Myofascial Cupping presented by David Sheehan “The fascia forms the largest system in the body as it is the system that touches all of the other systems.” James L. Oschman 2009 Photography & Video • For promotion: see Penny if you’d prefer not to be in picture • For filming demonstrations - go for it! Myofascial Cupping... ...Can change lives! Nociceptive pain? Neuropathic pain? Dysesthesia? Increased ROM Royal Hobart Hospital - Clinical Trial
What is Fascia? Dense irregular connective tissue which surrounds and connects every muscle, even the tiniest myofibril, and every single organ of the body. (R Schleip, 2003) Composition Extracellular Matrix (ECM) Ground Substance Gel-like – 70% water Collagen fibres most common protein in the body (approx. 25% of all proteins) Orient themselves on lines of tension Elastin fibres protein ~ ear, skin, ligaments where elasticity required Cells Fibroblasts (manufacture collagen fibres) Macrophages (white blood cells – big eaters of bad stuff incl. cell debris in e.g. trauma) Plasma cells (white blood cells which produce antibodies; produced in bone marrow) Mast Cells (involved in wound healing and defense against pathogens) Myofibroblasts – new discoveries discussed later What is Fascia? Ground Substance Gel-like containing: Insoluble protein fibrils Soluble complexes of carbohydrate polymers linked to protein molecules which bind water Can dehydrate due to: Trauma Overuse Immobility Aging process – decrease in ability to bind water Dehydration can cause: Reduced Range of Motion (ROM) Pain Postural deviation Trauma
Tensegrity – the role of fascia Tensegrity is defined as ‘tension + integrity’. Buckminster Fuller, building on the highly original sculptures of Kenneth Snelson, coined the term, to indicate that the integrity of the structure derived from the balance of tension members, not the compression struts - think soft tissue Vs. bone structure. Tensegrity – the role of fascia Human structure is ‘finitely closed’ ie we can keep our structure together standing, sitting etc. and not reliant on external structures eg a spider’s web is not ‘finitely closed’. Human structure is held holistically in balance by tension & compression. Musculoskeletal system serves this purpose both stationary and in movement. Tensegrity – the role of fascia Fascia and Tensegrity Connects the whole body and importantly… Pre-stresses the human structure Allows body to react quickly to changes in load Adapt to change with minimal effort Human structure responds to stress by: Muscular contraction (via nervous system) ECM remodelling eg trauma/collegen Fascial responses via contraction…
Tensegrity – a role of fascia Myofibroblasts (MFBs) in ECM Until recently, scientists viewed fascia as non-contractile and inelastic. Robert Schleip and his team in Germany confirmed ability of MFBs in ECM of fascia to contract. They demonstrated that MFB’s assist fascia in pre- stressing human structure. Fascia is able to contract in a smooth muscle-like manner and thereby influence musculoskeletal mechanics Originally published in Liepsch D: Proceedings of the 5th World Congress of Biomechanics, Munich, Germany 2006, pp 51-54 Tensegrity on all levels “If every cell has an ideal mechanical environment, then there is an ideal ‘posture’ – likely slightly different for each individual, in which each cell of the body is in its appropriate mechanical balance for optimal function” Myers, T. Anatomy Trains 2009; p59 • Balancing stress and strain = health & well being • S.A.I.D. principle (Specific Adaptation to Imposed Demands) • Tensegrity allows a balanced transmission of forces throughout the body.
Tensegrity on all levels The microvacuole concept Dr Jean-Claude Guimberteau – a pioneer in microsurgery and transplanatations Trained in hand and plastic surgery Presenter at the 1st Fascia Research Congress in Boston, USA (2007) Observations in vivo showed via video camera: the every-changing and maintaining purpose of fascia “Notions of different fascias ie superficialis or profundas fascia are obsolete” (Guimberteau, 2007) Muscle Attitudes presented by Dr. Jean-Claude Guimberteau, MD
Myofascial Release Myofascial release is a form of soft tissue therapy used to treat somatic dysfunction and accompanying pain and restriction of motion. This is accomplished by relaxing contracted muscles, increasing circulation, increasing venous and lymphatic drainage, and stimulating the stretch reflex of muscles and overlying fascia. (E DiGiovanna, S Schiowitz, D Dowling, 2005) Myofascial Release Gel-to-sol model Myofascial treatments influenced by Ida Rolf (IP Rolf, 1977) Stated that ground substance can be influenced by the application of energy (heat or mechanical pressure) resulting in its aggregate form from a more dense (gel) to a more fluid (sol) state. How long does this affect last?
Myofascial Release Beneficial responses to the Autonomic Nervous System – comments from Dr Robert Schleip deep sustained mechanical pressure produces parasympathetic reflex responses: causing local vasodilation decreased EMG [Electromyography] activity lower muscle tonus and a more quiet emotional state Myofascial Release Beneficial responses to the Autonomic Nervous System Mechanoreceptors also influence local fluid dynamics During myofascial release Interstitial receptors activate and trigger autonomic nervous system responses which: change the local pressure in fascial arterioles and capillaries (Schleip, R, 2003). can cause extrusion of plasma from blood vessels altering the viscosity of the ECM. Ruffini endings are also stimulated which lowers sympathetic activity Myofascial Release Beneficial responses to the Autonomic Nervous System Tissue Manipulations Palpable Stimulation of Tissue mecanorecept Response ors Interstitual and Local Fluid Ruffini Dynamics receptors Autonomic Nervous System
Myofascial Release Beneficial responses to the Central Nervous System Stimulation of intrafascial mechanoreceptors leads to an altered proprioceptive input to the central nervous system, which results in a changed tonus regulation of motor units (Schleip, R, 2003) Myofascial Release - CNS Loop Tissue Manipulations Palpable Stimulation of Tissue mecanorecept Response ors Tonus change Central of local Nervous muscles System Myofascial Cupping & its benefits Hybrid Is a form of Myofascial Release Creates a compression pressure with rim Creates a negative (tensional) pressure which: Passively stretches tissue resulting in increased ROM Increases blood supply/heat to area treated Increases fluid movement which assists in recovery ie decreased edema Increases nutrient-rich blood supply to injured area Breaks down fascial adhesions Increases overall hydration of the fascia resulting in an increased Critical Fibre Distance (CFD) Creates a response from the CNS Reduced local muscle unit firing (reduced local Muscle Tonus) Creates a response from the ANS lowers sympathetic activity Assists in re-hydration of Ground Substance Reduced global muscle unit firing (reduced global Muscle Tonus)
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