THE MYOFASCIAL WEB

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Ginevra Liptan, MD, explains trigger points and myofascial release bodywork.

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THE MYOFASCIAL WEB

  1. 1. Myofascial Web and Fibromyalgia Fibromyalgia Information Foundation 2014 Annual Conference Ginevra Liptan, MD
  2. 2. Fibromyalgia (FM) pain Hyper-reactive spinal cord and brain called “central sensitization” Pain generated from muscle tissue
  3. 3. 18 tender points used to diagnose FM
  4. 4. Fibromyalgia muscle pain sources -Fascia –connective tissue around muscle -Myofascial trigger points
  5. 5. What is fascia?  Connective tissue network  Surrounds both individual and groups of muscles  Highly sensitive to pain  Contracts to give muscles extra strength
  6. 6. Myofascial “web”
  7. 7. Connective tissue that envelopes muscles
  8. 8. Connective tissue that’s left after muscle cells dissolved
  9. 9. Fascia in FM  Increased tension  Inflammation  Prone to “ knotting up”( myofascial trigger points)
  10. 10. Myofascial trigger points  Hyper-irritable or taut band of muscle  Painful on compression  Refers pain  Can occur in any muscle under strain
  11. 11. Myofascial trigger point
  12. 12. Treatments for fascia/trigger points  Myofascial release (MFR)  Trigger point injections  Self-care
  13. 13. Myofascial release therapy  Manual traction and prolonged assisted stretching  Breaks up painful adhesions in the connective tissue surrounding muscle
  14. 14. MFR is not massage
  15. 15. Myofascial release for FM
  16. 16. Castro-Sanchez et al . 2011  20 weeks myofascial release therapy  Compared to sham ultrasound  Significant improvement in pain and tender points  Pain reduction persisted at 1 and 6 months post- intervention
  17. 17. Our study- MFR vs. massage Women between the ages of 21 and 50 with a confirmed FM diagnosis Randomized to myofascial release or Swedish massage Therapists had advanced training using the John F. Barnes MFR approach 90 minutes weekly for 4 weeks
  18. 18. FIQ-R Percentage Change in Myofascial Release SubjectsPercentagechangeinFIQ-R Myofascial release subjects 1–8 A change of 14% or more is considered significant
  19. 19. FIQ-R Percentage Change in Massage SubjectsPercentagechangeinFIQ-R Massage subjects 1–4 A change of 14% or more is considered significant
  20. 20. Trigger point injections  Injection of lidocaine  “Dry needling”
  21. 21. Trigger point self-treatment
  22. 22. Resources www.theracane.com www.myofascialrelease.com Book: The Trigger Point Therapy Workbook:Your Self- Treatment Guide for Pain Relief by Clair Davies Web sites:

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