Myofascial treatment techniques

These techniques are used to stretch the tissues: the first two techniques stretch the skin and superficial fascia while three and four are aimed at the deeper fascial layers. These techniques are applied without any lubricant because the skin must not slide under the hands.

1 Skin rolling may be used to release superficial fascia, and is frequently performed on the back, over the ribs. Place the hands on the part with the thumb abducted, lift and push the flesh with the fingers towards the thumbs, and roll this flesh with the thumbs, back towards the fingers. Repeat 3-4 times as needed, then move on to an adjacent area.

2 Vertical lifting technique may be used to lift the skin and superficial fascia away

Figure 9.9 Muscle rolling.

Hand applied stretch from underlying tissues. The hands are positioned vertically above the part, and fingers and thumb are held straight and pointing towards the tissues. The skin and superficial fascia are grasped between the fingers and thumb, and lifted directly upwards, held for a few seconds and then released. This is repeated 3-4 times in one area and then the hands move along to the adjacent area. Take care not to pinch the flesh; the effort is directed towards the lift.

3 Muscle rolling technique, this is usually used on the long-limb muscles. Place the muscles in their shortened relaxed position. Grasp the muscle between the fingers and thumb; the larger muscles will fill the palm. Lift the muscle if possible, then push it away from you and then pull towards you. Pull and push the muscle transversely in this way several times, to stretch and release the fascia. On long muscles it will be necessary to move along the muscle, and repeat the lift and pull/push again.

4 Stretch-release is a technique that targets the muscles and deeper fascial layers. The stretch must be applied in the direction of the muscle fibres. It is performed slowly and requires great concentration and ability to feel the resistance, and then the yield, in the tissue. With the arms crossed, one hand anchors the skin while the other hand applies movement in the opposite direction, pushing the skin and fascia horizontally until the point of resistance is felt. This point is held until the tissues release and yield slightly. Repeat the stretch until there is no further release. The hand then moves on to another area. Take care not to slip and chafe the skin.

Hand applied stretch

Hand anchor skin

Figure 9.10

Hand anchor skin

Figure 9.10

Both hands apply stretch

Stretch-release applied by one hand.

Both hands apply stretch

Figure 9.11

Stretch-release applied by both hands.

A similar stretch-release technique involves placing the crossed hands on the skin and moving them apart. Pressure is applied through the ulnar border of the hands as they move away from each other. Stretch is applied to the underlying tissues, held for a few seconds at the end of the stroke and then released.

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