Understanding Myofascial Pain

Ryan LaCorte Publications, Stefanie Armstrong

Within our bodies is a continuous layer of connective tissue called fascia. Fascia is a three dimensional web of tissue found throughout our body that plays a major role in the following:

1. Helps maintain structural integrity

2. Supports and protects the surrounding structures

3. Acts as a shock absorber

4. Transmits movement from muscles to bones

There are three layers of fascia: superficial fascia, deep fascia and visceral fascia; all of which have different functions and roles within our body. The superficial fascia is found just underneath the skin and is responsible for storing fat and water, acting as a passageway for lymph, nerve and blood vessels. The deeper layer of fascia is the tougher fibrous tissue that is responsible for covering and permeating the muscles, bones, nerves and blood vessels. The fascia itself doesn’t have blood vessels; however, it has receptors that detect the presence of pain in the body. The deepest layer is considered the visceral fascia which is responsible for holding organs in their cavities.

With overuse or injury, this connective tissue may tighten and contract creating undue pressure on muscles, nerves, bones or organs. This area of injury is often referred to as a trigger point. Myofascial pain syndrome is defined as a localized painful musculoskeletal condition affecting any skeletal muscle in the body, characterized by trigger points. Trigger points by definition are simply a taut band of skeletal muscle that is often felt as a “knot” within the muscle. These taut bands tend to be very sensitive to even light pressure, creating pain not only at the injury site, but also in various other areas of the body (referred pain). It is even common for an individual to experience symptoms that appear totally unrelated to the original injury. Individuals who suffer from myofascial pain may experience poor sleep habits, local or referred pain, reduced flexibility, tenderness to touch, popping and clicking, limited movement, and muscle weakness without atrophy.

Do you need to have surgery to treat myofascial pain?

The answer to the question above is simply no. If you suffer from myofascial pain, there are non-invasive treatment options available to you, including injections directly into the trigger point, NSAIDs to assist in managing your pain levels, massage therapy to reduce spasms and improve tissue extensibility within the muscles and physical therapy to prescribe an appropriate exercise program. Since myofascial pain has been linked to many types of pain, from stiffness or a deep, aching pain in the muscle to headaches, jaw pain, neck pain, low back pain, pelvic pain, and arm and leg pain, it is imperative that you work closely with your physician to rule out any other possible causes of pain.

How can physical therapy help?

Physical therapists are trained specialists that work with individuals to recognize the source of pain, identify trigger points and address any contributing factors to myofascial pain such as poor postural awareness, workplace ergonomic and biomechanical imbalances. Physical therapists can utilize a number of different techniques including soft tissue mobilization to improve tissue extensibility, strengthening through therapeutic exercises to restore muscle function, stretching exercises to improve postural awareness, modalities such as ultrasound and electrical stimulation to reduce pain as well as utilize techniques such as myofascial release.

What is myofascial release?

Myofascial Release is a technique, utilized by physical and massage therapists, to address connective tissue restrictions within the body created by trauma, poor posture or inflammation. It is a hands-on approach that utilizes gentle, sustained pressure to the restricted area for a minimum of 2 minutes, which allows the affected tissue to undergo histological length changes. After a series of length-tension changes occur, the affected tissue will become soft and pliable, resulting in restoration in biomechanical alignments, pain reduction and improved mobility.

At All-Care physical therapy, we are trained to identify fascial/soft tissue restrictions that may be impeding quality of movement and limiting quality of life. Please feel free to contact one of our offices regarding any questions.

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