Alpine Spine & Orthopedics - Myofascial Therapies

Myofascial Therapy

Many traumatic and chronic injuries result in myofascial scarring, tightness, and adhesions that can manifest as a complex constellation of symptoms including muscle tightness, nerve entrapments, joint dysfunction, spinal misalignment, and altered biomechanics. Muscles can acquire molecular-level binding between the actin and myosin fibers with frequent repetitive motions, with inflammatory injury, under repetitive stresses, with aberrant neural firing, with microscopic tears, and/or with electrolyte fluctuations, which can lead to symptoms such as stiffness, cramps, nodules, knots, bands, fibrosis, and adaptive muscle shortening over time. The detailed electrophysiology is described in this video, with the first part of the video describing the physics and mathematics and the second part (from minutes 20-27) describing some physiologic applications. Additional fascial injuries are also possible from many other mechanisms, such as Morel-Lavallée lesions after traumatic injuries.

Interestingly, these myofascial pathologies and neuromuscular adaptations can sometimes cause the development of taut bandsm fibrotic bands, adhesions, and trigger points, which are discrete, focal, sensitive locations in the neuromuscular bundle that can cause significant local and referred pain and irritation (such as a cramping, burning, or fraying sensations, which must be differentiated from other pathologies such as neuropathy, tendinopathy, etc.). This is where myofascial therapies can be of great benefit, such as myofascial release, deep tissue percussive massage therapy, scraping, gua sha, cupping, dry needling (acupuncture), wet needling (prolotherapy), hydrodissection, shockwave therapy, PRF or PRP injections, as well as prescription pharmaceutical transdermal compounding creams with a customized combination of muscle relaxants, numbing agents, anti-inflammatory agents, neuropathic agents, and peptides that can be concentrated on the local site. These therapies help to repair myofascial injuries, release and block nerve pains, calm spasming muscles, balance nerve functions, improve nerve gliding through myofascial layers, and restore neuromuscular tone, biomechanics, joint alignment, mobility, perfusion, and lymphatic flow.

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