Do you suffer from pain, injuries, or tension headaches? Do you know that a physiotherapist with experience in fascial manipulation can help treat these problems? One of the Beijing United Family Hospital (BJU)'s physiotherapists, Ying Swee Ong, is experienced in treating a wide range of musculoskeletal conditions. Read on as Ying Swee explains what fascial manipulation involves and what conditions this technique helps to treat.
Fascial manipulation is a manual therapy often used by physiotherapists. This technique is used in pain or injuries where the problem is caused by tight or restricted myofascial tissues. Myofascial tissue is a thin lining that surrounds and supports your muscles. When this layer of soft tissues gets tight, it may cause pain in other areas. Imagine it like a pair of stockings that runs from your toes to your waist. If the top part of the stocking is tightened, this will also lead to the tightening of the lower part of the stocking.
Often you'll feel like having knots in your muscles which are painful when you press on them. These knots are also known as trigger points. Sometimes, when you press on them, you will also feel pain or other sensation (e.g. numbness, pain, and tingling) in other parts of your body. If this is reproducing the pain that you normally have, then it is very likely that the cause of your pain may be originating from this trigger point.Upper Trapezius muscle (TrP2) refers to pain into the base of the skull
Lower Trapezius muscle (TrP3) refers to pain into the shoulder
One very common problem caused by myofascial tightness is tension headaches. Tension headaches present as a dull pain, tightness, or pressure in your head, neck, and sometimes behind your eyes. They are commonly caused by tight neck and shoulder muscles as these muscles are attached to the head. When these muscles get too tight and create increased in tension, it will start to refer pain to the head. Patients will normally complain of headache when they are static, such as spending long hours in front of the computer or phone. This is due to the tightening of muscles when you are not moving.The Sternocleidomastoid muscle refers to pain into the back of the head and ear, and also into the forehead and around the eye
When you see a physiotherapist, he/she will identify pain points in your neck and shoulder muscles that reproduce your symptoms. Fascial manipulation is where your physiotherapist applies constant pressure to these pain points. For the first few minutes, your symptoms may increase and the point that is worked on may be quite painful. Over time, when your muscle relaxes, the pain will become less. Depending on how much tightness you have in that area, the physiotherapist can work between 5 and 15 minutes in a single spot. No more than six points are treated in one session.
After the treatment, you may feel an increased level of pain in the areas that were treated. Sometimes, your symptoms will get worse before it gets better. This may continue for up to 48 hours, but it will slowly get better. It is advised not to do any strenuous activities after the treatment. If you feel uncomfortable after treatment, you may put a hot towel or a hot water bottle over the painful area. Depending on the severity and how long you've had this problem, it may take between four and eight sessions to see improvement in your symptoms.
Your physiotherapist will also give you advice on your daily posture. They will give you suggestions on exercise to help you strengthen muscles that are weak, and exercises to stretch muscles that are too tight. Other advice will also be given to you on how to self manage your symptoms.
References:
- http://massagetherapyconnections.com/symptom-directory/headache-2/
- https://www.kingofthegym.com/upper-trapezius/
- Ajimsha, MS, Al-mudahka NR, Al-Madzhar JA. Effectiveness of myofascial release: systematic review of randomized controlled trials. Journal of bodywork and movement therapies, 19(1), 102-112, 2015.
- Akbayrak T, Akarcali I, Karabudak R, Demirturk F. The results of connective tissue manipulation in the treatment of tension type headache. The Pain Clinic, 13(4), 343-347, 2002.
- Almeida RS, Gomes V, Gaullier CM, Dames KK, Nagueira LAC. Effects of manual therapy on cervicogenic headaches: a therapeutic approach. Acta Fisiatr, 21(2), 53-57, 2014.
- Roth JM. Physical therapy in the treatment of chronic headache. Current pain and headache reports 7(6), 482-489, 2003.
- Stecco A, Gesi M, Stecco C, Stern R. Fascial component of the myofascial pain syndrome. Current pain and headache reports, 17(8), 352, 2013
Ying Swee Ong is a New-Zealand-trained Physiotherapist. She speaks English, Malay, and Mandarin. If you wish to make an appointment with her or any of our other specialists, please call the BJU Service Center at 4008-919191.