Myofascial Therapy

by Gary A Clark, myotherapist

( myo = muscle) + ( Fascial = fascia or connective tissue)

Can you imagine twenty years of crippling pain? Pain that kept you awake night after night, and made each day a living hell?
Gone after just one treatment that was Leigh’s experience.

How about, after a car accident, back pain so severe that you were doubled over to the front and left side like a hunchback?
Cleared up so you could walk straight and pain free after only two hours of treatment - that was Arthur’s* experience.

Seems like a miracle doesn’t it? That’s how many people feel after their very first session of Myofascial Therapy. And yet there is no miracle, just good science in the hands of a skilled therapist.

These were people that consumed pain killers by the handful. Arthur even had an electrode implanted in his spine to block the pain. They had tried every form of treatment they could find in the hope that something just might work, and something did: its called Myofascial Therapy.

To understand where this amazing therapy came from, we need to go back some fifty plus years, to when a young doctor, Janet Travell, the daughter of a physician, became curious about the pain that some of her patients reported, that seemed to have no organic cause. This lead to her life’s work.

For fifty years, she mapped the pain pattens of virtually every muscle in the body, their cause and treatment, and, along with Dr David Simons, wrote the definitive work on the subject “ Myofascial Pain and Dysfunction: The Trigger Point Manual”. For this we owe Drs Travell and Simons an immense debt of gratitude.

One of the confusing things about myofascial pain syndrome is that the pain does not necessarily show up in the same area as the affected muscle. Muscles can develop exquisitely tender spots referred to as triggerpoints (TPs). These triggerpoints come about as a result of trauma, overuse, misuse, and perpetuating factors.

It is these triggerpoints that cause referred pain. For example, triggerpoints in the neck and shoulder usually refer pain to the side of the head top of the head and forehead and eye area. Even more confusing: triggerpoints in the abdominal muscles, readily refer pain to the lower and upper back.

A skilled Myofascial Therapist understands all the major muscles, their function, their attachment and referred pain pattern, and the various forms of treatment to resolve the triggerpoints. A skilled therapist can also recognise triggerpoints in a muscle by touch .

Triggerpoints may be, acute, recurring, or chronic. Acute triggerpoints often come about as result of overwork or excessive exercise. They will often deactivate and become latent if given sufficient rest, but are readily reactivated, and become painful, if subjected to stress.

Triggerpoints that are repeatedly reactivated can become chronic, subsequently causing ‘satellite’ triggerpoints to occur in other muscles along with additional pain. This in turn causes these muscles to be underused, so bringing about a cycle of reduced activity, and chronic pain, along with a devastating loss in quality of life.

Then there are perpetuating factors: these are physical or Biochemical factors that cause triggerpoints to keep recurring, until corrected. For example, one short leg ( 5mm or more will do it ) will cause the pelvis to tilt, creating a scoliosis of the spine with consequent muscle strain, triggerpoints and pain.That is just one example of a very common perpetuating factor.

It is the job of the therapist to observe these factors and eliminate them wherever possible, so that triggerpoints do not keep recurring. Triggerpoint pain is not imaginary. People who have experienced both, say the severity of triggerpoint pain compares to a broken bone, or heart attack. Although the pain can be quite severe, it is not directly fatal, but it can, and often does, ruin a person’s quality of life.

The cost of unrecognised myofascial pain is huge. Myofascial pain of the head shoulders and back is a major cause of lost industrial time. In Australia, low back pain alone costs a small fortune in lost work time. And just think of the time lost from whiplash, and RSI. Again the cost in misery is incalculable, how many people carry on with their lives in constant pain, only because they believe there is nothing they can do about it ?

Myofascial Therapy is not a cureall.
If you experience lasting pain, consult your doctor. Only when no organic cause for your pain can be found, should you consider myofascial therapy. Because, if you do have an infection, that most certainly should be cleared up first, as many forms of infection can cause muscle pain.

Having said that I would like to say that myofascial therapy is a very safe form of treatment, it is drug free and generally non invasive. In some ways myofascial therapy is similar to deep massage, in that the therapist locates the triggerpoints in the muscles by feel, but a major difference is the way in which the triggerpoints are relieved .

A myofascial therapist uses compression and gentle stretching, plus warmth and cold, to return a muscle to its normal length and range of motion, and in this way relieving the pain ( a muscle with triggerpoints is also a shortened muscle ). Attempting to stretch a muscle with triggerpoints without the appropriate use of heat and cold, will cause the muscle to resist, causing even more pain.

Finally once your muscles have been rehabilitated, we give you a stretch program, to do at home, so those painful triggerpoints won’t return. Remember that voluntary skeletal muscle is the largest single organ in the human body and accounts for about 40% of body weight. Muscles are the engines of the body and provide the energy for all physical activity. It is your responsibility to look after your muscles, provide them with the nutrition and exercise they need, and above all keep them free from painful and debilitating triggerpoints.

*Names have been changed to protect client confidentially

about the author: Gary A Clark is a myotherapist and founder of Pain Busters Clinic, where he helps his clients find lasting relief from their chronic muscle pain. For more information or to make an appointment phone Gary Clark at Pain Busters Clinic (Western Australia) 9472 3852 or 0402 945 700