Improving Functional Mobility
- By James D. McIntosh, Todd M. Gates
- Oct 01, 2001
An effective stretching program is an essential component of any rehabilitation or exercise program because, as we know, stretching helps to lengthen and relax tight muscles. In fact, the importance of functional strength, stability and flexibility has revolutionized fitness programs, explaining the recent resurgence of interest in Yoga and Pilates--techniques that emphasize the lengthening and elongating of muscles. Exercise ball training also has added unique dimensions to neuromuscular training, challenging participants to train deep into the body's core and promoting a balance between muscle strength and muscle length.
For years, therapists and fitness specialists have been striving to guide their clients through exercises that will ensure maximum results. But stretching exercises, in particular, have fallen short. One reason for the downfall of traditional stretches is that they've been solely focused on stretching the muscles. The body is not that simple. A connective tissue documented as myofascia has, until now, been grossly overlooked. But new techniques designed to release the complex, interconnecting web of fascia make it possible to stretch and relax the body to its desired state of functional mobility.
What is fascia?
Fascia is what holds the body together. It plays an important role in giving the body its shape and form. Fascia is a connecting web of cells that surrounds every muscle, fiber, bone, blood vessel and nerve in the body. It has a fluid-like matrix and a combination of viscoelastic components, which allows it to both stretch and have strength. In simple terms, being viscoelastic means fascia has the ability to change shape.
The relaxation of restricted fascia enhances the muscle's ability to respond to stretch. |
With age, trauma, disease or poor posture, healthy fascia may solidify and tighten or become restricted. Fascial restrictions cause a deep, hard-to-locate pain. This pain is difficult to pinpoint because the facial system is interconnected throughout the body, and a fascial restriction in one area of the body can result in a response in an entirely different area.
The relaxation of restricted fascia enhances the muscle's ability to respond to stretch. This is particularly true in such areas as the lower back and outer thighs, where fascia is especially thick and closely related to the surrounding muscles.
Fascia will relax under only a small amount of pressure. However, a small amount of pressure for an unsustained period of time will make only a temporary change in the fascia's form. If, however, pressure is applied slowly and for a significant period of time, the fascia will relax permanently or, at least until an outside factor causes it to tighten up again. The temperature of the fascia tissue also can affect its change in form. As tissues increase in temperature, the change in form also is increased. It is upon these principles that the practice of myofascial release therapy was developed.
Myofascial release is a highly interactive stretching technique that requires feedback from the patient's body to determine the direction, force and duration of the stretch, and to facilitate maximum relaxation of tight or restricted tissues.
The concept of myofascial release is not new. It has been traced back as far as the year 1843. It wasn't until the 1940s that a doctor by the name of Janet Travell pioneered and documented many myofascial release techniques. Physical therapists and massage therapists have known about myofascial release for more than 30 years.
In the traditional sense, myofascial release therapy is performed by a therapist, but led by the patient. There is no set methodology. Rather, the therapist is guided by the patient's physical, neurological and emotional responses. It is based on the premise that a patient inherently knows what he or she needs and therefore, is best able to guide the therapist, rather than the other way around.
Using his or her hands, the therapist applies pressure to the patient and monitors tissue tightness and restriction to both subtle and overt movement. This pressure gently encourages restrictions to release and also can create space between such joints as the spinal vertebrae. Creating space in these critical areas improves the conditions for blood flow and nerve conduction.
It requires time and training to become an expert in the field of myofascial release therapy, which may be part of the reason the technique has not yet been widely practiced. The recent development of a new self-myofascial release tool means that, in the absence of a therapist, patients who are not myofascial release experts can safely and effectively perform the technique on themselves.
Self-Myofascial Release
When the hands of a trained myofascial release therapist are not available, patients can use a new product called the FitBall Body Therapy Ball--a small, 5- to 7-inch ball-- for relief of myofascial tightness and pain. Like myofascial release techniques performed by therapists, self-myofascial release with the small ball is an extremely effective method of releasing such hard-to-reach areas as the ilio-tibial band and the lumbo-thoracal fascia.
Advanced participants wanting a targeted release should use the smallest ball size. |
Like the hands of a therapist, the small ball acts as an outside force or stress which then can be manipulated to stretch the fascia and create muscle length and space between joints. Working the small ball from a muscle's origin to the insertion generally produces the most favorable results.
Small ball releasing is easy and the results are typically felt immediately. Contraindications are few. However, participants with circulatory concerns, diabetes or acute injury must consult their physicians before using a FitBall Body Therapy Ball. Patients also should use care around such areas as the tailbone, breastbone, floating ribs and neck.
Small balls have been designed to ensure optimal support and comfort while providing a steady counter-pressure to the weight of the body. The textured surface of the balls was specifically designed to enhance sensory stimulation.
Choosing the right size ball:
FitBall Body Therapy Balls are available in three standard sizes small, medium and large. Choosing the right size depends upon the following factors:
In general, beginners should start with the largest, softest ball. Larger, softer balls also are recommended for lighter, more fragile body types or people experiencing acute pain or soreness. The large ball will provide a general, less isolated release than the smaller, firmer balls.
Medium-size balls generally can be used by intermediate or advanced participants who are comfortable with myofascial release techniques and are not experiencing acute muscle soreness or connective tissue discomfort. Medium balls usually are appropriate for people with a heavier body type.
Advanced participants wanting a targeted release should use the smallest ball size. Releasing with smaller balls is typically less comfortable and requires the practitioner to be aware of how the body is responding. Unnecessary discomfort will result in a guarding response by the body and will inhibit the releasing process. It is important to note that releasing will work best when the body is relaxed. While a little discomfort often results from small ball releasing, pain should not.
Small Ball Exercises
Eventually, a participant's small ball routine should become spontaneous and random with no set pattern. However, beginners can follow a 30 minute to 40 minute instructional video through a basic back and body release program.
FitBall Body Therapy Balls At Work
Relief of Tightness in the Lower Back
Anyone can suffer from tightness and discomfort in the lower back area of the body. People who are most susceptible are athletes, heavy laborers and those with a lordotic-lumbar posture. Unfortunately, when lower back muscles and associated fascia are tight, they often go undetected as the true culprits of a patient's restricted movement and discomfort. Instead, the patient's hamstrings, which often can be tight as well, are blamed.
Clearly, stretches designed to loosen the hamstrings will do nothing to release tight fascia in the lower back. Even in cases when lower back tightness is correctly diagnosed, traditional stretching routines for the lower back area also can fail to release the patient's tension and discomfort. That's because muscle stretches for the back do not have an effect on the patient's fascia and joint spaces, which also must be optimal for functional movement to be restored. Patients suffering from tightness in this area of the body can achieve unrestricted movement and relieve themselves of discomfort by using the FitBall Body Therapy Ball. Based on the patients' level of discomfort, expertise in using the balls and body type, patients should select the right size ball to meet his or her particular needs. Once a ball has been selected, the patient should place the small ball at the upper edge of the pelvis and lower back areas, and gently apply pressure by rolling back and forth to encourage a release.
Relief of Tightness in the Hips and Knees
Another area of the body that often tightens and causes discomfort is the Tensor Fasciae Latae. The Tensor Fasciae Latae originates from the anterior or inferior lip of the ilium and inserts into the long band of fascia called the Iliotibial Band that runs down the outer thigh. Restrictions in this area are very common and are particularly troublesome because they can directly affect the fluidity of movement at the hip and knee. They also can indirectly affect the joints above and below both of those areas. Patients experiencing restrictions of the Tensor Fasciae Latae or Iliotibial Band can return to functional movement by using the FitBall Body Therapy Ball. After selecting the appropriate ball to meet his or her particular needs, the patient can begin by placing the small ball at the top of the pelvis. Then the patient can slowly roll the ball down the lateral aspect of the pelvis toward the hip. From there, patients should work the small ball down the entire lateral aspect of the thigh until they have reached the insertions in and around the knee.
This article originally appeared in the October 2001 issue of HME Business.