The effects of long distance running on Fascia
About Fascia: In recent years there has been a major shift in focus (amongst body workers and sports therapists) from mainly treating muscles to more of a focus on releasing fascia. Traditionally, fascia has been seen as the sheath or outer skin of the muscle, but this view is outdated. The latest research shows that fascia is in fact a 3D, continuous living matrix running throughout the entire body. It binds the inner network of every cell in the body to it’s neighbours. The fascia is one continuum; from bone to periosteum to tendon to the epimysial fascia within the muscles and once again to the tendon, to the periosteum and to the joint capsule, etc. It’s all one living matrix with the ability to store and communicate information across the entire body. The fascia consists of collagen, elastin, and reticulin fibres in different densities throughout the body held together and suspended in a gluey, watery, gel like ‘ground substance’ (composed of mucopolysaccharides and glycosaminoglycans). The fascia is a fluid loving system and in a healthy body, this fluid ground substance not only provides a lubricated environment for the connective tissues to slide over each other, but on a cellular level it allows the essential exchange of substances between cells and blood and lymph vessels. This ground substance can become dehydrated and dysfunctional through injury, trauma or lack of use. It then becomes more viscous or solid and rather than allowing the exchange of substances, it becomes a storehouse of metabolites and toxins. Rather than provide a lubricated environment for the connective tissues, these collagenous fibres bind down tightly, limiting range of motion and in some cases putting huge pressures on pain sensitive areas and causing postural distortions. So, we can see that it is vital for overall health that the fascia is kept hydrated and as we will see, it is especially true for the athlete.
One of the functions of the facial system is to act as the body’s shock absorber and in a hydrated system it does this very well, responding to sudden changes faster than the nervous system. However, if the ground substance becomes dehydrated, the fascia loses these shock absorbing qualities, often resulting in pain for the runner. As most runners know, it takes time to build the strength and resilience to run long distance. Too much, too soon, often leads to injury. The fascia and it’s ground substance is always changing to meet the needs placed upon it, but this adaption takes time. Even in a seasoned runner, it is possible to injure and dehydrate the fascia through overuse, a change in training plans, or a change in terrain or running shoes. In my practice as a sports massage therapist and myofascial release practitioner I treat a lot of runners from the local running club, addressing common injuries such as shin splints, ITBS, patellofemoral pain (runners knee), hip imbalances, hip rotations, functional leg length discrepancies and muscle strains from partial tears to full Achilles ruptures. Through this work I have found that gentle, indirect JFB myofascial release (as taught by Emma Gilmore at the School of Bodywork) has been a key approach to help resolve most of these issues. I am a runner myself with first-hand experience of some of these injuries too which always helps when treating others. I will share with you one story of helping a long distance runner in the lead-up week to the London marathon using only gentle myofascial release techniques:
Treating a patient: Jamie contacted me in the week leading up to the London marathon saying that he may have to pull out of the event as his knees were so painful he could hardly bend them and he had great difficulty climbing and descending a single flight of stairs. Jamie had put in a lot of training for the event and it would have been terribly disappointing if he had to pull out at this late stage so I suggested he came for some treatment.
As a therapist, you start to asses your client as soon as you open the door (how they stand, how is their posture, how they walk, do they seem relaxed or tense, what is their state of mind, etc). It was easy to see that Jamie was in a lot of pain as he hobbled into the treatment room. He found it so painful to bend his knees that he struggled to take his shoes off. I couldn’t do much in the way of assessment whilst standing as it was too painful for Jamie to bend his knees. Once on the couch, I assessed the fascia in his thighs and it felt pretty solid. As stated earlier the repetitive nature of long distance running can take it’s toll on the fascia and Jamie’s quads felt dehydrated, hard and condensed. I learnt that he had bought a new pair of running shoes 6 weeks earlier and even though they were the same brand and model I suspected this was the cause. I began to apply a gentle cross-hand-release technique to his quads and it wasn’t long before we both started to feel releases happening. One applies gentle, sustained pressure into the fascial system and waits for the fascia to respond/release. This is a very different approach to sports massage where one is ‘doing’ a lot and releasing tension through the use of force. During the release, I could feel a lot of heat coming from Jamie’s legs and movement within the superficial and deep fascial layers. Jamie described the release ‘like honeycomb crumbling and falling apart’. After releasing the quads I moved onto the knees themselves. Traditional anatomy states that there are many components comprising and affecting the knee joint such as bones, ligaments, bursa, connective tissue, muscles (quads, hamstrings, gastrocnemius, popliteus, etc). As a sports therapist, one tries to fix the problem, for example, by releasing and lengthening tight muscles which may be pulling the joint out of alignment. However, as an MFR practitioner, the approach is different. One still assess the knee and tissues in the same way, but rather than get to work trying to fix what we believe is the cause, we simply feel into and engage with the fascial system and wait for a response. Listening through our hands, we follow the releases allowing the body or the fascial system fix itself. As I applied a sandwich hold (a fascial release technique) to Jamie’s knee, we were both amazed at how much activity began to occur. As well as an incredible amount of movement within the knee, I could only just meet the pressure that the knee was exerting on my hands as it was trying to expand. After a while I had to relent and loosen my grip and during this time we both felt the knee expand a great deal as the fascia was re-hydrating. This process happened a number of times during the fascial release. A fascial release will often have an emotional component and during this release, Jamie felt waves of emotion and shed a few tears. After releasing the knees, we carried out fascial releases on the hamstrings and the calf’s.
When Jamie got up off the couch, he was amazed that he was completely pain free even when squatting. He entered the London Marathon a few days later and completed it in a respectable time with no knee pain whatsoever. Having re-hydrated the fascia, it’s shock absorbing qualities had been restored and rejuvenated. He went on to complete another marathon a couple of weeks later.
So, if you are a runner, how do you know if your fascia is becoming, hard, dehydrated and compressed? Thomas Myers (a world renowned body worker) recommends the following: If you are running and you seem to have lost the spring in your step then your fascia may well be dehydrated. If training for long distance events it may pay to incorporate a run/walk strategy. Our bodies have evolved to repair themselves during walking, but this self-healing doesn’t work nearly as well when running. When you feel you have lost the spring in your step, walk for a few minutes. If, when you start to run again you notice the spring has returned then great, if it hasn’t then you may not have walked enough or maybe it’s time to visit a therapist.
Doug Orton; Bodhi Massage, Advanced Fascial Release & Sports Massage Therapist
Toby Taylor one year on…
“I found the School of Bodywork whilst at university. I had returned to education through frustration with my career, but found the same challenges whilst studying. I was profoundly dissatisfied with what I perceived to be a sedentary and abstract form of work which had little impact on people’s lives.
Until that point, I had enjoyed yoga and martial arts but had no idea how to develop these things professionally. As my studies progressed, I found less time for them and became quite depressed. And fat. Really quite fat. I was lucky enough to have made friends with a yoga teacher and his wife who both practised massage and through their encouragement, I decided to radically change what I was doing with my life.
I handed in my thesis, moved across the country to Exeter and began at School of Bodywork within 24 hours. I found that I was pretty good at what I was learning and the anatomy and physiology added a missing dimension to my yoga, which got me back into regular practice. As time went on, I was volunteering at charity and community events and found that people were really receptive to what I offered.
Since graduating a year ago, I’ve been able to successfully set up as a therapist and continued with the School’s post graduate programmes. My health has improved significantly and I’ve found a deeper satisfaction for my inclinations to explore and discover than I was offered previously. Through bodywork, I began a yoga teacher training course and have found that the massage gives a privileged perspective on posture and alignment. In truth, the insights I’ve been given through bodywork have far surpassed my expectations.
I currently work out of several practices in the Exeter area and I can’t see myself doing any other form of work. I feel privileged to have the support of the School and the local complementary health community.”
Toby has also studied Indian Head Massage, Remedial Massage and Fascial Release with School of Bodywork.
Emma Barnes on her progress
“Business has been going very well since the Remedial diploma, clients continue to attend for remedial treatment and Swedish massage. I treat three days a week, and for those days I am booked up well in advance. The Remedial Diploma not only gave me more of a library of techniques to use, it also gave me confidence in my self to trust my own judgement. I still treat a broad range of clients, a lot of which start coming for Remedial treatment and then continue booking appointments for Maintenance Treatments. I am very happy with the way my clinic has been received. It has taken a lot of effort and encouragement which is paying off now. The courses that I have done with School of Bodywork have given me an excellent grounding with which to start and continue my business.”
Emma studied the Complete Bodyworker and the Remedial Massage diploma with School of Bodywork.
Julie O’Neill from mobile therapist to clinic…
Since completing the Fascial Release course with Emma at the School of Bodywork my work schedule has been so busy. I remember Emma warning us in class that we would, but I didn’t realise at the time just how successful my business would become. My treatments have excelled forward with the results I’m achieving. I was working as a mobile Therapist before but have since opened up a clinic to save travelling time allowing me more time to cater for the demand. I would definitely recommend the Fascial Release course with Emma if you’re looking for techniques to really boost your treatments with positive results and expand your business. P.S. Already getting great results with the Rebounding!!!
Julie has studied to Advanced Fascial Release with School of Bodywork
Last week I completed a Foundation in Fascial Release (MFR) with The School of Bodywork in Exeter, working with a group of seven other bodyworkers. Director and Tutor of the training school, Emma Gilmore, took us through an eye-opening series of techniques that allow for muscle and pain relief with a very subtle approach. You can forget the more invigorating approach of deep tissue work and how certain techniques, using elbows for example, penetrate deep into the muscle. MFR allows the therapist to take time warming and gently stretching the area, while harnessing a connection with the body and mind, that enables the fascia to release its hold.
MFR offers a less aggressive approach than deep tissue massage or dry needling to encourage pain relief. The results from MFR can be felt from one treatment in some cases and it is perfectly normal to feel pain in places where it hadn’t been felt before, as the fascia is worked through.
As someone who swears by dry needling and deep tissue massage for my own pain relief I was inspired to learn such subtle movements and how much effect they can have on the body. Vibrations, twitches and pain relief can be felt in a different body part to the one being worked on. This is the evidence of how fascia is connected throughout the body and how important it is to care for this complex web of collagen and fibre in order to live a pain free life.
Research Paper by Nikki Collins
The study aims to describe the experience of receiving massage therapy whilst living with and recovering from mental illness. Using the Descriptive Phenomenological Method, the study gives voice to the lived experience of the individual. A purposive sample of four participants was recruited. The data analysis findings are written as a Descriptive Statement included in this paper in full. The outcomes deepen our understanding of how touch and the person of the therapist come together to provide a treatment for mental illness that centres on connection, safety and being of value and worth. Questions arise as to the degree in which massage may be regarded as a treatment and may be perceived as positively impacting mood. The implications of the study are relevant to massage therapists and open up discussion around accessibility and the provision of massage therapy within mainstream mental health services.
Extract from The Descriptive Statement: Recovery is self-acceptance of mental illness and its enduring nature. It is hopeof a life lived as happily and healthily as possible. It is having access to support that is individualised and self-directed, with a range of different resources to access at different times. It is resilience in the face of societal pressures and inadequate support.
Massage is experienced as a treatment for mental illness and, if ongoing, provides an alternative and effective support, reducing the need for other interventions. Massage takes on new relevance for individuals as an important resource for recovery, one of many within the recovery ‘toolbox’. For some individuals, massage remains a ‘luxury’ and too limited in its impact to regard as treatment. The effects of massage share commonalities with mindfulness, notably the effect of deep mental relaxation. Massage contrasts with mainstream treatments, particularly in relation to the absence of negative impact – massage is viewed as a wholly positive experience.
Nikki Collins is an APNT and BCMA registered massage therapist, working privately in South Devon and for Force cancer support centre. She is also a qualified mental health nurse, currently returning to practice at Devon Partnership Trust. She has two children and spends her spare time wandering in the forests of nearby Dartmoor.