW).

[James Orr]

On 6/7/2016 at 9:25 AM, Wesley Tan said:

Xabi,

The tightness in the lower back is definitely a reflex to another deeper structure of the spine that you have irritated/injured. Pain on flexion is 9 times out of 10 caused by some form of disc compression and associated complications. Minor disc bulges, small annular tears, ligament strains deep within the spine can and will produce quite strong muscular contractions via pain reflexes. 

I know this from seeing it in my patients and having experienced it myself numerous times. I have strained my lower back 2 times in the last 12 months. Each time taking around 3-4 weeks to feel back to myself again (that's 2 months of missed training) and on each occasion it has been from doing too much!

I have quite a busy work schedule and sometimes things come up during my week where I have to adapt my training days. Both my recent back injuries had been from me spending too much time in the gym in one session, over working movements like pancake and pike. 

My educated guess is you have sustained a very similar injury. My advice is to back off, don't stretch the back out into painful ranges and give it time to settle. When you do begin to work the pike again make sure you try to keep your spine long APT as much as you can!!!!

Eerie.  I logged on to ask about daily limbering I can do to compliment my front and middle split series because my low back has been aching since straining it a month ago.  

I strained my lower back badly after deadlifting poorly.  I was mad at myself because I usually think of my workouts as practice and try to use the best technique that I can.  That night, however, I repped out for no reason and got sloppy during the last few.

It took two weeks to move without any discomfort, and it still aches right along the first few vertebrae (L4 and L5 from looking at a Google Image) if I've been sitting for a while.  I did a bit of Front and Middle split yesterday afternoon to ease my way back in because I thought the back pain was the result of being so tight in that area.  I worked through the hurdler stretches on Front Split, then just did some pancake work for 5-10 minutes.  It was the first time I did any stretching since the pull.

Should I continue to not stretch?  I just started lifting again last week with 50 light but powerful KB swings, 3x5 light front squats (around 60-75% if I were to guess), and 3x5 KB presses on Monday, Bench on Fri.  I felt good after, but my back started aching a bit in the L4-L5 area on Fri.  It's right along the spine.   

[Wesley Tan]

Each time you lift weights you compress the spine and there is no way around this! As you have injured something it needs more time to heal. 

I have seen this in clients who lift, some don't listen and make it worse from continuing to lift. Low back issues from discs and associated structures often hurt the next day and not immediatley.

I would not lift for a while longer and if you really want to got through some of the movements, I would do it with a 10-20kg bar only.

I would continue to stretch for sure, but I would take out the seated pike work for now as a precaution, becasue in my experience this is often a position people don't get into correctly (not enough APT) and load the already injured area whilst seated. Best to stick to standing pike work and seated pancake as long as you can maintain APT. Seated pancake tends to spread the weight of the torso through the legs better as they spread wide and make contact with the floor over a larger area, compressing the lower back less.

It's eerie becuase the pattern of symptoms and aggrevating factors are so common. 

[James Orr]

Thanks, Wes.  That makes complete sense.  This morning I stretched by doing some doorway stretches to take the pressure off my back, some from frog, and then a wall straddle.  Thanks for the tips on the other things I can work on, too.  I really appreciate your input.