Physiological bases of fascia release and mobilization
Fascia surrounds each muscle, hosts pathways for nerves and blood vessels, participates in a nutritional supply and gas exchange and provides support for muscles when they are under a significant load. For example, when a biceps constricts, flexes forearm or lifts weight, fascia supports biceps action by sharing the load. Still, it is connective tissue; fibers cannot constrict. The physiology of movement relies on a constriction of muscles. Flexion, extension, stabilizations are the results of muscular constrictions. Muscles cannot relax by themselves. At the time of the movement relaxation in muscles happening due to action of antagonism.
Due to the negative effects of stress, physical activities, irritation of spinal nerves, etc., muscles can build tension. Tention expressed in the shortening of muscles. When muscles build up tension and especially pathological tension, massage techniques especially kneading, can stimulate the decrease of muscular tension while passive stretching can affect buildups of tension in muscles.
However, kneading and passive stretching have no effect on abnormally tense fascia. Being a connective tissue, fascia has no blood vessels anatomical structure. Of course, cells of connective tissue need blood supply like any other cell in our body. Blood vessels in neighboring muscles, release these supplies, and connective tissue cell membrane allowed to this supply in. This process is called diffusion. When muscles build up tension, blood vessels also constrict, thus making insufficient blood supply, to the fascia. If the insufficient blood supply to the fascia lasts a long time, it leads to tension build up in fascia. This tension is not the result of fibers shortening (as fascia fibers have no potential to constrict) but is the result of wrinkle- like buildup of tension.
To successfully stretch fascia, one needs to pull tense fascia in different directions mechanically. Without releasing buildups of tension in the fascia, it is impossible to sustain normal resting tone in muscles, to prevent reactivation, recurrence of trigger points, etc. In turn, it makes it impossible to help people who suffer from different painful skeletal muscular disorders.
The inhibition of pain doesn’t imply adequate rehabilitation and sustainable results. Failure to achieve sustainable results would lead to pathology, including faster developments of osteoarthritis, and other degenerative diseases such as tendinosis, developments of muscular syndromes, etc. Besides, even if the pain is inhibited, one shouldn’t expect that the patient will be free of pain, no flare-ups, and patient’s desirable functional abilities will be restored.
Addressing lateral abdominal walls
During my career, I had had many opportunities to provide successful treatments for people who suffered from essential hypertension. Although for some reason in the United States hypertension, secondary to vertebral artery syndrome, is also considered to be essential hypertension. In any case, when I deal with this syndrome, I have succeeded in most cases to achieve stable results.
A year ago, a doctor referred to me 62 years old man, who suffered from uncontrollable essential hypertension. Usually, when medications don’t work, I suspect vertebral artery irritation/sympathetic plexus irritation.
Numerous times I applied the protocol for vertebral artery syndrome. Based on my previous experiences, a patient could and should report some subjective evidence of improvement, like feeling calmer and exhibiting the ability to have a better sleep. At the same time, the objective indicators also showed an improvement, i.e. blood pressure measurement showed at least a little slightly reduced blood pressure.
Nothing like this has happened after eight treatments with this patient; no even slightest evidence that treatment worked. This realization unpleasantly surprised me and decided to spend a bit extra time on lower extremities including lateral toes massage.
Even after 11 treatments, I didn’t observe any positive changes. This was aberrant. Suddenly, it crossed my mind that in one of the conversations I had with Dr. Ross Turchaninov, he suggested amending the protocols for essential hypertension with Lateral abdominal walls massage.
Because I had success even without it, I forgot about his advice. However, with the current patient, I decided to include Lateral abdominal walls massage in the essential hypertension protocol.
After I provided only one treatment, the results were astounding! Altogether, I provided an additional 14 treatments for this patient, including Lateral abdominal walls massage in his treatment protocol.
During the last year, while treating patients suffering from essential hypertension, as an experiment, I included Lateral abdominal walls massage or only my old massage protocol. I concluded that lateral abdominal walls massage only, is not effective in stabilizing essential hypertension, at the same time for better and faster results one must include lateral abdominal walls massage in the protocol for essential hypertension. Claiming from experience, spending on average seven minutes on each side is effective.
To read more on the role of massage in the management of essential hypertension, please click this link
Use of massage in case of severe concussion
A person whose testimonial you’ll be acquainted with below attended my treatment sessions seven months ago. It was a well-observed case.
After the first evaluation, it was obvious that he couldn’t make it out of the bed on his own. In addition to acute pain, he demonstrated severe encephalopathy symptoms. His mom was positive, they were going to lose him. Honestly, it looked like his brain was about to shut down.
When I provided the first 15 treatments, my client was feeling good, was symptoms free, including totally restored brain function. According to the recommendation of professor Dembo MD Ph. D., after 15 treatments, a massage therapist should prescribe the two weeks interruption in treatment to his or her client. Then even if the patient will be 100% symptoms free, the therapist must perform another 15 treatments. The reason that interruption and subsequent 15 treatment, entails extended explanation, that is beyond the scope of this article and requires a separate article, which I will attempt to write at some point in time.
However, at that time, after one week of interruption, the patient asked me to resume the treatments, without waiting for another week. He didn’t complain that the symptoms return, but pointed to his intuition as the reason that urged him to reach out to me.
During many years in practice, I learned to take notice of the patient’s intuitions. Thus, I provided him with another 15 treatments. Since then, during the last seven months, every two weeks he comes for maintenance treatments. Giving to the fact, that he is a songwriter, and performer, I believe maintenance treatments, helped him to balance his autonomic activities.
During the last seven months, he produced two albums and performed in numerous concerts. Seeing him succeed and feeling well, made me think, what a privilege it was to be a massage therapist, to be able to help in severe cases, where conventional medicine is practically helpless. You’re welcome to ask questions,
Let’s call him Alexander.
I got a concussion on St Patricks Day, March 17th, 2018, I was at my friend’s house and was hit in the right side of my forehead by approximately 10-pound plexiglass ball that was suspended from a mechanized wire that was traveling in a circle at around 10 mph at the head level. I immediately went to the ER at UCLA and was diagnosed with a concussion; my CAT scan showed no bleeding in my brain. They gave me a prescription for 600mg ibuprofen and hydrocodone. After that, I stayed home in bed, in the dark, with no screen time and no activity. Looking at screens or any prolonged activity resulted in intense pressure headaches.
Over time, the pain in my head intensified. It became so unbearable that I consulted a neurologist who told me that, based on my symptoms, it sounded like I had a tear in the dura that was causing a cranial spinal fluid leak and that they could do a brain blood patch that had a 75% chance of causing the tear to close and the pain to go away. When in the operating room, where I was scheduled to get the blood patch, I spoke with the doctor and he recommended I do not undergo the treatment and that I’d have better luck waiting it out at home, I returned home but within a few days the pain became so intense that I had to go back to the ER where I was hospitalized. There they did an MRI that showed no brain tear. By this point I was very worried; the pain in my head was incredibly intense. I was hospitalized for five days, trying out a myriad of medications and was ultimately sent home with Valium and Amitriptyline. While the medicine provided some temporary relief, the pain in my head persisted. I spent around four and a half months bedridden and was fearful that I wasn’t going to recover from the chronic severely intense tension headaches.
This was my life, until I had the incredible luck of finding, through my mom’s friend, Boris Prilutsky at the Sports and Medical Massage Center in Burbank. The first time I received treatment from him I had immediate and remarkable relief from the tension in my neck. I started seeing him twice a week and he was brought back more and more each session, and I tapered off the medications. Somehow, Boris’s method of treatment was able to help eliminate the intense symptoms of my diagnosed post-concussion syndrome that I was experiencing every day, without using drugs. I attribute my recovery entirely to his work. I have no idea how I would have survived without him and I am so grateful that I was introduced to him and his practices.
To take advantage of the massage techniques in application to concussion please follow this link
Is massage therapy an “innocent” procedure? Part 4
Thank God, I always have been successful during my entire career. Somehow, from the very beginning, I understood that the development of hands-on skills is a lifelong process. In this respect, the sky is the limit. I also understood that massage being a science-based procedure, is also an art, and like any artist. We need inspiration and need to have it constantly.
As one can say: “if for many decades, massage therapist reproduces outcomes, what kind of inspiration does one need?”
What constantly fuels our inspirations? It is an ongoing development of a sense of touch, the development of clinical thinking, the passion for achieving results, and the celebration in our hearts of the great outcome.
My main goal in writing this series of articles is to try to inspire others.
Other people inspired me. I have explained in part 1, how by the comment of a nice fellow inspired me, leading me to rethink the greatness of massage. In the previous sentence, I said:” leading me to rethink the greatness of massage” practically realization of power/greatness of massage generated powerful therapeutic energy, that we using when treating sick people. Not to repeat me, please read the article The placebo effect and its role in massage therapy part ii
If inspirations of composers, writers, painters, and other artists, create energy to compose great music, etc. in our case inspiration of creating energy, allow us to deliver greater results.
These days, out of nowhere, the idea crossed my mind: “Is it possible that massive stimulations by massage, can lead to the prevention of cancer?”
I have a patient, who is a known oncologist, head of the Department at the local medical center; he is a clinician and a researcher, who has contributed a lot to the developments of immunotherapy. I wrote to him asking to have a short meeting with me, to clarify some questions I had. Upfront I told him, I couldn’t have written these questions, as I am positive he’d never be able to understand them in a written form because in this case, I would have difficulty explaining myself in writing.
Our conversation lasted for an hour and 20 minutes.
My first simple question was:” Is the main reason why cancer cells replicate themselves, is because they can hide from our immune system?” He said: ”Yes, Boris.” Next, I asked him “If immunotherapy would help our immune system to discover these cells, would the illness be overcome?” He agreed.
Then I asked him, whether some individual immune systems might be in the process of discovering and destroying cancer cells? Such people would never know that their immune system prevents them from developing cancer. He said “yes.”
Then I have asked him to listen carefully to my presentation on the physiological effect of massage on the human body.
I emphasized the fact that the therapist hands generate a huge amount of electrical activities, including and not limited to action potentials, piezoelectric potentials, streaming potentials, etc. I have explained to him in detail the mechanism of the somatovisceral reflex as well as the viscerosomatic reflex, how the massive electrical potentials stimulate the central nervous system, awakening multiple positive changes in the functions of organs and systems. Then I said:” I’m here to ask a question. Based on all I have presented, can we speculate that all these massive electrical activities possibly can mark cancer cells, thus exposing these cancer cells to the immune system?” It took him some time to think over my question and respond.
Numerous times, he asked me to extend my explanations further
In particular, he requested to explain again the concept of pathways of Piezoelectric and streaming potentials. When I explained it to the best of my knowledge, including stressed changes in electrophysiology of the tissues to normalize extracellular matrix, he said:” Boris, I trust your presentation on the physiological effect of massage on the human body. I could even envision what powerful potentials you are releasing and I think you can speculate that massage possibly can mark/expose cancer cells to the immune system.”
Then he continued: “As a researcher, I would say that a study like this should be undertaken, including control grouping. We have enough testing equipment, for early detection.” I smiled: “No one will do such extensive research. More so, I will never claim, that massage exposes cancer cells to the immune system. However, thanks to you and your answer, I feel I know that during my career, I and thousands of my colleagues, exposed cancer cells of our clients’ to the immune system, and maybe prevented them from tragedy.” He liked my response.
”After my meeting, I was thinking, that as an M.D. he uses different techniques to expose cancer cells to the immune system. After listening to me, he said: ”You can speculate that.”
Ross Turchaninov is an MD. Ph.D., but also a medical massage practitioner. No one knows the science of massage better than he does
I decided to ask him the same question: ”can we speculate that massive electrical activities massage therapists create under their hands, can expose cancer cells to the immune system?
He replied: ”Interesting enough. In the next issue of JMS, we plan to publish an article that possibly can echo with your speculation on the issue.”
To me, it was a “WOW” moment. What a coincidence! I cannot wait to read his upcoming article.
Practically today, while finishing this article, I again send an e-mail to this oncologist, just to clarify a few more details. He started explaining to me about cytotoxic T cells, and about how it triggers a response from the immune system, etc. Of course, I appreciated his explanations. Yet, between us, I wasn’t interested in all the “scientific” explanation. What will I do with this information? Can I place this printed email against the body of my client?
I asked: “Tumor, edema, etc. increase pressure in ECM. And it is a fact that massage therapy can decrease pressure within ECM( extracellular matrix). When we treating sprain strain type of injury, we achieve a decreased pressure within ECM (extracellular matrix). Would this fact additionally support my speculations?” He answered: “Yes, it would. It would add to all your explanation, you have offered during our meeting”.
Once again I’d like to stress the following point. As much as we know about the effects of massage on the human body, and the multiple positive changes in functions of organs and systems caused by the original stimulation, including those on the cellular level, it’s still is the tip of the iceberg.
My opinion is based on my longtime clinical experiences. We all would agree: ”nothing in medicine is written in stone. Repeatedly seeing unexplainable, witnessing so-called “miracle changes”, in certain cases, I cannot think differently. We only know a fraction of what the real therapeutic power of massage. Scientific base as we know it today is huge, but still, it’s the tip of the iceberg.
How one can explain the phenomenon that I once presented in my writings? Six years ago, a Parkinson patient was referred to me. He developed a sharp pain in his lower back. While treating his lower back we’ve inhibited the panic attack he developed on the table. Besides, by performing massage on his neck and upper back, not only that we eliminated painful muscular crump in the lower back, but also stopped his shaking.
Last six years I continued to give him maintenance treatments.
Today he is playing tennis and driving a car. Two years ago, this patient insisted to repeat a CT scan, with radioactive dopamine contrast. Images showed that he is a Parkinson patient, but clinically he demonstrated no symptoms of Parkinson’s disease. There are many more unexplainable cases. As I have stated previously, being artists, it’s extremely important to have an inspiration. This was the reason why I decided to share my speculations with you. Yet those speculations are based on massage science, logical thinking, and clinical experiences.
Often, when describing the physiological effect of massage, I say that the stimulation leads to multiple positive changes in the functions of organs and systems. Is massage therapy an “innocent” procedure? It just crossed my mind, that this question requires a more extensive answer.
In my next blog, in the simplest way possible, I will discuss it more extensively.
I hope that so far, in previous parts of “Is massage therapy an “innocent” procedure?”
I already made my point: ”no, massage procedure can be considered “innocent”, but safe and extremely powerful.
As always questions, agreements, and disagreements are welcome.
Is massage innocent 3
I didn’t finish my discussion: ”Is massage therapy an innocent procedure?”
To further illustrate my point I’ll share with you something that just came up. Hopefully, that would prevent anyone from saying:” I wish you would share it earlier.”
Here is what has happened…
Recently I received a text message from my client from a long time ago, who requested me to treat his close friend. Supposedly, he pulled his leg muscle while playing tennis.
At the initial evaluation, the fellow described 3 weeks old incident as follows. ”At the time when I tried to reach a tennis ball and was making a fast movement to the right, I heard a loud crack in my groin and felt a sharp pain. Since then I cannot walk normally and am feeling a strong pain. I saw an orthopedic surgeon, who said that I have nothing to worry about but a pulled muscle. He prescribed ibuprofen 1200 mg a day, and physical therapy. Three weeks later, there were no changes. I only developed stomach aches.” In the end, he said: ”Perhaps I even have greater pain and more difficulties in walking.”
The client is a lawyer. He complained not to be able to appear in court or even to see clients. He described the pain as being destructive, disallowing him to focus and think.
I asked him about the quality of his sleep.
He responded that it was terrible. He was waking up, at least, five times a night because of pain, and any attempt to turn from side to side produced sharp pain. I commented that the most likely inability to focus is the results of sleepless nights. Three weeks of poor sleeping can exhaust a person.
I asked him to lay on the table. Numerous times, very gentle I slid my hand on the inner part of his thigh. A little depression on his inner thigh suggested the possibility of muscular fibers’ tears.
I would like to have your attention. I brought a piece of paper, and said, “Sir I will dictate and you please write down.” He couldn’t understand what do I want, but said okay, whatever. My dictation was the following “while gently sliding his hand on my right inner thigh, Boris informed me, that he felt depressions. They could be the evidence of a few muscle fibers’ tears. In such a case, we can suspect the formation of a hematoma, deep inside those that I cannot see. By reducing muscular tension within muscles, Boris informed me about the possibility of this hematoma showing on the surface, which as Boris explained, is a positive phenomenon that will stimulate the healing process. I understood that I cannot blame Boris’ massage procedure, for this hematoma.”
He signed the paper. All this dictation process, he accepted as a game, like a joke. We laughed. I said that, at times, my clients forget my warnings. That is why I like them to sign a memorandum.
Little by little, starting as always from L/spine region, gluteus massage, general introductory massage on front thigh, increasing threshold of pain, little by little, I started focusing on, adductor brevis, adductor longus where I suspected the muscular tears were.
I was able to reduce severe protective muscular spasm successfully.
When he stood up from the table, he was happy, start walking, and told me that he barely felt the pain.
Of course, I was happy too and scheduled him the next appointment. The next day at noon, his friend texted me:” Boris that’s what has happened. After your treatment, my friend ended up in the emergency room. He had a huge bruise on his inner thigh.
If I wouldn’t feel sorry for the fellow, I’d laugh. My answer was, can he walk better? One hour later, he texted, yes, when he walks with a much lesser pane. I said, “advise him not to miss the next appointment.”
Seconds after releasing this text, my patient/lawyer texted me,
“Hey Boris, after the treatment, a huge bruise appeared on my inner thigh, where you massaged. I was so scared that I referred myself to the ER. Any advice? I wrote:” my advice is not to panic, especially, in view of the fact that we discussed the possibility of having a big bruise. Most likely, after the treatment you couldn’t see these bruise, usually, it appears a few hours after the treatment. Of course, I have included a picture of a signed declaration LOL.
He was not late for his next appointment, and for four more appointments.
He is doing well now. For some time I recommend withdraw from playing tennis. He is walking and lifting weights.
ER doctors discharged him fast and referred him to a primary care physician.
How was I able to predict the appearance of a hematoma on the next day?
It was predictable since the hematoma was sitting deep and creating pressure, contributing to the pain, and fueling the muscular spasm. The muscular spasm prevented this hematoma from surfacing. Practically the entire goal of my massage therapy, at this point, was to release tensions within muscles and increase the blood supply. The moment I achieved the desired results, hematoma surfaced.
Guys, my advice when you hearing similar reports from your patients, please ask them to sign the acknowledgment document. As you can see, even though I informed him, the fellow rushed himself to the ER.