Massage & Bodywork

MAY | JUNE 2023

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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 77 perimysial bundles to slide and individual muscle fibers to glide in their fascial, endomysial sheaths. When it goes wrong, the HA gets thicker and sludgier and becomes more adhesive. Things don't slide well. This is called densification. It can happen for any number of reasons, including elevated pH levels, overuse syndromes, injuries, and surgeries. Densifications tend to lead to compensation patterns. They can also lead to myofascial pain. And long-term, it can lead to fibrosis. Something else that is abundant in the sliding interface between the muscle and fascia are sensory nerves, particularly type IV proprioceptive nerve endings. When these nerves can no longer enjoy a smooth ride along their immediate fasciomusculoskeletal environment, they are trapped by a densification. And those nerve endings are going to tell you about it, most likely by generating a pain signal. The automatic response is to avoid moving that area, which will only serve to increase the densification—and cause more compensations. This should lead us to think about different strategies for treating entrapment syndromes. While hyaluronan exists in a variety of tissues throughout the body, our main area of interest is the sliding zone between the deep fascia and perimysium. This zone exists between the deep fascia and perimysium of one muscle and its neighboring muscle(s), ensuring that they slide and glide along one another with ease. MOTION IS LOTION, LITERALLY Fasciacytes love shearing motions. When things are moving and grooving, that keeps them pumping out the HA we need to stay sliding and gliding, lubricated and happy. As far as we know, this isn't something you can get by taking hyaluronic acid supplements. Therapeutically, fasciacytes respond to pressure and perpendicular, shearing motions as opposed to long, sliding strokes. This response can change the viscosity of the HA, making it less dense. Mechanical perpendicular vibration (using mechanical vibrators and the like), as well as rapid back-and-forth motions (tangential oscillation) with the knuckles can engender this effect, with the latter approach having recently been shown via imaging to increase water content around the areas of densification. I often use the outside edges of my hands (or a concert of fingertips) like a wedge between epimysial divisions of particular muscles (at least, that is my therapeutic intention) while simultaneously engaging in rocking and/or oscillatory motions to root out and Skin Superficial fascia Deep fascia Adipose tissue Adipose tissue Muscle Epimysium Fibroblast Fasciacyte Collagen Hyaluronic acid

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