Historical overview of fascia release mobilization
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. The rest of the world knows it as connective tissue massage/fascia release and mobilization techniques.
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.
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.
The case of “Breaking my fascia”
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.”
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 to constrict. To read about physiological bases of fascia release
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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.
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.
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,
Best wishes.
Boris
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