Healing Myofascial Injury With Therapy

By Hima Dalal

Have you ever been in a car accident and experienced whiplash? In the aftermath of such a tragic event, you may have experienced what is called myofascial pain syndrome. Simply described, myofascial pain syndrome is our body's way of reacting when fascia is injured or traumatized. Myofascial injuries seem to occur more routinely than ever, which is why it is important to know how fascial injuries are caused and what to do in the event of a fascial injury.

Fascia is very densely woven connective tissue wrapping and protecting muscle, bone, nerves, arteries and organs. Fascia is continuous: one structure that exists from the head to the toe without interruption. As with most connective tissue, injury, trauma, surgery and poor posture cause scarring in fascia very easily. Since there is little elasticity and pliability in connective tissue, scaring or cross links in fibers causes loss of flexibility, range of motion and tension in underlying muscles. According to myofascial expert and physical therapist John Barnes one square foot of facial tissue can exert 2,000 pounds of pressure against underlying tissue, illustrating just how powerful and important fascia is.

Myofascial pain syndrome may involve either a single muscle or a muscle group and develops from an injury or strain to a particular muscle or muscle group, ligament or tendon. In some cases when a person experiences pain, the location of the pain may not be the location of the cause. Myofascial pain caused by injury can center around sensitive points in muscles called “trigger points” and is usually diagnosed by testing trigger points, postural observation and checking soft tissue pliability. It persists or worsens differently than normal muscle pain and can be linked to seemingly unrelated headache, jaw pain, pelvic pain, and arm and leg pain.

Causes can include car accidents/whiplash, injury to the intervertebral column, repetitive motion, immobilization while hospitalized, strokes, fracture, strains, dental work issues, poor posture, flat feet, clenching of the teeth, Plantar Fasciitis and sudden weight gain or weight loss. Age, sex, stress and anxiety are factors that can affect the severity of myofascial pain.

Symptoms may include deep aching pain in a muscle, pain that persists or worsens, muscle stiffness that increases after stretching, joint stiffness near the affected muscle, area of tension in your muscle that may feel like a knot or tight spot and could be very sensitive to touch, and difficulty sleeping due to pain. Symptoms can include vague or general pain and may be difficult to specify.

One of my patients related the following when referencing her myofascial pain syndrome: “I lived in constant pain. My neck stayed forward, shoulders were rounded, my back hurt constantly and pain increased so much in my trigger points that even the slightest breezed caused tremendous pain. I could not lift my arm up, turn my head to drive, transfer from sit to stand without excruciating pain and even breathing hurts. I was so depressed.”

Test and Diagnosis

If you feel the symptoms of myofascial pain syndrome, it is important to seek the advice of and possibly be examined by a therapist with myofascial therapeutic experience. During an examination, your therapist will ask you questions about your symptoms and test the areas where pain is felt by applying gentle finger pressure to the painful area(s), checking for your body's response and sensitivity tot he pressure. Your therapist will note where jolting or twitching occurs as trigger points are stimulated. These are important clues as to the nature and severity of myofascial pain syndrome you may be experiencing.

Treatment

The therapist will work with you to identify and correct your daily living factors that may be contributing to your pain. For instance, if poor posture is causing muscle stress in your low back, an occupational therapist may guide you through exercises to correct your posture. A therapist may also change your exercise routines and diet. Yoga, walking, swimming and bike riding are some of the better exercises to help you cope better with pain, especially when accompanied by a healthy diet and adequate restful sleep. The same patient noted previously states that her treatments, “including Myofascial Release Therapy, muscle energy work, and stretches using yoga posture, special stretches in sitting, standing and laying positions and stretching in the Hydroworx pool against jet pressure, really helped.” her lifestyle adjustments were coordinated with her husband and children for support at home. She further states, “I have learned to keep myself pain free without much of the anxiety or depression with plenty of rest, stretching, regular exercise and relaxation.”

Although this is just one success story, there are people all over who live with less myofascial pain because of personalized physical therapy treatment. Don't be afraid to ask for advice from qualified professionals, because your body is worth it.

Hima Dalal is the owner and head therapist of Vital Energy Wellness and Rehab Center in Lexington and is a board certified, licensed occupational therapist with 28 years of experience. Hima has written for national and international publications of subjects of health, fitness and healing, making media appearances and leading lecture on health. She is co-chair for the Wellness Special Interest Section of the South Carolina Occupational Therapy Association (SCOTA). Vital Energy and Wellness Rehab Center is at 163 Charter Oak Rd. For more info, call (803) 359-1551 or visit VitalEnergyTherapy.com.