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NASM CES Chapter 3: Inhibitory Techniques 5

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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 plan to inhibit or modulate the nervous system’s activity that innervates the Myofascia.

The most common technique relies on self-myofascial release.

Health professionals may use other techniques for the treatment of Myofascia. 

Myofascial Rolling

In the past decade, foam rolling has emerged as a pretty common and 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. 

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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 occurs, 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.

Davisโ€™s Law is one thing that starts to come into play. 

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

The soft tissues will remodel and rebuild in the collagen matrix that forms randomly and not in the same direction as 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.

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 categorized as a 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 arterial perfusion and improve the function of vascular endothelial tissues.

Neurophysiological effects include the relaxation of tissues and pain in the local and surrounding areas. 

Application Guidelines for Self-Myofascial Interventions

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

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Pressure

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

A smaller tool will exert more pressure than a larger one.

No studies look at the pressure needed, but it depends on 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 softer and more moderate densities get better results, but this can vary slightly. 

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 affects 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 of various sizes and densities and usually give more pressure than 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 rollers with these vibration effects will likely elicit similar benefits. 

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 examined 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 using Myofascial release programs, which limits furthering the research in the field.

However, the programs 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 too complicated, follow the rule of targeting the muscle with a roller for 90 โ€“ 120 seconds. Roll the muscle slowly for the desired time.

Length of Time for Self-Myofascial Rolling

5 โ€“ 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 are the lumbar spine hyperextending, the cervical spine flexing too much, and the shoulders’ elevation 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 to the areas of discomfort and doing 4 โ€“ 6 reps of active movement.

Intensity should be somewhat uncomfortable but you can still relax and breathe. 

Duration is 5 โ€“ 10 minutes and 90 โ€“ 120 seconds per muscle group. 

NASM CES Chapter 3: Inhibitory Techniques 6
NASM CES Chapter 3: Inhibitory Techniques 7
NASM CES Chapter 3: Inhibitory Techniques 8

Tyler Read - Certified Personal Trainer with PTPioneer

Tyler Read


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