Whether active duty, retired or military dependent, many have dealt with a soft tissue injury at one time in their lives. “Shin splints” and “IT-Band Syndrome” are commonly referred to as “myofacial pain.” Although these injuries are common among athletes, even recreational athletes or “weekend warriors” can be prone to these injuries. For example, think of someone in their 30s or 40s training for a first marathon who has never been a runner and is now training five days a week, running 5-10 miles per training session.
In order to best define myofacial pain, one has to take a quick look at soft-tissue anatomy. The superficial fascia is a soft, connective tissue located just below the skin. It wraps and connects the muscles, bones, nerves and blood vessels of the body. Together, muscle and fascia make up what is called the myofascia system. For various reasons, including disuse, not enough stretching or injuries, the fascia and the underlying muscle tissue can become stuck together. This is called an adhesion and it results in restricted muscle movement. It also causes pain, soreness and reduced flexibility or range of motion.
In recent years, health disciplines such as physical therapy, chiropractic and orthopedics have focused on treating these adhesions in the fascia to improve pain, flexibility and to optimize performance in sports. Myofascial release is a body work technique in which a practitioner uses gentle, sustained pressure on the soft tissues while applying traction to the fascia. This technique results in softening and lengthening of the fascia and breaking down scar tissue or adhesions between skin, muscles and bones.
As a physical therapist, the most common areas that I see patients for myofacial release are for IT-Band Syndrome and shin splints. Most of my patients benefit from a few short treatments in-clinic, and then we recommend a home exercise program that incorporates the use of a foam roller. This is a great addition to any home gym. Taking a few minutes at the end of a workout or after a run to focus on sore spots with a foam roller is a great way to prevent myofacial pain.
IT Band (start)
IT Band (finish)
One should foam-roll after their workout. It can be moderately uncomfortable if one is new to using a foam roller or have some significant myofacial pain. Light to mild bruising can be normal for some people. Those who do bruise should start with twice a week foam-rolling and work up to three times a week.
Shin splint (start)
Shin splint (finish)
Make sure to drink water after finishing foam-rolling. Good hydration allows for more nutrients delivered to the tissue and waste products eliminated from the tissue. I would not spend more than five minutes on a single area. When starting out, one may only be able to tolerate 30 seconds at a time; try to do three to four sets of 30 seconds. As the techniques become more tolerable, work on longer time periods up to a maximum of five minutes.
For more information about this article, the techniques in this article or finding a good foam roller, email moshe.greenberg@us.army.mil.
