physical therapy Archives - Amazing Health Advances

Preventing Rotator Cuff Injuries

The AHA! Team — Mon, 08 Sep 2025 05:38:15 +0000

Morgan deBlecourt via Duke Health – Rotator cuff tears are more common than you may think. About 10% of people in their 50s and half over the age of 70 will have one. While many rotator cuff tears are related to aging, they can occur in younger people as a result of overuse, poor shoulder mechanics, or injury. Rotator cuff injuries affect all types of people — sedentary adults, weekend warriors, and elite athletes. Fortunately, there are steps you can take to reduce your risks. “Good posture in the shoulder blades, stretching, and some very simple strengthening exercises will help prevent many of the shoulder problems you could have,” said Jocelyn Wittstein, MD, a shoulder specialist at Duke Health. “Also, modifying lifting and exercise practices can reduce the risk of shoulder injury or reinjury.” Overhead Activity Leads to Shoulder Injuries It’s true that baseball pitchers suffer rotator cuff tears — or rather, fraying on the edges of some tendons — because of the extreme position of the shoulder and the tremendous force they exert on their shoulders every time they throw the ball. But overhead activity of all kinds is what tends to injure people: reaching up repeatedly to paint a wall, putting a heavy suitcase in an overhead bin, or serving a tennis ball. “Any time your arms are raised up over your head, the rotator cuff might be in an awkward position,” said Dr. Wittstein, a Duke orthopaedic surgeon. “This in combination with lifting or lowering something heavy away from the body really strains the rotator cuff.” The first sign of a rotator cuff injury is often nagging shoulder pain when performing everyday activities such as washing your hair, lifting a gallon of milk, or reaching for something on the back seat of the car. Pain is usually felt at the side of the shoulder and can often radiate toward the elbow. Injured shoulders can also be troublesome at night when lying down allows the inflamed joint to stretch or when sleeping on your side. Occasionally, nighttime pain can get so bad that sleep is possible only in a reclining chair — and some patients can’t sleep at all. Exercises Can Prevent Rotator Cuff Injuries The shoulder has more range of motion than any other joint. Most of its stability and movement relies on the small rotator cuff muscles and the larger muscles that surround the shoulder joint. Traditional weightlifting and aerobic exercise provide many benefits but typically do not focus on strengthening and stretching the complicated assembly of muscles that keep the shoulder joint stable and healthy. Dr. Wittstein said that a shoulder exercise program should work the muscles that retract the shoulder blades, stretch the chest and the back of the shoulder joint, and strengthen all the muscles of the rotator cuff. These exercises will strengthen your rotator cuff and help prevent injury, whether you are active or inactive, young or old. Treatment Options for Torn Rotator Cuffs If you tear your rotator cuff, there are several treatment options. The type of treatment depends not only on the extent of the injury but also on your age and functional demands. While many complete rotator cuff tears benefit from surgical repair, surgery is not always necessary. Cortisone injections can reduce pain but should be used sparingly, as they can affect the ability of the rotator cuff to heal if you decide to have a surgical repair in the near future. Other medications like Tylenol and anti-inflammatories may also help. People with a partial tear or who want to avoid surgery can benefit from physical therapy, which they are encouraged to continue at home. Sometimes, strengthening is all that’s needed, even if your rotator cuff is torn. That’s because “four separate rotator cuff tendons surround the shoulder,” Dr. Wittstein explained. “If you have torn half of one tendon, you still have three and a half tendons left. If those are strong, it can often fully compensate for the torn part.” However, rotator cuff tears that involve the full thickness of the tendon and remain painful may enlarge over time. “Those are the rotator cuff tears we are more likely to repair with surgery early on,” she says. She added, “Many people with a small tear can have a pain-free, strong, healthy shoulder with full ability to do an overhead activity. That’s why keeping those muscles strong is so important.” If you think you may have a rotator cuff injury, consider scheduling an appointment with a Duke shoulder specialist. To read the original article click here.

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A Farm Where Animals and People Heal From Trauma Together

AHA Publisher — Fri, 04 Nov 2022 07:00:27 +0000

Abigail Klein Leichman via Israel21c – The three-legged fox, the chameleon that can’t stick out its tongue, and about 200 other creatures on the modern-day Noah’s ark of psychotherapist Yoni Yehuda are rehabilitating from disability, trauma or injury – as is Yehuda himself. Puffing on medical cannabis to ease chronic pain resulting from a 1987 army parachuting accident and a 1996 terror attack, Yehuda explains that he and each of the rescued animals at his Havayot Center outside Jerusalem is an equal partner with patients in his unique “Therapeutic Triangles” model of animal-assisted psychotherapy. “The basis of the work here is saving animals and taking care of them. We are responsible for their welfare as long as they are in cages in our possession, which is not where they are supposed to be.” As he speaks, he’s hand-feeding a bald baby parakeet while a mare named Venus gives a contented snort in her corral outside. Aside from those born here, all animals at the one-acre Havayot Center arrived after some trauma rendered them unable to survive in the wild, temporarily or forever. Some were former patients of the Israeli Wildlife Hospital; others were saved and brought to Yehuda by individuals or by the National Parks Authority. The Triangle Animal-assisted psychotherapy isn’t new. In 1961, American clinical therapist Boris Levinson wrote a paper titled “The dog as a ‘co-therapist’” and coined the term “pet therapy” in 1964. Animals are known to induce calm, self-awareness, compassion and emotional adjustment. However, in typical animal-assisted therapy, usually with dogs or horses, the animals are adjuncts to the therapeutic process. At Havayot, they are fully part of the process as the client and therapist jointly care for the animal’s needs. “We are together on the same level and there is a triangular connection with the animal and with the therapist,” explains Yehuda. “Everything comes from a lot of respect for the animals and letting them lead the process. As a therapist, I have to put my ego aside and then the client can project things on the animals and start to speak about his own world and reach for solutions.” The therapist must have the knowledge and observational expertise to decide which animal will have best therapeutic value for each client. Yehuda chooses from a large variety: insects, fish, reptiles, birds, rodents, an assortment of wild and barnyard animals, dogs and a cat. He gives each one a name and comfortable conditions for its needs. University of Denver Prof. Philip Tedeschi, an expert in animal-assisted therapy and founder of the Institute for Human-Animal Connection, has visited the Havayot Center several times. “Philip said this may be the only place in the world with such a large range of animals for therapy. It was certainly the first of its kind,” says Yehuda. Goldfish Are Therapists, Too When I ask how fish can be therapeutic partners, Yehuda points to Yossi, a handsome goldfish swimming in an aquarium. “Put your finger on the glass and tap it. Now move your finger to the other side and tap it. He will come over to you because Yossi loves to be in touch with people,” Yehuda instructs me. Sure enough, Yossi follows my finger. “Now, think about a very shy child. He may have selective mutism. You want to give him the feeling of connection with an animal, but with Yossi he doesn’t have to be in physical touch with it and he doesn’t have to speak to it,” says Yehuda. “If he wants to, he can try to read Yossi’s body language and become his spokesman. If a child doesn’t want to speak to me but starts speaking to the animal, then he can speak to me. The animal makes the change.” An empty Jack Daniels bottle was placed in Yossi’s aquarium by a client struggling with alcoholism ever since his birth to an alcoholic mother. “The water in the aquarium symbolizes life, the womb. The fish represents our ability to return to the womb and be reborn,” says Yehuda. “Leaving the bottle in the aquarium allowed this man to start over. He was able to stop drinking. And neither I nor the fish had to say anything.” Yehuda shows me a maze constructed by a child grappling with his parents’ divorce. The mouse begins from one house and learns to follow a long route leading to two houses — a mother’s house and a father’s house. Insects such as butterflies, walking sticks and gigantic Madagascar hissing cockroaches can be effective in treating various phobias and difficulties. Snakes help clients with sexual identity issues because of the way they shed their skin and develop a new one as they grow throughout their lifetime. It’s Personal When Yehuda was 13, his beloved cousin Noam was killed in action in Lebanon. The two boys had enjoyed caring for Noam’s pets including a sheep. They used to talk about how animals helped them understand their own feelings. At the time of this tragedy, the Yehuda family was living in England. Sensitive to their son’s grief and his connection to animals, Yoni’s parents signed him up for a class for gifted children at the London Zoo under Sir David Attenborough. At 19, after a military parachuting accident rendered him unable to walk for some time, Yehuda was one of the first wounded soldiers treated by equine therapy pioneer Anita Shkedi, who later founded the Israel National Therapeutic Riding Association. Thus, when he was shot in a terror attack nine years later, “I knew that I had to have animals around me because only with animals could I understand what was happening inside me.” Yehuda, now 54, has a master’s degree in special education and a PhD in psychology. A man of faith, he speculates that God was the first animal-assisted psychotherapist. “To save humanity, God puts Noah in the ark with all these animals. He could have just put him to sleep and woken him up after the flood. But God put people with animals to save their own souls,” he says. Clients need not share his religious beliefs to benefit from his therapeutic model, he emphasizes. The nonprofit Havayot Center, built with Yehuda’s own hands and funds on the grounds of his home in Elazar in 1998, is supervised by the regional veterinary authorities and other governmental agencies and ministries. The center accepts private clients and is an authorized provider for victims of terror attacks and war. Yehuda opened a School of Animal Interventional Therapy at the Hebrew University of Jerusalem and traveled extensively lecturing about his work and teaching his protocols. In 2009, the Israel Postal Service issued a series of stamps recognizing the influence of Yehuda’s Therapeutic Triangles model in the field of animal-assisted therapy in Israel and around the world. Saying Hello to Each Animal But Yehuda’s ongoing physical and emotional rehab forced him to take a step back. He grapples daily with PTSD, fibromyalgia, CRPS (complex regional pain syndrome) and other ailments including osteoporosis from intensive steroid therapy. He has daily physical and hydrotherapy and periodically receives hyperbaric oxygen therapy for PTSD. Currently, he’s donating his services to members of an Israeli organization that helps people dealing with PTSD; the Jerusalem-area group encompasses more than 70 families. “My innovation was that I work with the families as well, because they are neglected,” says Yehuda. “No one ever asked my wife, Liat, if she needed help. When I was in a wheelchair, the need for help was obvious. But when you have PTSD, it’s hard for people to understand the hell that’s happening in your head and how it affects your family.” The Bernie Madoff financial scam and the Covid epidemic have left the Havayot Center struggling. Yehuda had to let go many staff members and rehome some horses. But despite his limited energy, time and money, he is carrying on – as much for himself as for his clients. “I don’t know what I would do if I didn’t have the feeling of responsibility to wake up every morning and spend three hours saying hello to each animal,” he says. For more information, click here To read the original article click here.

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How to Use the Mind to Improve Your Physical Performance

AHA Publisher — Mon, 03 Jan 2022 08:00:51 +0000

Abigail Klein Leichman via Israel21c – Most of us can conjure up a vivid mental image of our favorite food. Just thinking about it can make our mouths water. Israeli physical therapist Amit Abraham heads a lab at Ariel University that’s translating this phenomenon into innovative training protocols to enhance dancers’ and gymnasts’ performance and improve rehab results for people with Parkinson’s disease. Over the past year, he worked with Israel’s Olympic rhythmic gymnastics team, which finished the Tokyo Games in sixth place. “Mental imagery by itself has been extensively used and researched. Even ancient Egypt used mental imagery,” Abraham tells ISRAEL21c. “Our lab is one of very few in the world studying the neurocognitive aspects and integrating it into training and rehabilitation. Some of the things we are doing in this field for the very first time internationally.” Following his postdoc research at Emory University School of Medicine in Atlanta with movement scientist Madeleine Hackney, Abraham returned to Israel in 2020 and established the Mental Imagery & Human Embodied Potential Lab in Ariel University’s Department of Physical Therapy. Not Child’s Play The lab’s goal is to provide scientific evidence for the motor and cognitive benefits of creating experiences in the mind. “We do group and one-on-one sessions in a specific process of bringing to life the mind-body connection,” he explains. “A lot of athletes visualize before competing. But they are not trained in how to use this efficiently as a tool to its fullest potential. That is my goal.” In his initial session, he often needs to overcome participants’ hesitancy. “People think mental imagery is childish and feel embarrassed to use it, especially in a group setting,” Abraham says. “So we start from scratch by explaining how to use it, what are its possibilities and limitations, the science behind it, and how to address lack of belief in it. Once people get excited about it, they can step out of their comfort zone and then it’s easier.” Imagine Motion Without Moving Abraham explains that just as it’s possible to imagine the taste of coffee without drinking it, you can imagine moving your arm without moving it. “Or you can lift your arm slightly while imaging your arm doing a full range of motion,” he says. “If you want to improve your quality of movement, you can imagine your arm as light as a feather. That’s called ‘metaphorical imagery’ and it’s a core component of the Franklin Method, developed my mentor and colleague, Eric Franklin, for teaching body alignment.” This is not always simple. For someone has lower back issues, for example, it is challenging to image the spine moving fluidly without pain. “We are confronting a reality that doesn’t always match the imaging,” Abraham says. “However, this is exactly the huge potential of mental imagery — to overcome the reality with the goal of changing it.” The final step is individualized interventions or training protocols, whether for a rhythmic gymnast or an individual with Parkinson’s disease. “My training as a musculoskeletal physical therapist helps because we can address a problem mechanically as well as with mental imagery,” says Abraham. “We’re trying to be less dependent on the therapist or on technology and more focused on the individual’s potential for self-empowerment.” Openminded Coaches Abraham finds that if the team trainer or coach is open to trying this evidence-based approach it’s more likely to catch on with the athletes. In the case of Israel’s rhythmic gymnastics team, head coach Ira Vigdorchik was quite enthusiastic to try this approach. Abraham did group training in collaboration with Vigdorchik’s coaching team, individual training to address specific areas for improvement, and an assessment of how the trainings impacted performance. “We started with traditional motor imagery: They lie on their back and mentally image the entire sequence of an exercise. We made it more codified, feeling the sensations and perspectives of first and third person,” he says. Abraham also does metaphorical imagery. For example, while balancing on one leg the gymnast visualizes that leg as a tree rooted in the mat. Team member Bar Shapochnikov tells ISRAEL21c: “The mental imagery work with the Franklin Method and Dr. Abraham helped me enhance my performance. My range of motion increased, my confidence in performing increased, and the training became more efficient.” Abraham admits that achieving further improvements at this high level of expertise is extremely difficult. “Therefore, we’re constantly looking for novel approaches that can help the gymnasts and athletes without putting them under even greater physical stress.” Neurocognitive Imagery for Parkinson’s At Emory, Abraham did the first research on integrating dynamic neurocognitive imagery into Parkinson’s disease rehab. He tailored a pilot intervention, based on the Franklin Method, to correct distorted mental representations of the body that can worsen motor and cognitive functioning. “Parkinson is a multifaceted condition, mostly known for slowness of movement, rigidity, balance dysfunctions and resting tremor. But about 60 percent of individuals also have sensory and cognitive deficits that are less talked about. We thought mental imagery could address these deficits,” he explains. This unique embodiment approach taught people to connect imagery with physical sensations. This intervention eased both motor and non-motor symptoms of the disease, as described in a paper Abraham and colleagues published earlier this year in a special issue of Brain Science exploring novel therapies for movement disorders. “We have to develop protocols in this and other neurological and orthopedic populations,” says Abraham. “It’s kind of out of the box to focus on different populations but I see mental imagery as connecting them all.” Abraham aims to become an international leader in the field of mental imagery for rehabilitation and performance. “We collaborate with various researchers in the US and Europe, but this is more than just research. We are looking to really make an impact on dance and gymnastics performance. We are constantly looking for teams and dance companies worldwide willing to try it to enhance performance and wellbeing,” he says. “Shoot me an email amitab@ariel.ac.il if our research intrigues you.” To read the original article click here.

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Pain Is Always a Perception’: Physical Therapy Can Help Prevent, Treat Opioid Use Disorder

AHA Publisher — Mon, 12 Apr 2021 07:00:31 +0000

West Virginia University via EurekAlert – When you think of ways to treat opioid use disorder, you might think methadone clinics and Narcotics Anonymous meetings. You probably don’t imagine stretches and strengthening exercises. But Anne Swisher–professor at the West Virginia University School of Medicine–is working to address opioid misuse in an unconventional way: through physical therapy. She and her colleagues have enhanced physical therapy instruction at WVU to emphasize the profession’s role in preventing and treating opioid use disorder. “Students have different interests and passions within the profession, and they find their niche,” said Swisher, a researcher and director of scholarship in the Division of Physical Therapy. “No matter what their passion is, there is a way they can make a difference, whether it’s by preventing people from starting down the road of opioids–by minimizing pain medication and doing movement interventions–or whether it’s by helping people in the recovery process become healthier overall.” Swisher and her team devised a model to show doctor of physical therapy students how key topics in their curriculum–such as women’s health, pediatric care and sports therapy–could all address opioid use disorder in various ways. Their model–which was published in prestigious rehabilitation journal Physical Therapy–is innovative because it goes beyond musculoskeletal issues and addresses how physical therapists can assist people across the lifespan, from neonatal to hospice settings. It also illustrates how physical therapists can help improve human movement across what Swisher calls the “whole addiction spectrum.” “In our curriculum, our students learn about all of these different aspects–what to do with somebody who’s critically ill, the appropriate developmental milestones for children, how to help older people stay active–but it was really just a matter of connecting it all together,” she said. For instance, by making it easier for pregnant women to manage their aches and pains without opioids, physical therapists can help prevent neonatal abstinence syndrome in newborns. By combining special exercises with pharmacological treatment, they can reduce opioid use in patients after spinal surgery. And by promoting healthy physical activity in general, they can support people as they recover from opioid use disorder. “I think it comes back to movement,” Swisher said. “One of the catchphrases we like to use is, ‘Motion is lotion for the joints.’ And we know that regular physical activity releases the body’s own opioid chemicals. That’s the so-called ‘runner’s high’ that makes us feel good. Physical therapists can partner with people to work through their barriers to becoming more physically active.” What are some of those barriers? Well, it depends. An overweight patient may find movement difficult because he has knee pain. A patient recovering from hip surgery may fear the pain of exercise so much that she avoids attempting it. And a new mom may find caring for her baby so overwhelming that even a walk around the block feels herculean. “Pain is always a perception,” Swisher said. “It is always influenced by your own experiences, your motivation. If you get a tattoo to celebrate something monumental, you’re causing tissue damage, but you don’t perceive that as painful as putting your hand on the stove accidentally. We’re educating our students–and our colleagues–to understand that whole context working with pain.” As described in the article, she and her team also incorporated their model into the clinical rotations that DPT students complete in rural Appalachian communities. As part of their rotations, the students choose a topic to develop into an educational program for a specific population in their community. They research issues specific to that community and consider those issues when designing the program. “So, you get a small group of students who love women’s health,” Swisher said. “Maybe they develop an exercise program for women who have had babies that might have chronic pelvic pain.” All of the programs are stored electronically so that as the students make their way through their rotations, they can access each other’s programs and work with their own clinical supervisors to tailor them to the communities they’re serving. “I think when we’re looking at any kind of healthcare provider going into these rural communities that are really struggling with addiction, you have to look at those psychosocial and emotional reasons why people might find a desire to escape some pain, whether they perceive it as physical pain or whether it becomes more of an emotional pain,” Swisher said. “We have to consider how we as physical therapists interact with people as complex, bio-psychosocial individuals.” The complex, bio-psychosocial individuals who call Appalachia home have been disproportionately affected by the opioid crisis. Appalachians are more likely to die prematurely than people who live elsewhere in the United States, and opioid-related deaths are a main reason for this disparity, reports the Appalachian Regional Commission. West Virginia, in particular, has been hit hard. In 2018, the state had the nation’s highest rate of opioid-involved overdose deaths, according to the National Institutes of Health. That same year, healthcare providers in the state wrote 69.3 opioid prescriptions for every 100 West Virginians. The national average? Just 51.4. Preparing the next generation of physical therapists to deal with opioid use disorder is important because “there’s such a huge issue here in Appalachia, especially in rural communities,” Swisher said. “If you’re a physical therapist, you don’t need a special certification in opioid recovery to influence something across this whole addiction spectrum,” she said. “Just do the things that you do as a physical therapist, in your area.” To read the original article click here.

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Virtual Physical Therapy After Knee Replacement Brings Similar Outcomes, Lower Costs

AHA Publisher — Wed, 22 Jan 2020 05:28:55 +0000

Wolters Kluwer Health: Lippincott Williams and Wilkins via Newswise – A virtual system for in-home physical therapy (PT) provides good outcomes for patients undergoing rehabilitation following total knee arthroplasty (TKA) – with lower costs than traditional in-person PT, reports a study in the January 15, 2020 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer. Newswise — January 16, 2020 – “Relative to traditional home or clinic PT, virtual PT with telerehabilitation for skilled clinical oversight significantly lowered three-month health-care costs after TKA while providing similar effectiveness,” according to the clinical trial report by Janet Prvu Bettger, ScD, of Duke University, Durham, N.C., and colleagues. Virtual PT After TKA Is Safe and Effective, Randomized Trial Reports The study included 306 patients with an average age of 65 years undergoing a knee replacement procedure. Patients were randomly assigned to undergo traditional PT, either at home or at clinic visits, or virtual PT with use of a virtual telehealth system. The FDA-cleared Virtual Exercise Rehabilitation Assistant (VERA) was designed to provide remote rehabilitation services. The cloud-based system features a digitally simulated coach to demonstrate and guide activity, including visual and audio instructions. The system also uses 3D tracking technology to assess the patient’s pose and movement, enabling immediate feedback on exercise quality. The VERA system provides a virtual video connection for weekly live telehealth visits with a remote physical therapist, who monitors the patient’s progress and reports back to the surgeon before follow-up clinic visits. Patients were able to receive in-person PT, if deemed necessary. The study compared the costs and effectiveness of rehabilitation following TKA for the virtual and traditional PT groups. In the 12 weeks after TKA, median total costs were $1,050 for patients assigned to the virtual PT system, compared with $2,805 with traditional PT. Mean costs were $2,745 lower in the virtual PT group. Patients using the VERA system participated in PT an average of 5.9 days per week, compared with 3.3 days in the traditional PT group. Eighty-eight percent of patients in the virtual PT group said they completed all assigned exercises, compared with 65 percent with traditional PT. After 12 weeks of rehabilitation, knee function, walking speed, and other functional outcomes were similar with virtual and traditional PT. Patients in the virtual PT group reported less difficulty with knee function during sports and recreational activities. There was no difference in physician, urgent care, and emergency room visits, but patients in the virtual PT group had fewer hospital readmissions. Safety outcomes were also similar between groups. The risk of falls was somewhat higher for patients assigned to virtual PT. Postoperative PT is important for helping patients to regain physical function following TKA. But PT care can be challenging to access, with barriers including cost and a shortage of physical therapists. Virtual or telerehabilitation programs such as VERA might help to increase home-based access to PT for patients undergoing TKA. The new study finds substantially lower costs in the three months after TKA for patients assigned to virtual PT, compared with traditional PT. Effectiveness and safety are similar between groups. Some outcomes might be even better with virtual PT (ie, knee function during sports/activities and rehospitalization risk), although the risk of falls may be higher. “These findings have important implications for patients, health systems, and payers and suggest that virtual PT with a telehealth therapist for remote clinical monitoring and guidance should be considered for patients after TKA,” Dr. Bettger and colleagues conclude. Although further study to guide implementation and uptake is needed, the authors believe that virtual PT systems have the potential to improve access while lowering costs of PT for patients undergoing TKA. To read the original article click here.

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Myofascial Release Therapy for Back Pain, Posture and More

AHA Publisher — Fri, 06 Dec 2019 08:00:28 +0000

Jillian Levy, CHHC via Dr. Axe – Whether you’re an athlete looking to improve your training and performance, or someone trying to reduce pain and achieve better alignment, myofascial release therapy can likely help. This type of manipulative therapy targets hard knots and trigger points in the muscle tissue that can elicit tenderness, pain, stiffness and even twitching. While it’s still considered an “alternative treatment,” one that has been studied significantly less than similar approaches, there’s evidence that it may be beneficial for those dealing with pain or inflexibility even after trying surgery, medication and stretching. What Is Myofascial Release? Myofascial release (or MFR) is a type of hands-on treatment that is used to reduce tightness and pain in the body’s connective tissue system. It’s intended to improve range of motion, flexibility, stability, strength, performance and recovery. The purpose of MFR is to detect fascial restrictions — areas of connective tissue that are tight, painful or inflamed — and then to apply sustained pressure to that area in order to release the fascia. Since it originated in the 1960s, literature regarding the effectiveness of MFR has been limited, shown mixed results and not been of the best quality. Recently, however, a 2015 systematic review concluded that “MFR is emerging as a strategy with a solid evidence base and tremendous potential.” What Is Fascia? Although experts currently don’t agree on one official definition of fascia, it’s considered to be a band or sheet of connective tissue, made up mostly the type of collagen protein that attaches and stabilizes muscles and other internal organs. It’s described as having has an appearance similar to a spider’s web or a woven sweater. This system covers every muscle, bone, nerve, artery, vein and internal organ, spanning the entire body from head to toe. It surrounds and attaches to all structures, supporting overall functionality of the body. Normally, fascia is relaxed and has the ability to stretch and move. But when it becomes inflamed or damaged, it starts to become tight and restricted in movement as it loses its pliability. Not only can this cause inflexibility and pain, but it causes tension to develop in other parts of the body too, since the body’s fascia is an inter-connected system. Myofascial release therapists often describe dysfunctional areas of fascia as trigger points, knots, adhesions, ropes or scar tissue. When someone has many of these, it’s referred to as myofascial pain syndrome (MPS). Releasing these trigger points or knots, as well as the surrounding area, is the focus of MFR treatments. Not only does this dissipate pain at the specific trigger point, but it can help stop pain from “rippling out” to other parts of the body. How does MFR compare to other manipulative techniques? Is foam rolling the same as myofascial release? The use of foam rollers is popular for practicing self-myofascial release (SMR). MFR doesn’t necessarily require the use of a foam roller (since it can be done with a therapist’s hands), however foam rolling has the same purpose: It uses application of pressure to help break up scar tissue and soft-tissue adhesions that lead to pain and stiffness. The main difference is that foam rolling is performed by the individual on themselves, rather than by a practitioner. Foam rolling is also encouraged as part of a warm-up or cool-down before and after a workout because it increases blood flow to muscles and helps to “lengthen” connective tissue, improving range of motion. What is a myofascial release massage, and how does it differ from other massages? MFR technique is somewhat different than some other types of manual adjustments, including other massage therapy techniques and rolfing, because it’s performed for a shorter time and directly on the skin without oils, creams or machinery. MFR, massage and rolfing include some of the same techniques, but with MFR there’s more focus on specific trigger points, rather than the whole body. MFR maintains pressure for three to five minutes at a time on a targeted area. It also requires steady pressure to soften and stretch fascia. Overall it tends to be firmer and more targeted (and sometimes less relaxing) than typical massages. How It Works Myofascial release therapy involves applying gentle and sustained pressure applied to connective tissue using the therapist’s hands. Another way it is described is “low load, long duration stretching.” According to the MFR Treatment Centers & Seminars website, “This essential ‘time element’ has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate.” MFR therapists use a variety of myofascial release techniques and tools, treating each patient uniquely based on their specific symptoms. Here’s what you can expect from an appointment with a MFR therapist, which usually lasts between 30–60 minutes per session in total, including discussion before and after: • First, your therapist will work on locating the areas of fascia that appear to be restricted. • Tests will be performed to measure the level of loss of motion or pain you’re experiencing. • Your therapist will perform hands-on treatment that is slow and gradual. Usually this takes place in a private therapy room, much like with physical therapy. • Ideally you will continue to be treated weekly or several times per week, for several weeks or even months. The duration depends on your specific condition and symptoms. • You may also be instructed to perform myofascial exercises at home between sessions. In many cases, MFR will be combined with other treatment approaches and remedies for pain management. Some examples include: use of hot or ice packs, stretching, acupuncture, chiropractic adjustments, physical therapy, occupational therapy, and use of non-prescription pain relievers. Who Can Benefit People who can benefit most from myofascial release therapy include those with: • Pain felt mostly in one area, such as the neck, back, shoulders, hips, or one side of the body • Physical trauma, such as a fall, car accident or whiplash • Chronic injuries • History of inflammatory responses that lead to physical limitations • History of surgical procedures that leads to scarring • Emotional trauma that causes muscle tension • Habitual poor posture • Repetitive stress and overuse injuries among athletes • Temporo-mandibular joint disorder pain (TMJ) • Carpal tunnel syndrome • Fibromyalgia • Migraines You may be a good candidate if you struggle with pain and limitations but results on standard tests like x-rays, CAT scans, electromyography, etc. haven’t been able to pinpoint a specific physical problem. Myofascial restrictions are not always easy to spot on these tests, but they can still exist and impact your quality of life. How can you find a qualified myofascial release therapist? Treatments are offered by practitioners including osteopathic physicians, chiropractors, physical or occupational therapists, massage therapists, or sports medicine/injury specialists. Look for a provider that has completed specific myofascial release training courses and has earned a certification. One of the founders of myofascial release massage is John F. Barnes, PT, LMT, NCTMB, who is considered to be one of the most influential people in the field of manipulative therapies. Barnes has been treating patients since the 1960s and today is the owner, director and chief physical therapist at two MFR “sanctuaries” located in Pennsylvania and Arizona. He also manages an educational company called Myofascial Release Seminars which has trained thousands of therapists. To find a therapist trained in his technique, visit his website here. Benefits 1. Helps Restore Proper Body Mechanics MFR treatments focus not only on pain reduction, but also on restoring postural and movement awareness in order to reduce future injuries. Good posture is important for preventing tightness of tissues that leads to restriction and pressure. Over time, poor posture can cause parts of the body to be pulled out of alignment, leading to muscular compensations and overuse injuries. This commonly affects parts of the body including the shoulders and hips, in addition to the glutes and back. 2. Helps Reduce Pain Myofascial pain is thought to have several primary sources: pain within tight skeletal muscle or connective tissue that is being contracted, and pain that generates outward to a nearby structure that is being cut off from blood supply or put under pressure. MFR treatment is believed to help loosen “bound down” fascia so that movement is restored, while also preventing other connected parts of the body from suffering. There’s evidence that not only can this type of treatment reduce muscle pain in specific parts of the body, such as the shoulders or back, but it can also decrease symptoms stemming from tension throughout the body, such as headaches and neck pain. 3. Enhances Strength and Performance Myofascial release massage helps the body handle stress and impact better, including the types purposefully applied to the body via exercise and strength-training. Sometimes MFR is used prior to training to help athletes prepare, or used in combination with other treatments to promote recovery and make other forms of stretching/strengthening more effective. Research indicates that some of the perks associated with MFR for athletes include: improving range of motion, blood flow and joint function; protecting against injury; reducing soreness; and shortening recovery time (post-exercise fatigue) after a workout. 4. Improves Flexibility Fascial restrictions negatively affect both flexibility and stability, so resolving tight areas of fascia can be an effective way to improve mobility, the ability to perform daily activities and overall quality of life. 5. Emphasizes Self-Help and Patient Independence While it’s not exactly the same thing as visiting a therapist, you can practice mysofascial release on yourself at home. How do you do myofascial self-release? The most popular way to do self-myofascial release is with a foam roller. Massage balls and sticks are also available, which help to apply pressure to specific areas of muscles. Some experts recommend limiting use to about two minutes or less per muscle group, specifically focusing on muscles that feel tight. Foam rolling for too long or with too much pressure can actually reduce the effectiveness (especially if you’re doing it as part of a warm-up before exercise) and start fatiguing your muscle, so keep it brief. Begin my moving at a consistent tempo of approximately one inch per second while remaining on areas of tension for up to 90 seconds. You should feel your muscle warm up, loosen and relax. Risks and Side Effects When performed by a trained therapist, this type of manipulative therapy is considered to be very safe. However, it shouldn’t be performed on anyone with open wounds, burns, fractured or broken bones, or deep vein thrombosis. Because some studies suggest it doesn’t work for everyone with chronic musculoskeletal pain, it also shouldn’t replace other treatments or doctor’s visits. Does myofascial release hurt? Some people report feeling some discomfort during or after myofascial massage, however it shouldn’t be very painful. You may temporarily feel sore or have difficulty moving, but this should improve within 1–2 days. If you have concerns about getting started, it’s a good idea to speak with your doctor, chiropractor or orthopedist first. He or she can recommend which type of manipulative therapy is best for your condition, and give you instructions for practicing self-MFR at home. Final Thoughts • What is myofascial release? It’s a type of hands-on/manual therapy technique that focuses on reducing tightness and pain stemming from dysfunctional myofascial tissue. It targets trigger points or knots, which are inflamed or damaged parts of fascia, a system of connective tissue that wrap, connect and support your muscles. • Myofascial massage benefits may include improving range of motion, flexibility, stability, strength, performance and recovery, while reducing pain. • Trained therapists or doctors usually perform MFR. You can also perform self-myofascial release using a foam roller, balls or sticks. To read the original article click here. For more articles from Dr. Leaf click here.

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