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Tuesday, June 6, 2023

Guidelines for Self-Administered Release Techniques

Brent Brookbush

Brent Brookbush

DPT, PT, MS, CPT, HMS, IMT

Self-Administered Release Techniques:

by Brent Brookbush MS, PES, CES, CSCS, ACSM H/FS

Why Static Release?

“Self myofascial (same as static release in this case) release is used to alleviate myofascial trigger points and areas of hyperirritability located within a band of muscle (1).” Until these areas are addressed a muscle cannot return to optimal length and function. For example, stretching a short muscle with a trigger point will result in a momentary change in length, but the muscle will return to the previous dysfunctional length in response to the hyperirritable region.

What is a trigger point?

A trigger point is an acute area of increased activity and irritability within a muscle. It is hypothesized that these regions of irritability are the result of damage to the motor endplate and/or a localized metabolic “crisis”3. With this in mind, it may be interesting to note the similarity between trigger point sites and motor points (see Motor Point Map ).The development of trigger points has been linked to postural dysfunction, congenital factors, occupational and leisure overuse patterns, and referred or reflex involvement of the viscera (internal organs)2. It is important to note that trigger points will return unless the underlying cause is alleviated2-3.

Where are trigger points located?

Generally trigger points are located close to the center of a muscle (near the motor end plates), or close to the muscle’s attachment to bone (often satellite sites)2-3. Trigger points may develop in any muscle, but it is recommended that trigger points located in overactive muscles that are relatively shortened by postural dysfunction are addressed first. Although, muscles lengthened by postural dysfunction may also develop trigger points and areas of hyper-irritability these points often reduce in severity and number when posture is corrected. Further, if trigger points are first released in “long” muscles, these muscles may lengthen further, exacerbating dysfunction.

How do release techniques work?

Three mechanisms have been hypothesized for the reduction of trigger points in response to pressure.

  • Pressure may stimulate mechanoreceptors (golgi-tendon organ, etc.) and initiate autogenic inhibition1,3.
  • Acute mechanical stress to the hypertonic region may locally deform connective tissue and prompt soft tissue adaptation2,3.
  • Ischemic pressure may decrease local blood flow and the transport of chemical messengers that fuel inflammatory processes and dysfunctional local metabolism2,3.

Much to learn:

Despite decades of use, the available research on these techniques is limited and often contradictory. The techniques and protocols used vary from study to study, release techniques are often preceded by or followed by inconsistent parameters, and rarely does research consider the integrated use of this methodology. In my humble opinion the most frustrating lapse in progress is research that does not consider the available body of work on the subject, essentially “reinventing the wheel” and wasting resources. The terminology itself often changes making it difficult to locate and compare studies. Consider this: the term “myofascial release” in reference to foam rolling is inaccurate, as “foam rolling” (as is discussed above) is a type of static release that follows protocols described in Travell and Simons. The term “myofascial release” refers to a specific technique, described by John F. Barnes Myofascial Release: the Search for Excellence, which is hard to approximate without the assistance of a licensed manual therapist

Personal Trainers and Scope of Practice?

The scope of practice of a personal trainer has not been well established. However, it is wise for the personal trainer to keep from encroaching on the practice of licensed professionals and follow the laws established by the state they work in. In summary, personal trainers do not assess, diagnose, or treat injuries. Further, in many states it is illegal for the non-licensed profressional to perform manual release techniques. The personal trainer can educate the consumer on release techniques that they can self-administer - with the goal of improving the effeciency of the human movement system.

Self-Administered Static Release Protocols:

  • NASM’s - Essentials of Performance Enhancement Training – “After a sensitive region has been identified, hold the foam roller on that region for 30 seconds.” Note: Thirty seconds will generally reduce sensitivity of a tender region, but more fibrous structures, thicker musculature, and deeper trigger points may require more time.
  • Leon Chaitow - Muscle Energy Techniques - “Locate a sensitive region, apply 5 seconds of pressure, release for 2-3 seconds, apply 5 seconds of pressure again, release for 2-3 seconds, and repeat until the sensitivity of the tender area is significantly reduced.”

Contraindications:

If it pulses, throbs, numbs, or tingles find a new spot. Although I have not heard of any injury arising from self-administered release techniques; the shunting or impingement of large vessels and nerves is potentially hazardous, and certainly uncomfortable. Further contraindications may include but are not limited too, peripheral vascular disease, advanced metabolic disease, neuropathy, open wounds, active cancerous tissue, lymphodema, etc.

Bibliography for Self-Administered Release:

  1. Michael A. Clark, Scott C. Lucett, NASM Essentials of Performance Enhancement Training, © 2010 Lippincott Williams and Wilkins
  2. Leon Chaitow, Muscle Energy Techniques: Third Edition, © Pearson Professional Limited 2007
  3. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilkens
  4. Tom Myers, Anatomy Trains. © Elsevier Limited 2001

© 2014 Brent Brookbush

Questions, comments, and criticisms are welcomed and encouraged

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