The topic of my upcoming e-book " Hip & knee self-soft tissue recovery techniques for runners" turned out to be more complex than I bargained for. As I began to investigate manual therapy terminology,methods, theories and techniques it became evident a lot of perceived facts are assumptions. In short, manual therapy, including self-myofascial release, is convoluted and confusing because the premise of manual therapy is based on theories extrapolated from scientific laws which some professionals perpetuate as fact. Making matters more confusing is the incorrect usage of terms applied to self-use techniques and methods. I strongly believe many of these self-use techniques help with injury recovery, but I disagree with both the terminology and cause(s) encouraged by many.
While the commonly used term "self-myofascial release" is misleading, even more concerning is the inaccurate information proliferating about how self-use techniques or any manual therapy methods, for that matter, work. The fact is WE DON'T KNOW! However, this does not mean we should stop using them. On the contrary, we know anecdotal outcomes show benefits in recovery and research is beginning to confirm some claims. Personally, I witnessed my clients benefit from improved range of motion and decreased pain by performing self-use techniques. But how, why or what is occurring remains to be determined. We don't know whether muscles, nerves, fascia or skin is affected. Likewise, is it mechanical, emotional, chemical, neurological or all of the above? We don't know.
Consequently, using the term self-myofascial release to describe a technique with no evidence fascia is affected is misleading. But what's even more baffling is only highly-trained practitioners can differentiate between fascia and muscle. It's simply impossible for the lay person to distinguish between muscle, nerves or fascia during self-use techniques. Yet, the term self-myofascial release remains. And, yes, I admit using the term. But, these techniques could affect any, all, or none of the soft tissue. Therefore, in my e-book I propose a more general term "self-soft tissue recovery " (SSTR) to describe techniques. Hopefully, soon the industry will agree on terminology that best represents self-use techniques.
Inaccurate nomenclature is one thing, but proposing theories as fact is another. Somewhere along the way older theories on how manual therapy and other therapeutic techniques like foam rolling work were interpreted as fact. Yet, several newer more plausible theories exist and have yet to be proven. Thankfully, there are several industry leaders investigating the feasibility of how self-use techniques work. For example, Chris Beardsley, from www.strengthandconditioningresearch.com provides various resources and research in his article on the Foam rolling and self myofascial release. He provides valuable content including theories, even though I disagree with the term self-myofascial release being used. In addition, Todd Hargrove is a clinician leading the charge on foam rolling. He provides thoughts, research and resources on the science of foam rolling at www.bettermovement.com. Likewise, Brett Contreras also of www.strengthandconditioningresearch.com provides an intriguing summary between Greg Lehman and Todd Hargrove on how self-use techniques work.
In addition to myself, many others believe SSTR techniques work through a symbiotic action among mechanical, neurophysiological, and psychological elements. However, further complicating matters are other variables like type, location, severity, and duration of injuries. And these variables may determine when and what elements are involved during the recovery timeline. Which likely makes finding an answer much more complex.
Outcomes of therapeutic techniques continue to be researched, but how techniques work at a cellular level remains elusive. As professionals we should offer plausible theories to our clients, but not perpetuate them as fact. Whether you believe theories like diffuse noxious inhibitory control, stretch tolerance, gate control theory, somatic sensory receptors, fascia, placebo, a combination of theories or others theories its okay to admit we don't know how specific techniques work. Likewise, we should use accurate descriptors for these techniques. Ideally, some day we will have a better grasp of what occurs cellularly to improve methods and outcomes.
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