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NASM CES Chapter 3: Inhibitory Techniques 1

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    Chapter Goals:

    • Find the current evidence regarding myofascial interventions.
    • Be able to explain the function of myofascial techniques in programs for corrective exercise.
    • Find the modalities for myofascial interventions and their common uses.
    • Find the appropriate strategies to use for implementing these myofascial interventions.

    Introduction

    This is the first phase of the corrective exercise continuum.

    In this phase we are planning to inhibit or modulate activity of the nervous system that innervates the Myofascia.

    The most common technique or this relies on self-myofascial release.

    There are other techniques that may be used by health professionals for treatment of the Myofascia. 

    Myofascial Rolling

    In the past decade, foam rolling has emerged as a pretty common and a practical solution for use in the fitness realm.

    This has grown greatly in the last five years and focused on the use in therapeutic and physiological worlds.

    Myofascial Rolling and the Cumulative Injury Cycle

    It is essential to understand and reiterate some of what was gone over in the previous chapter.

    Health professionals need an understanding of poor posture and repetitive overuse movements and all of their effects on the human movement system.

    These dysfunctions will inevitably lead to some form of injury and repair response within the body.

    This is the basis of the cumulative injury cycle. 

    Repetitive movements and things like poor posture will lead o tissue trauma and inflammation in the body.

    The response to inflammation s going to be a protective mechanism of increasing the tension of the muscles and causing the muscle to spasm.

    As a result of the spasm that occur, we see adhesions form in the myofascial tissues.

    The adhesions will form some weak and inelastic matrix that decreases our mobility in the soft tissues.

    Davis’s Law is one thing that starts to come into play. 

    Davis’s Law states that the soft tissues of the body will model themselves along the line of stress.

    The soft tissues will remodel and rebuild in the collagen matrix that forms a random fashion and not the same direction of the muscle fibers.

    So, these alterations will cause relative flexibility, or the phenomenon of the movement system of the human body seeking the path where there is the least amount of resistance.

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    These compensations will possibly lead to further imbalances and injuries over time. 

    Scientific Rationale for Myofascial Rolling

    There are two main reasons to do myofascial rolling:

    • To affect the dysfunction of local myofascial tissues.
    • To influence the autonomic nervous system in some way.

    Myofascial rolling and Myofascial Dysfunction

    Myofascial rolling is put in the category of compression intervention where an external object is used for compressing the Myofascia.

    This is usually called self-myofascial release. 

    Myofascial Rolling: Local Mechanical and Neurophysiological Effects

    The local mechanical effect of the pressure from the roller will possibly change the viscoelastic properties of the local Myofascia by mechanisms like thixotropy, fluid changes, cellular responses, and reducing the restriction of these Myofascia.

    Rolling has also been found to reduce the arterial perfusion and improve the function of vascular endothelial tissues.

    Neurophysiological effects are things such as the relaxation of tissues and pain in the local and the surrounding areas. 

    Application Guidelines for Self-Myofascial Interventions

    These tools will vary in the shape, size, and density, and this will slightly affect the overall influence. 

    Pressure

    This is a product of the diameter and the density of the tool.

    A smaller tool will exert more pressure than the larger ones.

    There are no studies looking at the pressure needed, but it is more to your comfort level, pain threshold, and perception. 

    Density

    This plays a vital role in the pressure put out on the tissues.

    The denser the roller, the more people think it gets deeper and works better.

    Studies have shown that it is actually the softer and more moderate densities that get the better results, but again this can vary a bit. 

    Diameter

    The diameter influences the surface area and the amount of acute pressure that will be applied.

    A smaller diameter will give more acute pressure and influence the deeper layers of tissue, while the opposite is true of the larger diameters.

    The larger ones will hit a wider portion of the more superficial tissues. 

    Texture

    The texture has some effect on the overall results, but the studies more or less decided it varies between users.

    They both have different applications.

    Self-Myofascial Intervention Tools

    Myofascial Rollers

    These are known as foam rollers, and they are the most widely known and used form of tool for self-myofascial release.

    Myofascial Balls

    These are also known as massage balls. They are spherical tools that are in various sizes and densities and they usually give more pressure than that of the rollers. 

    Handheld Myofascial Rollers

    These are the rollers, but they are meant to be held on each end and then rolled along the body by the user or by another person using the device. 

    Vibration

    The research for this is mostly in the realm of whole body vibration, but it is likely that rollers with these vibration effects will elicit similar benefits. 

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    Cupping

    This is a relatively newer form of myofascial release, and it is used to promote the movement of blood and other fluids through our tissues. 

    Precautions and Contraindications for Self-Myofascial Rolling

    These negative effects have not been thoroughly looked at for corrective exercise, so instead we look at research from therapies. Some of the precautions that we see are:

    • Hypertension
    • Diabetes
    • Osteopenia
    • Pregnancy
    • Varicose veins
    • Scoliosis
    • Recent injuries or surgeries
    • Fibromyalgia
    • And a few others.

    Some of the Contraindications we see are:

    • Osteoporosis
    • Deep vein thrombosis
    • Bone fracture myositis ossificans 
    • Bleeding disorders
    • Cancer or a malignancy
    • Connective tissue disorders
    • And some more.

    Key Points for Practical Application

    There is a lack of consensus from the community regarding the use of Myofascial release programs, and this poses limitations on furthering the research in the field.

    The programs do however agree that they should have a two-step approach.

    Step 1: Reduce the Overall Tension

    Step 2: Introduce Tissue Movement 

    If these two steps are found too complicated, simply follow the rule of targeting the muscle with a roller for 90 – 120 seconds at a time. roll the muscle slowly for the desired time.

    Length of Time for Self-Myofascial Rolling

    5 – 10 minutes while focusing on one muscle group at a time for 30 seconds to 2 minutes has been seen to give optimal results. 

    Frequency of Self-Myofascial Rolling

    Performing self-myofascial rolling following a warmup has been seen to be helpful and somewhat common. 

    Body Position

    The user should do their best to ensure that they are in a safe alignment of their body while rolling so that they may avoid injury rates increasing or any form of pain.

    Two common mistakes see the lumbar spine hyperextending and the cervical spine flexing too much, and also elevation of the shoulders when sitting. 

    Acute training variables

    The frequency is most days of the week unless it is specified some other way.

    Sets should be one set.

    Repetitions are holding on the areas of discomfort and doing 4 – 6 reps of active movement.

    Intensity should be somewhat uncomfortable, but still having the ability to relax and breathe. 

    Duration is again 5 – 10 minutes total and 90 – 120 seconds per muscle group. 

    NASM CES Chapter 3: Inhibitory Techniques 2
    NASM CES Chapter 3: Inhibitory Techniques 3
    NASM CES Chapter 3: Inhibitory Techniques 4

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