Session Title

Presenter namePresenter email

WHAT WE TOLERATE, WE

ACCEPT!!

- Cassidy Phillips

Some other factors that cause Triggerpoints..

Overuse - extrinsic factors.

Training errors

Inadequate preparation

Inadequate massage for sore and tired muscles

Overhard or soft surfaces

Inappropriate shoes/equipment;

Environmental conditions

Overuse- Intrinsic factors..

Poor biomechanics

Muscle fatigue

Muscle weakness

Joint instability/hypermobility

Lack of muscle flexibility.

The Physiology of Tightness

Joint ROM can be limited by the following factors (Hutton, 1992):

1. Joint constraints

2. Subcutaneous connective tissue.

3. Neurogenic constraints (voluntary and reflexive)

4. Myogenic constraints

Can you explain the word ‘Tight’?

Muscle Fibres (myogenic effect)

Can stretch to at least 50% greater length than when at rest (last cross bridges intact).

Magnesium deficiency can cause tightness (cramping) as magnesium facilitates actin-myosin release.

Muscle Spindles (neurogenic effect)

•Primary stretch receptors in the muscles.

•reflexive capabilities via alpha-motoneuron (the alpha-motoneuron is responsible for initiating muscular contraction)

•Strong phasic contraction upon detection of stretch, followed by controlled tonic contraction.

•Regular stretching may decrease sensitivity of muscle spindles

•This may explain acute performance decreases post-passive stretch

Fascia

Composed of collagen and elastin, providing tensile and elastic properties.

Continuous structure that surrounds and integrates tissues and structures

Can affect relationship amongst structures

Fascia cont’d

Contributes >40% of resistance to movement

Immobilisation decreases space between collagen fibres- causing a sticking together

Muscle overactivity can result in increased fibroblast activity (>collagen deposition).

Interconnectedness of fascia can result in patterns of tightness in muscle slings.

Myofascial restriction:

Trigger points

Discrete, focal, hyperirritable spot in taut band of muscle

Occurring in all patients with musculoskeletal pain

Can be active or latent

Symptoms:

Painful on compression

Referred pain/tenderness

Motor dysfunction

No evidence for development mechanism of Trigger Points

Acute and chronic trauma, chronic lengthening, sleep disturbance, anxiety

Some common Triggerpoints(Back)

Some common Triggerpoints(Front)

Myofascial release – the alternative

Similar to massage

Uses palpation, pressure and tissue stretch to relieve tension and improve:

Muscle tone,

Length,

Timing,

Strength,

Endurance,

Control

Can be used on various soft tissue abnormalities:

Local increased muscle tone

Trigger points

Muscle shortness

Fascial tightness

Deficits in motor activity or control

Can result in pro-inflammatory effect and decreased fibroblast activity and collagen production (short-term)

Myofascial release- cont’d

• It is an important tool helping the body correct imbalances throughout the myofascial system.

• Applying gentle force to the adhesion; the elastic collagenous fibers are manipulated from the bundled position into an alignment that is straighter with the direction of the muscle and /or fascia. (Theory!)

• The gentle pressure applied with the roller will assist in releasing the tension by stimulating the GTO

Exercise and myofascial release

Exercise is vital for myofascial release treatment

Resets neurological programming (Theory)

Both needed for permanent change

Self Myo-Fascial and Trigger Point Release

Interactive soft tissue release requiring feedback from patient to determine correct position, amount of pressure and duration of stretch

Uses body weight on tool i.e. foam roller or tennis ball

Penetrates into muscle and or fascia

Easy and effective

Releases tightness and trigger points

Can be painful

Research to prove efficacy is poor and inherently

difficult to achieve.

Practical programming

Warm up:Self-myofascial release/ joint capsule workActivation exercisesDynamic warm up with progressive loading

(jog, add speed and direction change, dynamic stretch, agility, skill)

Cool DownDecrease metabolic load for waste product clearanceSlow dynamic stretching movementsSMFRStatic stretching later

Look at what is short/tight and facilitated (assess!!)

Address Right/left and front/back imbalances

Consider performance effect of chosen modality

So, how does it work?

Traditionally, we thought…

Rolf believed that applying manual pressure to fascia can change its density and arrangement, making it less dense and therefore more fluid. (Thixotrophy)

The Piezoelectric model (Schleip or Juhan)

‘Fuzz’ – Gil Hedley

But..

These two models appear to be effective over the long-term not short-term.

A modern approach..

The Golgi reflex arc…

GTO- Ruffini and Pacini Corpuscles

Motor unit not fibre activation??

DNIC (Diffuse Noxious Inhibitory Controls)

Important things to remember

• Cue the client to breathe & relax when a tender point is found.

• Muscles are three dimensional, don’t roll in one plane/direction!

• If unsure about the clients imbalances REFER them to a Professional!

FAQ…

• Which direction do I go?

• How long do I hold?

• I feel referral to other parts of my body, is this normal?

• I don’t feel anything, is this possible?

• Do I really need to do this?

• Which parts of the body can I use it on?

THANK YOU!

Enjoy the rest of your SPINNING® SHOWCASE 2017