With any injury or pain there is a certain amount of responsibility that has to be undertaken by the client in order to maximise any treatment or advice administered by a therapist. It's a 2 way approach. If you don't follow up with post treatment advice and do 'your' part then the results are going to be limited.
Part of this relationship is the introduction of exercises and 'homework' that is often given to clients to do in their own time. This is important to follow up with a lot of the soft tissue release work that we do on the table to ensure length and malleability of fibres that have been shortened or in trauma. Perhaps one of the most important aspects of this equation is MOVEMENT. Movement is vital for keeping fibres and soft tissue free and malleable for a greater and easier treatment and addressing of soft tissue injuries.
Perhaps one of the issues that we do find in presenting symptoms for many of my CBD based clients is not only that the muscular fibres contain adhesions but that there is a certain amount of Fascial Adhesions present in that all important fascia that covers our bodies. The large collections of fascial fibres (found in locations such as the thoraco-lumbar fascia or Ilio-Tibial Band) often can become the areas where ‘tension’ is located and most obviously felt.
Part of these fascial adhesions come from being ‘inactive’ during the day. Fascia is present in our body to provide an integrated network of connective fibres that allow other structures to attach, be held in place or provide shape and form to a muscular compartment. READ HERE I always liken Fascia to a layer of cling film that provides support for our organs and muscles. Chefs working with pastry will understand the analogy of trying to mould dough and keep it in a shape whilst you refrigerate it.
Whilst the primary function of fascia is to reduce friction and muscular force, it does also have kinetic or movement properties, holding and releasing kinetic energy from muscular actions. One of the functions of fascia is to provide form and support for the muscles which it covers as well as transmitting muscular tension generated by the muscles themselves. This is particularly true of DEEP FASCIA that is found in muscles and muscular compartments. What this means is that fascia can help to utilise power generated by the muscles. Thus if our fascia is found to be restricted or contain adhesions, then the amount of power or force our muscles generate may be compromised by ineffective fascial function.
BUT WHAT DOES IT MEAN?
Essentially this means that our fascia can assist with the amount of power we generate. Fascial Training has been used by many trainers and athletes to help assist with advancing the body’s inherent power. Targeting elements such as elastic recoil and quality of movement to maximise the power generated is a particular element of fascial training. It makes you move better.
So one of the ways in which we can help to maintain our fascial length is not only via massage, foam rollering and stretching but MOVING. Movement keeps structures pliable and health. If we don’t move, we don’t keep asking our tendons, muscles, fascia to keep stretching and remain usable. Much like an elastic band left out in the sun for too long, if we don’t move, those facial fibres become brittle and ‘stuck’. This is particularly important to those of us who are stuck in sedentary positions all day in industrial or desk bound jobs. Without movment, our connective tissue becomes brittle and unpliable and pretty soon we are all of us feeling like a bodybuilder who is unable to move because he has too much bulk and not enough flexibility to lift his arms over his head.
In this regard, movement is vital. I say to many of my clients ANY movement is good movement. This is difficult to qualify sometimes as there are certain individuals whom take that as Carte Blanche to get straight back into full blown, high intensity full load of training. However for most people trying to get the body out of pain and into feeling normal is difficult if they haven’t already had an active movement based regime in place already. For these sorts of people MOVEMENT IS VITAL. To move is to have blood flowing into areas and to keep elasticity of the all important muscles, tendons and fascia (soft tissues) at some sort of measurable level of operation.
For those who take the dog for a walk and move along the pavement with casual repose, a variety of movement patterns and moving in different planes is even more important. Not just a gentle easy swagger down to the shop to get a newspaper, donut and a latte. We need to move in different ways to challenge our soft tissues to twist, rotate, shorten, lengthen and basically keep those fibres moving in all directions. Rotational movements (which I have spoken about before) are all important in particular to keeping the fascia at bay and in good working order. Like wringing out a tea-towel, you want to get as much moisture out as possible so you don’t just pull it apart, you wring it – in a rotational matter to get more out of it. The same holds true for fascia. And this effect of ‘wringing’ is excellent for keeping fascia in a good pliable condition. So – moving rotationally is good – even sweeping the path is good for you as it has you rotating through your lumbar curve and working transversely with your core to get a whole myriad of soft tissues operating.
When you are rehabilitating the last thing you want to do is to sit still. After having a treatment there has been a series of lengthening and fibrous work to remove adhesions and restrictions in soft tissues. By being sedentary, especially in less than advantageous postures (such as lying on the couch) you are not helping to reinforce the new and more ideal positions that have been established in a treatment. Therefore, light movement such as a walk, light swim, gentle yoga or tai chi helps to keep these new pliable soft tissues open and – well – pliable! This helps to keep the length in what has been created and this is why gym work, intense training or exuberant activities, shorten fibres and are detrimental directly after a treatment.
When trying to get activation happening in a joint space that has not been able to move, the caution exercised is even more important. However the saying still holds true – that movement is everything and that you need to keep the joint space moving in all its directional ways so that it doesn’t become glued or stuck. Here you have to be much more careful to not move in ways that may risk further injury or overloading the joint space. Moving easily through the range of motion is important but this should be done gently and without speed or excessive force. This is particularly true for things like shoulders, which respond to activation and some work to keep them lithe, supple and free. Not moving them at all means that they will restrict further.
Only when there is a risk of dislocation or instability at a high level would a joint space be restricted or immobilised. The trend in emergency treatment and post surgery conditions is to not immobilise structures, but to actually introduce load gradually and quickly to encourage the healing process to be able to bear the loads that will be exerted on it in normal activity. This is why people are walking out of knee operations now rather than being placed in casts. Movement is key.
So no matter what issue or injury you may have, there is always a movement component that should be explored. If you are the gung ho athlete that needs to be tied down to prevent you from re-injuring the area, then perhaps this dogma is not the best for you. But whenever healing is involved in regards to soft tissue injuries – “any movement is good movement”. Don’t be scared to move yourself and keep things pliable and supple – it’s the best way to encourage strong and complete recovery.