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Introduction of Myofacial Stretch Release Technique..

The myofascial release approach is a form of soft tissue therapy used totreat somatic dysfunction and resulting pain and restriction of motion.

History of Myo facial technique

Andrew Taylor Still MD, DO (August 6, 1828 – December 12, 1917)

Andrew Taylor Still

Andrew Taylor Still in 1914

Born August 6, 1828Lee County, Virginia

Died December 12, 1917 (aged 89)Kirksville, Missouri

Citizenship US

Nationality American

Fields osteopathy , medicine

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Anatomy OF Fascia…..

Fascia is the soft tissue component of connective tissue system that permeates thehuman body. It interpenetrates and surrounds muscle, bones, organs, nerves,bloodvesseles and other structures.

Fasica is uninterrupted there dimensional web of tissue that

extends from head to toe from front to back and also from interior to exterior.

It’s a term applied to masses of connective tissue large enough tobe visible to unaided eye.

Muscles with the help of its fascial binding supplies the tensionthat life gives to osseus frame work. Muscles and fascia are functionally linkedcombining the properties of

Muscle Origin Insertion Artery Nerve

ezius down the midline,from the external,the nuchal ligament , the medial part of the superior nuchalline , and the spinous

processes of thevertebrae C7-T12

at the shoulders, intothe lateral third of the clavicle , the acromion processand into the spine of the scapula

transversecervicalartery

major nerve supply isthe cranial nerveXI.cervicalnerves C3and C4 receiveinformation about painin this muscle

retracti

simussi

spinous processesof thoracic T6-T12 ,thoracolumbar

floorof intertuberculargroove of

artery,dorsal

thoracodorsal nerve pullsthe for

Institutions Baker University , A.T. Still University

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fascia , iliac crest andinferior 3 or 4 ribs

the hummers

mboids nuchalligaments , spinousprocesses of C7-T5vertebrae

medial border of thescapula

dorsalscapularartery

dorsal scapularnerve (C4 and C5)

Retractto deprfixes thwall .

rhomboid or

spinous processes of the T2to T5 vertebrae

medial border of thescapula , inferior tothe insertionof rhomboid minor

muscle

dorsalscapularartery

dorsal scapularnerve (C4 and C5)

Retractto depralso fixthe tho

rhomboid or

nuchalligaments and spinousprocesses of C7-toT1 vertebrae

medial border of thescapula , superior tothe insertionof rhomboid majormuscle

dorsalscapularartery

dorsal scapularnerve (C4 and C5)

Retractto depralso fixthe tho

atorpulae

posteriortubercles of transverseprocesses of C1 -C4 vertebrae

superior partof medial border of scapula

dorsalscapularartery

cervical nerve (C3 ,C4) and dorsal scapularnerve (C5)

Elevateitsglenrotating

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Fascia in the body parts..

ROLE OF FASCIA IN BODY

It is responsible for maintaining structural integrity.

It provides support and protection.

It acts as schok absorber and stabilizes helping our body to stand erect and movefluidly

Facsia has an essential role in hemodynamic and bio-mechanical process andprovides the matrix that allows for intercellular communication.

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Fascia acts as the body first line of defense against pathogenic agents andinfection.

After injury it is the fascia that creates an environment for tissue repair.

Fascia not only contributes contour to the body but also provides lubricationbetween structures for movement and nutrition

LAYERS OF FASCIA.

There are three layers of fascia they are:-

A) Superficial fascia

B) Deep fasciaC) Visceral or sub serous fascia

Superficial Fascia :-

It is a general coating of the body beneath the skin made up of aloose areolar tissue with varying amounts of fat.

The fibourus mesh filled with fat connects the dermis to the underlying sheet of deep fascia and particularly dense in scalp; the back of neck; the palms of hand andsoles of the feet thus binding the skin firmly to the deep fascia.

In addition to it sub-cutaneous prescence,this type of fasciasurrounds organs and glands neurovascular bundles capillary channels and lymphvessels run through these layers.

Important Feautures of Superficial Myofascia.

I. Superficial fascia is more distinct in lower part of anterior abdominal walland limbs.

II. It is very thin in dorsal aspects of hand ;feet and sides of neck III. Very dense in scalp palms and soles

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Functions:-

I. Superficial fascia facilitates movements of skin.

II. It serves as storage medium for fats and water.III. It serves as soft medium for the passage of vessels and nerves to the skin

Deep Fascia :-

It is the dense fibrous connective tissue that inter penetrates and surroundsthe muscles ; bones; nerves and blood vessels of the body.

It is the fibrous sheath which inserts the body beneath the superficialfascia. It is devoid of fat and usually inelastic and tough.

It is continues with the fibires of superficial fascia and send widepartitions between muscles from its deep surface.

Thus it ensheaths the muscels vesseles and nerves which lie betweenthem. This sheath from a major part of attachment of many muscels for they passdeeply to become continues with the fascia which surrounds and tightly adherent to

bones.

Distribution :-

Deep fascia is best defined in limbs where it forms tough and sleevesand in neck where it forms a collar.

It is ill defined in trunk and fascia.

Important features :-

Fascia reacts readily by laying down collagen fibers parallel to anyforces applied to it. Thus it becomes thickened

I. Extension and prolongation of deep fascia formeda) A intramuscular septum which divides the limbs into

compartments.

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b) The fibro areolar sheath for the muscels and nerves.II. Thickenings of deep fascia

a) Retinaculae of certain joints like wrist and ankelb) Palmar and plantar aponurosis for protection

III. It provides connection and communication in the form of ligaments,tendons,aponurosis,joint capsule and septa.

IV. The deep fascia envelopes all bone,cartilage and blood vesselsand become specialized in muscels and nerves.

Functions :-

Deep fascia keeps the underlying structure in position and preserve thecharacteristic surfaces contour of the limbs

It provides extra surfaces for muscular attachments. It helps in venous and lymphatic return It assist muscels in there action by the degree of tension and pressure. It exertsupon there surfaces

The retinaculae acts as pulleys and serve to prevent the loss of power.

Visceral fascia :-

Visceral fascia suspends the organs within the cavity and wraps them inlayers of connective tissue membrane.

Each organ is covered in a double layer are separated by a thinserrous membrane. The outermost wall of organ is the partial and skin of the organis visceral layer.

The organs have specialized names by visceral fascia i.e..

a) In brain known as meninges.b) In heart known as pericardiac) In lung known as plurea.d) In abdomen known as peritonea.

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BIOMECHANICS OF FASCIA:-

The fascia one connected network from the fascia attached to the inner aspects of

the skull to the fascia in the soles of feet there exists only one fascia structures.

If any part of this deformed or distorted there may be negative stress imposed ondistant aspects and on the structures which it divides, envelopes support and withwhich it connects.

The musculoskeletal system the mechanical component of human machinecompromising 60% of the masses of the body, exists in a state of structural andfunctional continuity between all of its hard and soft tissue and it the fascia that

provides movement and continuity.

Symbiotically functioning assortment of t issue comprising skin, muscles,ligaments ,tendons neural structures vessel and lymph chnn els all givenshape cohesion and functional ability by the fascia.

A part its immense roll in the support structural organsation and motion of thebody fascia is involved in numerous complex biomechanical activities.

Connective tissue provides a supporting matrix for more highly organizedstructures and attaches extensively to muscles .

It provides by its fiscal planes path ways for nerves blood and lymphaticvessels and structures.

Where the connective tissue is loose in texture it allows movement betweenadjecent structures.

Deep fascia ensheaths and preserves characteristics contour of the limbs and

promotes the circulation in the veins and lymphatic vessels.Superficial fascia allows for the storage of fat and also a surface coveringwhich aids in conservation of body heat .

It aids in repairs of injuries by deposition of collagenous fibers.

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The ensheathing layer of deep facsia as well as inter muscular septa andinterosstus membraine, provides vast surfaces areas used for muscularattachments.

The histocytes of connective tissue comprise part of an important defensemechanism against bacterial invasion by their phagocytic activity.

Fascia is not only a background structures with little function a part from itsobvious supporting role, but is an tenacious connective tissue . Which is deeplyinvolved in almost all of the fundamental processes of body structures functionand metabolism.

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PATHOMECHANICS OF FASCIA.

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Any mal function of fascia tissue due to trauma posture or inflammation cancreative a binding down of fascia resulting in abnormal pressure on nervesmuscles bones or organs. This can create pain or malfunction through out thebody with bizarre side effects.

Fascia surrounds infuses & protects every other tissue , tendon, muscel, boneLigament & organ of the body. In healthy conditions the fascial system is relaxedand wavy in configuration .

This provides a cushioning and support mechanism allowing us to move safelywithout restriction or pain. But in abnormal conditions the fascial system is tensed& can lead to pain & malfunction through out the body.

Following and physical and emotional trauma & through poor posture fasciascars, and hardness is affected sited. This causes the fascial network to loose itscushioning mechanism and internal structures become pulled out of alignment.

This inturn crates abnormal pressure crushing nerves blood & lymphatic vessels &further crating tension on adjacent pain sensitive structures and those alongfascial pull.

Any degree of degeneration however minor changes the bulk of the fascia modifiesits thickness and draws into ridges in areas overlying deeper tension and rigidities.

Sudden stress of fascial tissue will result in burning type of pain.

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MYOLASCIAL CYCLE

Repetitive use visceral disease

Postural stress Physical Trauma

Exposure to cold Structural inadequacies

Emotional tension Un-co-ordinated movements

Muscle Strain

Pain

Retained Mobilities odema & Inflammation Muscle Spasm

Vasoconstriction Ischemia

Sustained Contraction

Fibrous Reaction

Soft Tissue Contracture

Persistent joint and somatic dysfunctions

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Myofascial conditions are triggered by many causes and can become self pre -petuation cause of pain, spasm & joint dysfunction.

Trigger Points

Definition: -

Trigger Points are desecrating focal hyperirritable spots located in a taut band of skeletal muscles.

They produce pain locally and in a referred pattern and often accompany chronicmuscular skeletal conditions.

Acute trauma or repetition micro trauma may lead to the development of stress onthe fibers and the formation of trigger points.

Patients may have riginol, persistant pain resulting in a decreased range of motionin the affected muscles.

These include muscles used to maintain body posture such as those on the neck and shoulder and pelvic girdle.

Trigger points may also manifest as tension headache, tinnitus temporamandibulas joint pain decreased range of motion ion the legs and low back ache.

Trigger points are usually associated with taut band a ropey thickening of musclestissue. Typically a trigger points when pressed upon, will cause the pain to be felt.This is what considered as “Referred pain “.

Types of Trigger Points:-

1) Active trigger points: - It is an area of extreme tenderness that usually lies

within skeletal muscles and is associated with local / regional pain.2) Lateral trigger points: - Its is an inactive area that has the potential to act like

a trigger.3) Secondary trigger points:-it is a highly irritable spot in a muscle that can

become active due to a trigger point and muscular overload in anothermolecule.

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11. Nervous tension or stress.12. Infection and allergies.13. Psychological factors such as depression anxiety and tension.