Self-Myofascial Release Therapy Discussion 1

   SMR (stands for Self-Myofascial Release) tools are EXTREMELY useful for loosening tight muscles, and can generally give a good indication of how much a particular issue needs work. The pain/discomfort typically felt upon certain tissues when using SMR technique and tools is a good indication of the quality of those tissues being worked upon. The higher the discomfort level, the greater the need for myofascial release. Foam rollers have become quite common in the fitness world, but most are familiar with white, marshmallow-soft foam rollers that have become practially ubiquitious. There are tools that are FAR ahead of the aggressiveness of therapy level than these and I will detail over the next series of articles some of the best ones, ways to use them (including cross fiber, and dual- and tri-planar methods of using them that you MAY not be familiar with), and how to make several kinds at home with simple materials.
Short primer on myofascial release and trigger point therapy: 

• Trigger points are knots of muscle fibers. See Figure 2.1 above.
• Tying knots in anything shortens whatever is tied: rule of physics - shortest distance between two points is a straight line.
• Shortening a muscle means whatever is attached to the muscle (at origin and insertion points), whether bone, tendons, metal screws, etc., is necessarily picking up the new, higher level of tension, since the two points that a muscle attaches to at beginning and termination are a fixed distance (not necessarily always true but for the good for the purposes of what we are describing here) at that particular point in a muscle's ROM.
• This stress transfers through fascia and ligamentous tissue to anything that is touching it. Fascia are interconnected webs of connective tissue from muscle to muscle, and transfer tension EXTREMELY well across seemingly unrelated parts of the body. Refer to study: "Epimuscular myofascial force transmission: A historical review and implications for new research. International society of biomechanics. Muybridge award lecture, Taipei, 2007."
• These stresses can literally "pull" joints and joint angles away from optimal or even healthy movement patterns. And as these joints change in response, so do the rest of the joints surrounding the primary affected one, in a somewhat predictable manner we will call "movement accomodation patterns." These forces/stresses can become magnified as translation through several tissues and joint complexes occurs, and at a terminal end of a kinetic chain can cause gross motor problems.
• The stresses and accomodations patterns are applied to not only joints, and soft tissues, but to skeletal structures as well. An excellent example would be hip, knee, and ankle motion/flexion inhibition, possibly due to trigger points in hip flexors (as well as a chronically shortened psoas, and hip capsular issues) or anterior tibialis and surrounding structures. These stresses force an accomodation pattern, which translates shear force along the tibia, and this shear force combined with linear loading to the tibia, is quite effective at producing stress fracture-inducing loads. This can occur easily through squatting, or for even higher force loading, look at running for extremely high stress loads applied to the tibia.
• When accomodation patterns have been ingrained, mobilizing the affected tissues will be drastic in changing the 'feel' of movement, almost as if one needs to learn how to run again, since tissues that have been holding the kinetic chain (hip, knee, ankle, etc.) in certain abbreviated ranges of motion are now suddenly freed.
• Massage of certain types, as well a direct pressure, literally "unties" these knots in muscle fibers through unknown mechanisms. Refer to study: "New Views of Myofascial Trigger Points: Etiology and Diagnosis, David G. Simons, MD."
• Direct pressure and massage are VERY close to replicating the effects of manual myofascial release, such as foam rolling, thera-cane work, or any of the redundant ball-on-a-wall techniques used in trigger point therapy and SMR.
• Notes: The tibia is commonly recognized as the strongest load bearing bone in the body (I would argue the femur but who am I) and if you have stress fractures occuring here there are serious biomechanical issues present, or repetitive blunt force trauma due to abuse through Muay Thai style kicking. (uses the shin bone as the operative weapon instead of the foot, and this trauma occurs through chronic methods, such as an unaccustomed high volume of kicking a heavy bag, or acute methods, such as a singular Thai kick to someone's skull or elbow, or any other sufficiently hard object.)

 Now that we have covered what they are used for, go here to see the many kinds and the (sometimes) high prices that they sell for: http://www.optp.com/Rollers/Soft-Tissue-and-Trigger-Points.aspx
Now, you should know that Kelly Starret has MANY unorthodox methods of using these tools and is very, VERY good at what he does with fixing problems with athletes worldwide at ALL levels of competition. Check out his blog here: http://www.mobilitywod.com/
We will learn how to make some of the tools he uses, as well as some he doesn't, at home for much less than retail. The one covered today is a type of "shiatsu-bag," which is basically a cloth bag with several kinds of balls, of varying sizes and densities contained inside it. Go here to see the original and price of retail: http://shiatsubag.com/

This is the original Shiatsubag

Now that you know what they look like, just know that this is just another tool that can be used. If you are familiar with lacrosse ball techniques for SMR you should immediately realize the potential/pain that this bag has. If you are NOT familiar with lacrosse ball use for SMR, go here: http://www.youtube.com/watch?v=HWfnAUsYUTI&feature=player_embedded for an excellent video from Joe Defranco.Watch, try, and cry.

Here is a homemade version. Please note that the circular/round shape of the original has no bearing upon the effectiveness of the device, but if you would like to replicate that, use an old soccer ball and cut it, then lace it up, instead of a cloth bag. This is just an old Crown Reserve bag, this works well since its easily tied closed and allows for removal and interchangeability of the balls inside for various applications (ie muscles of varying sensitivities).



As you can see here, its very simple, really, to take a few balls of varying sizes and densities and put them
inside this bag. 

 

Here we have a baseball, a lacrosse ball, a hackey-sack, and 3 other random sized balls of varying firmness. This doesnt indicate that you should use this assortment though. 3-6 tennis balls would work well for ppl with serious sensitivites, and a bag full of golf balls or baseballs for very desensitized tissues.

   Once you have assembled this in whatever way you would like, simply use it like Defranco has outlined in his youtube video, but for most muscles, not just the piriformis/glutes. Since this bag does not roll very well, it can be used excellently to displace tissues laterally (aka "cross-fiber myofascial release"). A foam roller, in comparison, does not have that quality.

This can be used as in figure 5.44 shown above, with literally any muscle group, and a elevated surface of any height, provided you can do it safely. I particularly like to hit hamstrings at a height a few inches higher than comfortable seating height, one leg at a time, and make small circles or figure-8s, and then try to move laterally on the ball and displace the hamstring tissues one direction at a time. Another technique, known as 'dual-planar' myofascial release, is fairly effective (and kinda painful); this is performed by displacing the tissue either laterally or longitudinally, and then displacing the tissue AGAIN from this lateral/longitudinal position at a RIGHT ANGLE to the original displacement. Most of these techniques can also be done against a wall, as similar in figure 4.13 below, applied to the trapezius, or seated on the floor, as Defranco's Agile 8 video shows for the piriformis.

Another area I find extremely sensitive and causing problems is the rhomboids, and every client/athlete I have had the pleasure to train has had issues with these. I will show you how to dig into these with this shiatsubag with some photos:

Details correct placement and body lean into the shiatsubag on the wall.

You should be having this much fun. This shows the digging in of the rhomboids, the area between the shoulder blade and the spine. Please note this is NOT fun, I was simply laughing because the photographer told me when I did it correctly that I grimaced and looked like I was trying to drop a deuce.

Once you lean into the bag after placing it in between you and the wall, it will find the trigger points without much effort. Simply raise up onto your toes and lean over, lower your toes and lean over to the other side, and you will be able to make figure-8s and circles, which will allow you to hit multiple trigger points from a variety of angles that you may not get with simple perpendicular compression/pressure. The next article should be coming soon!