Understanding Myofascia: Key Concepts and Techniques

1. Chapter 20 Myofascial and Deep Tissue Approaches

2. Topic 20–1: Myofascia • Muscle • Myofibers: fine fibers (myofibril); smaller structure (myofilaments). • Each myofiber encased in fascia called endomysium. • Groups of myofibers bundled together into fascicles by sheets of fascia (perimysium). • Muscles: groups of fascicles wrapped in fascia (epimysium). • Fascia merge to tendons to attach muscle to bone.

3. Topic 20–1: Myofascia Connective Tissue • Varies in density, thickness, strength, elasticity, rigidity. • Consistency: watery sol state; semifluid sol state; viscous gel state; solid crystalline structure of bone. • Fibroblasts most abundant cells. • Mast cells produce heparin and histamine. • Macrophages, plasma cells, leucocytes occur.

4. Topic 20–1: Myofascia • Connective Tissue • Ground substance: fluid produced by fibroblasts. • Collagen: protein that forms tough rope-like strands; make up fibrous content of skin, fascia, tendons, ligaments, cartilage, bone, blood vessels, organs. • Elastic fibers: yellow; made of protein elastin. • Reticular fibers: formed from smaller, more delicate collagen.

5. Topic 20–1: Myofascia • Connective Tissue • Thixotropy: gels become more fluid when stirred up; more solid when they undisturbed. • Viscoelasticity: deformed when outside force manipulates it; will remain deformed.

6. Topic 20–1: Myofascia • Connective Tissue • Piezoelectricity: pressure electricity; ability of tissue to generate electrical potentials in response to mechanical deformation including massage. • Adhesiveness: packing of collagen fibers and increased hydrogen bonding; occurs in response to tissue stress.

7. Topic 20–1: Myofascia • Fascia • More ground substance than other forms of connective tissue. • Maintains structural integrity of body in many ways. • Tensegrity model: muscles, tendons, fascia provide continuous tensile forces that maintain upright structure of skeleton against forces of gravity and allow changes in tension to create movement.

8. Topic 20–1: Myofascia • Fascia • Protection and shock absorption. • Immune defense. • Cellular exchange. • Superficial fascia: just below skin; anchors skin to underlying structures. • Deep fascia: surrounds organs and muscles, carries nerves and blood and lymph vessels, wraps structures.

9. Topic 20–1: Myofascia • Fascia • Horizontal planes of fascial: places where fascial sheets converge at joints. • Fascial bands: superficial fascia in horizontal strips that restrict fat deposits. • Myofascial chains: connect foot to top of head— anterior and posterior—superficial and deep.

10. Topic 20–1: Myofascia • Fascia • Myofascial Dysfunction • Postural habits • Diet • Repetitive mechanical stress • Injury • Chronic stress • Lifestyle

11. Chapter 20 Myofascial and Deep Tissue Approaches

12. Topic 20–2: Myofascial Techniques • Effects of Myofascial Techniques • Melt ground substance. • Increase piezoelectricity. • Reduce fascial restrictions. • Decreased adhesions. • Reduce stress.

13. Topic 20–2: Myofascial Techniques • Assessment of Myofascia • When you lift the skin, you are also lifting superficial fascia. • Fascial restrictions can occur anywhere in body; show up in postural asymmetry. • Three techniques: fascial gliding; slow skin rolling; passive range of motion. • See Technique 63: Identification of Fascial Restrictions.

14. Topic 20–2: Myofascial Techniques • Guidelines for the Application of Myofascial Techniques • Comfort and safety: should not feel painful; client may feel burning sensation. • Use of lubricant: use very little or no lubricant. • Depth: lighter work engages superficial layer of fascia; deeper pressure accesses deeper fascial layers. • Take out the slack: drop into tissue; then take slack out of tissue.

15. Topic 20–2: Myofascial Techniques • Guidelines for the Application of Myofascial Techniques • Work in all directions: stretch one direction, such as longitudinally; next pass stretch horizontally; then stretch at oblique angles. • Feel the burn: as long as burning sensation is not too uncomfortable, this is good sign. • Avoid tissue compression: motion of your hands is not to compress tissue into structures beneath it or to bone.

16. Topic 20–2: Myofascial Techniques • Guidelines for the Application of Myofascial Techniques • Work slowly: if tissue is dense or feels thick, cold, and viscous, slow down and warm tissue fully before dropping into deeper structures. • Let the tissue guide you: let go of your preconceived ideas about where stretch needs to occur; follow path of unwinding tissues.

17. Topic 20–2: Myofascial Techniques • Guidelines for the Application of Myofascial Techniques • Use passive and active movement to reset proprioception: • Use passive range of motion to re-educate myofascia about its potential for movement. • At end of session when client is dressed, have him or her take different joints through full available range of motion actively.

18. Topic 20–2: Myofascial Techniques • Techniques for Working with Myofascia • Myofascial skin rolling. • Gross myofascial stretches. • See Technique 64: Myofascial Arm Pulling. • See Technique 65: Myofascial Leg Pulling. • See Technique 66: Crossed-Hand Stretch.

19. Topic 20–2: Myofascial Techniques • Techniques for Working with Myofascia • Focused myofascial stretches. • See Technique 67: Fascial Spreading. • See Technique 68: Fascial Torquing. • See Technique 69: Fascial Cutting. • See Technique 70: Fascial Bowing. • Passive and active range of motion.

20. Topic 20–2: Myofascial Techniques • Integration of Myofascial Techniques with Swedish Massage • Myofascial techniques absence of lubricant; applied first. • Next Swedish techniques used. • Finally area passively stretched. • Order in which body areas addressed depends on your preferences, client’s preferences, session goals.