Do you possess enough expertise and experience to break my fascia?
Below is my blog about this bizarre request “to break fascia.” In this blog, I am not only presenting this case, but also explaining fascia/muscles relations, pathophysiology, and much more. In addition, I am providing information about the historical developer of this methodology. It’s a fascinating story.
“Breaking fascia” is not the only special memory that I have about fascia misunderstandings. Several years ago, there was a lot of excitement around the fascia congress. Many of my friends and students attended. I have the graduates, a group of personal trainers, who attended my school and for many years, they combined personal training with practicing massage. Through them, I received a lot of information about fascia congress.
I asked one of the attendees: ”why no one at Congress mentioned the name of Elizabeth Dickle, who made known the importance of tension build-up in the connective tissue/fascia and its impact on chronic somatic and visceral abnormalities to the scientific community.
He answered that this Congress wasn’t for massage therapists. I asked was it for personal trainers? I didn’t get a clear answer. It’s okay.
In fact, this brief commentary, it is specifically FOR massage therapists
Five years ago or so, I received a call from a patient referred by MD. Her first question was: “Do you possess enough expertise and experience to break my fascia?”
Jokingly I answered: “I’m in the business of repairing, and not breaking.” Regrettably, she felt that my humor was not appropriate and angrily retorted: ”Boris, I have developed myofascial tissue problem. For two months, I was seeing “fascia chiropractor”, and little by little started feeling much worse. Now my pain us not only in the scapula, but traveling to my arm, and I cannot sleep at night because of pain. In the beginning, it wasn’t like this, I could sleep without pain. Of course, I asked what chiropractor did, the answer was:” he tried to break my fascia, but my case is difficult and he couldn’t succeed. My primary care physician believes you can do it.”
Thinking about terminology…
To tell you the truth I don’t know where the terminology “breaking fascia” and “myofascial tissue” come from. No book of histology will support the existence of myofascial tissue. We have fascia and muscle alliance, an anatomical unit that is working together. Yet, histologically speaking, these are different tissues. Fascia is a connective tissue, which means fibers of fascia have no potential to constrict while the function of muscles is to constrict. I have invited her for treatment, and using a very convincing tone of voice, told her: ”clinical picture as you described, can be the result of buildups of tension within fascia and muscles. I possess the expertise to detect these abnormalities and eliminate this tension, in which case you can feel much better.
More about the case…
It was a difficult mechanical pain case. In addition, the patient exhibited anterior scalene muscle syndrome that triggered a neurological picture, radiating pain to the upper extremity. During the first five treatments performing connective tissue massage/fascia release and mobilization techniques, trigger point therapy, and massage techniques addressing muscles I have achieved positive change in the clinical picture. The patient could sleep at night, experienced no radiating pain to the upper extremity, was free of pain movement of the neck and upper back.
Of course, I convinced her to continue treatments in order to increase the threshold of muscular irritability. She agreed, and I have provided seven more treatments. Since then, during all these years I treated her sciatic nerve neuralgia, and knee sprain/strain type of injury. Today she is doing well. Her neck and upper back symptoms have never come back.
Briefly “About muscles /fascia”
Fascia surrounds each muscle, hosts pathways for nerves and blood vessels, participates in a nutritional supply, provides support for muscles when they are under a significant load. For example, when a biceps constricts, flexes forearm, 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. At the time of the movement relaxation in muscles happening due to action of antagonism as muscles cannot relax by themselves.
Due to the negative effects of stress, physical activities, irritation of spinal nerves, etc., muscles can build tension, expressed in 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.
Tension in muscles
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 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 will be restored desirable functional abilities.
The history of connective tissue massage.
The works of Austrian physical therapist Elizabeth Dickle made known to the scientific community the importance of tension build-up in the connective tissue/fascia and its impact on chronic somatic and visceral abnormalities.
As with many important discoveries, Dickle’s discovery was an accidental find. For several years, she suffered a failure of arterial circulation in her lower extremities resulting from Thromboangiitis Obliterans. The disease had progressed to the stage when amputation became a real possibility. Dickle also experienced chronic, lower back pain caused by her limping. While rubbing her lower back and trying to relieve tension, she noticed sensations of warmth and weak pulsations in her feet. Intrigued by her finding, she started using various techniques on her lower back. She noticed that pulling the skin on her lower back triggered the most intense warm sensations in her feet. After several months of self-therapy, she was able to restore circulation through her lower extremities and prevented double amputation. Powerful stuff!
Dickle shared her findings with Prof. W. Kohlrausch. Their combined efforts, as well as the later works of Prof. N. Veil and Dr. Luebe in Austrian and German clinics, shaped a major method of somatic rehabilitation they called Bidegewebsmassage or connective tissue massage/fascia release and mobilization techniques as it is known by the rest of the world.
During the extensive research, they developed connective tissue massage/fascia release and mobilization hands-on protocols, including the stipulation regarding the direction of movement. This was presented in a straightforward way so that thousands of massage therapists could learn these techniques and, successfully, implement them on patients. Thousands were replicating their outcomes when treating back and limp disorders, internal organ diseases, etc.
Russian Medical Massage
The work of Prof. Sherback, which is a fundamental plateau for medical massage, is also a fundamental groundwork for any massage therapy. Today, the concepts that lay the foundation of his works were tested and massively utilized for many years, and thus proved their clinical viability.
to post questions, agreements, and disagreements.
You’re also welcome, to watch videos, where I demonstrate the utilization of silicone jars for fascia release and mobilizations. It is very powerful.
The uniqueness of massage therapy
“Five years ago or so, I received a call from a patient. Her first question was: “Do you possess enough expertise and experience to break my fascia?” 😊 Jokingly I answered: “I’m in the business of repairing, and not breaking.”
“To break fascia” Below is the link to my blog about this bizarre request. In this blog, I am not only presenting this case, but also explaining fascia/muscles relations, pathophysiology, and much more. In addition, I am providing information about the historical developer of this methodology. It’s a fascinating story.
“Breaking fascia” is not the only special memory that I have about fascia. Several years ago, there was a lot of excitement around the fascia congress. Many of my friends and students attended this congress. For example, a group of personal trainers, who graduated from my school, and combined personal training with practicing massage. Through them, I received a lot of information about fascia congress.
I asked one of the attendees: ”why no one at Congress mentioned the name of Elizabeth Dickle. This doctor made known the importance of tension build-up in the connective tissue/fascia and its impact on chronic somatic and visceral abnormalities to the scientific community.
He answered that this Congress wasn’t for massage therapists.
That is another reason for my post about fascia. In fact, it is specifically FOR massage therapists.
My management company, kindly offered a set of silicone jars(4 pieces ) and an instructional DVD, for $34.95. (regular price is $69.95)
Recently, a person from our fields, a friend of mine, posted this article on his site.
Effect of the Suboccipital Musculature on Symptom Severity and Recovery After Mild Traumatic Brain Injury
To me, the information presented in the article was a borderline distortion if not disinformation and I posted my considerations about it on his site.
Below I would like to share with you this what I have written there.
In my opinion, the aforementioned article was not written for massage therapists. In fact, it isn’t written for physical therapists or anybody who is applying physical methods of treatments.
As a massage therapist, I possess considerable clinical expertise and rich clinical experience in rehabilitation of post-concussions. The main goal of this rehabilitation is not the elimination of symptoms but the prevention of post-trauma brain dysfunction/encephalopathies. I would like to repeat not the elimination of symptoms only.
- “Neck musculature mass has been suggested as a biomechanical contributor to injury severity.” I hope we all agree that muscle mass cannot contribute to the severity. At least, this is not our professional language and approach.
- In my opinion, the sentence below represents the claim of health care professionals, who are radiologists, and who have never managed post-concussion rehabilitation:
“Overall and individual muscle cross-sectional areas were correlated with symptom severity, neuropsychological testing, recovery time, and headache.”/p>
Can MRI cross-sectional examination determine the high resting tone (tension) in all suboccipital muscles?
No, this examination cannot.
When treating painful skeletal muscular disorders, because of pain sensation, neighboring muscles immediately elevate the muscular tone even those that do not share the same innervations.
When treating muscular syndromes such as piriformis muscles/sciatica, all gluteal muscles increase muscular tone. In the case of the head trauma/concussions, all neck muscles, including suboccipital muscles, are in the state of a protective muscular spasm. As massage therapists, we must address all of the surrounding muscles, in order to reduce tension, and achieve results. In the case of the buildup of tension in the fascia, massage therapists must address it too. We can release this tension. At the same time, because of this article, one might address rectus capitis posterior only, and thus never will be able to achieve real results.
Unlike painkillers that only block pain impulse to reach the brain, one of the greatest unique features of massage therapy is in addressing the real causes that produce pain and disorders/dysfunctions. The same is true to say in cases of post-concussion rehabilitation.
Below is my article Rehabilitation VS inhibition of symptoms
If you won’t have much patience to read it in its entirety, then please read at least the summary and conclusion. It will give you a quick overview of how and why we as massage therapists can prevent encephalopathies/
You’re welcome to challenge all that I stated in this post. Professional discussion can advance our level of professionalism.
1. I am of the opinion that massage therapists must remember about the great uniqueness of massage therapy when treating any disorders/dysfunctions. Our methods are not similar to painkillers that block pain impulses from reaching the brain but address the real causes that producing pain, and other dysfunctions.
2. Just because the article is published at PubMED.gov, it doesn’t mean that this article is written for massage therapists and/or this is good and scientifically valid material. Some time ago PubMED.gov published this article
Please Google:” Massage Impairs Post-exercise Muscle Blood Flow and ‘‘Lactic Acid’’ Removal” and you will find many other “scientific publications” repeating the same nonsense, Massage Impairs Post-exercise Muscle Blood flow”??????
In truth, the mere fact of something being published in PubMED.gov doesn’t guarantee it is a reliable material and could, in fact, be absolute nonsense.
Even today, doctors practice suboccipital injections, be it Botox/toxin injection, or corticosteroids hormones injections. Can it inhibit pain? In some cases, it can. Does it address causes that lead to encephalopathies? Positively not.
”In mild traumatic brain injury, the rectus capitis posterior minor is the only suboccipital muscle whose cross-sectional area is associated with symptom severity and worse outcome. Given the unique connection of this muscle to the dura, this finding may suggest that pathology of the myodural bridge contributes to symptomatology and prognosis in mild traumatic brain injury.”
To make the aforementioned claim, by all scientific standards, the researchers should first assess autonomic activities, and only then administrate these injections.
One cannot do Botox/toxin or corticosteroid injections nonstop and then, after a minimum of four months of observation, do a test of autonomic activities again. The test must be run much more frequently especially in view of the fact that test equipment can assess the irregularity or normalizations of the autonomic system rather quickly. Only when the test would establish normalization of the autonomic activities, anyone can claim what they claimed in this article.
Besides, why use the injections? Injections that have side effects. When it comes to muscular tone, by means of massage, we can achieve sustainable results without side effects, and in a relatively short time.
Boosting the immune system made simple
It just crossed my mind that now because of the global tragedy it is appropriate to talk about the most powerful methodology in our toolbox that allows boosting the immune system. This is a methodology of detoxification and manual acceleration of lymphatic drainage. There is no other clinically proven scientifically based methodology, capable of competing with it.
In the video clip, I stated that the techniques that I offer on this DVD are not massage. Perhaps it isn’t entirely true. In trying to emphasize the difference, my primary concern was that people might apply too much pressure, the pressure comparable to the moderate pressure applied during the massage. I’d like to emphasize that while performing lymphatic drainage the pressure must be VERY LIGHT. Pores of lymphatic vessels are large, and if one applies even a moderate pressure, instead of being drained through lymphatic nodes and on, lymphatic fluid would be pushed back to extracellular space.
On my DVD#5
During my hands-on demonstration, I am explaining the necessity of light touch, in order to accelerate lymphatic drainage. We perform these techniques on the full body and, in my experience and in the experience of many other experts in the field, they are extremely efficient in boosting the immune system.
In addition, I feel it would be beneficial to watch a four-minute video clip below. The video discusses the immune response to a bacterial infection. Yet the immune system reacts to viral infection the same way. Once you understand how anti-bodies neutralize infection inside the lymph nodes, it would become clear why delivering more so-called infected lymphatic fluid to the nodes boosts the immune system. All the techniques related to the acceleration of the drainage through lymph nodes we perform on the full body.
Please don’t hesitate to post questions and state your opinion.
I was able to convince my management company, to offer a special price of $10.
I believe it is important to learn step-by-step, full-body lymphatic drainage acceleration techniques. It’s always important and especially important today
To access specially priced DVD #5 click here
Managing stress on your own
To all my dear friends,
I hope that you and your close ones are safe and healthy.
It’s a tough time. The time of much worry, anxiety, and stress. We cannot avoid stress. Rather if we manage it properly, we can avoid its detrimental consequences on our immune system and health in general.
We are all in it together and every little bit of help counts. I decided to remind you about the self-stress management massage that would keep stress under control.
There are two parts of it:
This is approximately 7 minutes of step-by-step acupressure, that is not only has a positive effect on headaches if it is present but clinically proven positive to affect autonomic activities. I highly recommend to learn these steps and to apply them approximately twice a day.
In this article
I explain, why these important techniques included in the treatment of post-concussion cases, as well as certain cases of migraine headaches.
To explain how to perform self-stress management massage of the neck and upper back click
If you would like to know more about the mechanism of stress debilitations please follow
To find out about utmost importance of proper posture in front of the computer
Best wishes and many blessings,
Special Price of Today
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Fascia mobilization is an important massage modality. Unless a therapist releases tension in fascia it is impossible to achieve results. To find out why this is important on the physiological level. To find out why this is important on the physiological level
If a therapist finds extra tense regions, they use methods of fascia release developed long ago by Austrian physician Dickle. If you are interested in finding out the history of fascia mobilization
There is actually quite a bit of misconception about fascia in the histological sense and in the treatment sense. To read about an actual amusing clinical case that will reveal such a misconception.
In the following video, I demonstrate the methods of fascia mobilization by hand.
As you can see from the above video the methods of fascia mobilization, require a certain skill and experience. Improperly done, they might have detrimental consequences on the entire massage sequence and will lead to an incomplete mobilization of soft tissue.
Luckily, and I say this with a good share of joy, several years ago I discovered these flexible plastic jars, which do an amazing job as far as fascia release is concerned and are fairly easy to administer. Please see the video clip below
In addition, the usage of silicon jars presents additional benefits. You can find out about them watching this video clip
To go to the clearance page click the picture