Myotherapy (“Muscle Therapy”) = Myofascial Trigger Point Massage + Trigger Point Dry Needling (Medical Acupuncture)
There is often an assumption that soft injuries to muscle tissue, whether in the form of direct trauma or repetitive strain, will recover on their own and are not as serious as injuries to other tissues such as bone and ligament. However, whilst it may be the case that muscle injuries often show a rapid rate of recovery, their recovery is often not complete. The end result of direct trauma or postural strain is very often hyper-irritable taut bands and trigger points within the muscles, with the muscles and the casing around them (fascia) becoming shortened and fibrosed. Regardless of other causal factors that should be addressed (such as mal-posture, weak core muscles etc), these tight hyper-irritable portions of muscle can themselves become a perpetuating factor by limiting mobility, causing altered muscle patterning and (trigger point) referred pain, even after the original causal factors have been addressed.
Furthermore some pain experts estimate that 90% of the discomfort experienced during degenerative unremitting conditions, such as osteo-arthritis, comes from myofascial tension and trigger point referred pain.
For various reasons there has been a trend in recent years within the physiotherapy world to steer away from soft tissue massage based treatment as this is seen as only treating symptoms and not addressing the underlying cause. In some instances this has lead to a dumbing down of soft tissue release skills taught at undergraduate and postgraduate level. However, effective soft tissue treatment when conducted alongside prescriptive corrective exercise can aid and complete rehabilitation. In the case of unremitting degenerative conditions, appropriate soft tissue treatment can serve as an alternative pain management strategy to long term pain killers.
Our experience at Spine Plus is that the most effective myofascial release comes from trigger point dry needling (medical acupuncture) coupled with myofascial and trigger point massage. These are specific forms of massage that will not cause increased trigger point irritability unlike other forms of massage. An expert knowledge of anatomy and muscle fibre orientation combined with excellent palpatory skill is required for this to be done effectively. See below for an outline of these techniques.
Trigger Point Dry needling (Medical Acupuncture): Needles are inserted into the hyper-irritable bands of muscle with the goal of eliciting the “twitch response” that will signify likely deactivation of the trigger point. This also improves blood flow, releasing chronic tension and referred pain from deep muscle bands that would be hard to reach with a hands alone approach. (See our Trigger Point Needling page for more information).
Trigger point massage: Uses short amplitude, slow, deep strokes at 90 degrees to the muscle fibre direction with little or no oil in order to achieve maximum fibres contact, sometime with the aid of massage tools to anchor and strip the muscle fibres even more effectively.
Myofascial Massage: Uses gliding strokes, often with some oil to stretch muscles and their casing (fascia) longitudinally.
At Spine Plus all our osteopaths and physios receive in-house training in the above approaches, often incorporating these techniques into osteopathy/physiotherapy sessions, or you can ask to specifically be booked in with them for a dedicated myotherapy treatment.