Connective tissue or fascia surrounds all our muscles, bones and organs to hold them into place. The superficial fascia lies just below our skin and is often what we work on when doing fascial work. Fascial work is a soft tissue manipulation technique designed to improve the extensibility of any soft tissue that limits mobility by manipulating the connective tissue that binds the soft tissues. Fascial shortening, adhesions or restrictions can appear for many reasons, some possible reasons are due to inflammation, trauma, surgery, pathology or postural imbalances creating abnormal tension patterns.

Assessment is required to accurately locate possible restrictions prior to treatment & there are many different techniques we can apply that fall under the “Fascial work” category dependant on what works best for the patient & the severity of the restriction.

Did you know treating specific areas of skin can have a reflexive effect on specific organs? Did you know you can apply different temperatures of hydrotherapy to different body parts simultaneously for different effects?

Hydrotherapy treatments can affect the body in many ways by taking advantage of the body’s own homeostatic responses. Depending on the hydrotherapy chosen & how we apply them there is a wide range of results we can achieve. They can stimulate, relax, relieve pain, increase or decrease muscle tone, detoxify (stimulates lymph flow), relieve inflammation (decreasing local blood flow), soften connective tissue (stimulates blood flow), alter body temperature and can even cause numbness. With hydrotherapy the circulatory, integumentary & nervous systems can be manipulated to enhance your results from massage.

Trigger points can be active (they are always hurting) or latent (meaning they don’t hurt until we do some massage in the area/ it is palpated) There is a range of techniques we can apply in order to treat trigger points (muscle knots) which include skin rolling (a fascial work technique), repetitive muscle stripping, ischemic compression, cold application with stretching & percussion with stretching.

In order for us to know if it is a trigger point (muscle knot) or something else causing the painful spot, as an RMT I will be monitoring for a few things: A twitch response (the muscle with a trigger point twitching), referral pain (not just pain local to the spot), a palpable spot, jump sign (a pain response, such as wincing) or reduced muscle length.

The following treatments all work towards the same goal in treatment, which is to lower muscle tone, reduce muscle spasm & “work” on an area that may be too painful for direct manual treatment.

GTO’s (proprioceptive nerve receptors) are located in our tendons near the junction with the muscle. These receptors detect the “load” placed on the tendons as past of a protective reflex to prevent muscle injury or rupture through relaxation of the muscle. Therefore we are able to “trick” the GTO by direct compression on the tendon thinking it is working much harder then it is & causing a reflexive effect. O&I works with the same principle but is used on muscles with short tendons.

Muscle Approximation works on the muscle spindles in our muscles, they are proprioceptive nerve receptors located in the muscle belly that monitor muscle length & stretch placed on the muscle to prevent overstretching. The muscle spindles can set different tones in a muscle in response to activity or stress. We use muscle approximation to take advantage of that reflex to reduce tone or spasm in muscles.

Painful joints may cause reflex muscle guarding & muscle spasm which is able to be treated with joint play or low grade (1 & 2) joint mobilizations. The small movements can inhibit pain, and the gliding or distracting movements of a joint mobilization can also cause synovial fluid motion which brings new nutrients into the articular cartilage. Higher grade joint mobilizations (3 or 4) are more helpful for potentially increasing limits in the joints range of motion if caused by hypomobile capsular & ligamentous connective tissue.

Grade 2 mobilizations are frequently used in assessment to assess a joints “end feel” to get a better idea on what is causing the patients issue.

All of the above listed joint mobilizations are lower in grade then what you would potentially receive at a chiropractor appointment as chiropractors can do above a grade 4 mobilization.

We may move joints passively when there is acute, inflamed tissue, when a patient is not able to actively move or if a patient has had surgical repairs of contractile tissues. With this technique we aim to decrease complications that would occur with immobilization & may use it to assess the causation of limited ranges of motion or pain in conjunction with other ROM & orthopedic testing. Our goal for this technique is to:

★ Maintain joint & connective tissue mobility

★ Minimize the effects of the formation of adhesions & contractures

★ Maintain elasticity of muscle

★ Assist circulation and vascular dynamics

★ Enhance synovial movement for cartilage nutrition & diffusion (movement) of materials in the joint

★ Decrease or inhibit pain

★ Assist with the healing process after injury or surgery

★ Help maintain the patients awareness of movement

When a patient is able to move but is weak we will assist doing active range of motion, otherwise regular active range of motion is used. Our goal when using either active range of motion is too

★ Maintain elasticity & contractility of active muscles

★ Provide sensory feedback for the contracting muscles

★Provide a stimulus for the bone & joint tissue integrity

★Increase circulation and prevent thrombus formation

★ Develop coordination & motor skills for functioning activities

Active range of motion for those with strong muscles does not maintain or increase strength. Aside from for the above benefits it is often used in conjunction with other ROM & orthopedic testing to assess the causation of limited ranges of motion or pain.

This is especially useful for those with respiratory conditions (COPD, Asthma) as it can help with apical breathing patterns. It can also help with pain relief and relaxation.

There are two main types of FST that I use dependant on what is going on with the patient. They are called Hold-Relax & Agonist Contact. These techniques are used to inhibit or activate specific muscles helping to increase flexibility & range of motion.

A technique used to mobilize nerves aiming to reduce pain & improve range of motion by releasing nerve tension. It may help with relieving nerve related pain, aching or numbness. (Note: can make some nerve issues worse, an assessment is needed before nerve flossing is added into a treatment regime)

I always aim to get the best results we can within our treatment time together, that being said daily habit changes or incorporating customised workout/stretching regimes will always be a welcome addition & will add to your benefits. This doesn’t always mean heading to the gym for an hour, depending on the patient and what is going on it could mean adding in 5 minutes of walking, 1 minute of stretching or learning some minor self massage techniques for between massage appointments.

Lets talk about what your goals are and what would work for your lifestyle.