Creating a Window of Opportunity: How Myofascial Mobilization Makes Way For Strengthening
By Tyler Baca, PT, DPT
Both in the clinic and at the gym, I will get asked: what is the best “mobility tool”?
There are endless options that range from foam rollers and lacrosse balls to scrapers, massage guns, and car buffers. While each tool may create a different sensation of stretching or relaxation, they are all producing a similar neurophysiological effect. To start this conversation, let’s discuss what is meant by “neurophysiological” and how these changes are fleeting.
“Neurophysiological” changes: How are we going to take a physical pressure applied muscle and create a change in the nervous system to allow the muscle to chill out?
The lacrosse ball is a common staple in my physical therapy practice. I explain to patients that the lacrosse ball is a powerful tool that can help reduce symptoms that may be produced by tightness or restrictions in specific muscles. Pressure, whether it be from a manual therapist’s hands or a mobility tool, stimulates mechanoreceptors in the myofascia (think muscles and the white stringy stuff you see surrounding it). Imagine little sensors in the myofascia that are designed to specifically respond to applied pressure. Once these sensors have been adequately stimulated, they transmit a signal through the spinal cord to the brain. This process leads to stimulation of our sympathetic nervous system to decrease the tone to the “tight” muscle in question. You can think of your “tight” muscle as an overcooked steak: firm and rigid. Your muscle, in a state of decreased tone, should feel more like the consistency of a raw steak: pliable and soft. This decrease in tone may lead to pain relief or decreased pull on structures that are causing pain. The big caveat to this complex mechanism is that these results are TEMPORARY.
Now this is not to say that I expect the patient to live with a lacrosse ball on hand all day. Instead, I explain how this quieting of the myofascial system creates a “window of opportunity” to create a long term change in the tissue…. This means strengthening!!
For example, for a patient that has shoulder pain, we may have found that the lacrosse ball to the back of the shoulder provides a window of 2-3 hours where he or she can move the arm with a lot less pain. During that window, I would expect the patient to have completed the rest of the home exercise program that I had prescribed. This home exercise program likely includes strengthening exercises to address the source of the patient’s symptoms. If prescribed and completed correctly, I would expect the strengthening exercises to start contributing to a lasting relief in that shoulder pain. We are able to address the source of the symptoms while minimizing discomfort while doing so.
Bonus: Completing exercises with decreased discomfort will create a positive association with the strengthening program when compared to trying to complete the exercises while in pain.
It is important to get proper guidance in myofascial mobilization and strengthening of the specific muscle tissues. Our PT’s at Therapydia can help you identify the underlying source of your symptoms, provide mobility exercises through the use of many different mobility tools, and prescribe strengthening exercises to ultimately create lasting change.