V. Self-care for Chronic Myofascial Pain of the Back, Neck, & Extremities
18. Dr. Fors could you demonstrate for us how to utilize the Fenix Rehab Systems to treat specific myofascial pain syndromes?
For specifics on treating the trigger points of various myofascial pain syndromes with the FENIX Rehab Systems click on the article that is of interest to you below.
19. Dr. Fors, now that you have shown us how to self-treat our pain causing active and latent trigger points; is there more we can do to overcome or rehabilitate our chronic pain?
Well, the one thing I have kept emphasizing throughout the demonstration was the importance of stretching the tissues after applying any pressure massage techniques. We demonstrated many of those important stretches as we went through each area of the body in the previous demonstration. Also there is a pictorial display in the back of the Fenix Rehab System's 20 page guidebook that shows you how to stretch each area after trigger point treatment.
20. Why is it so important to stretch myofascial tissues?
Because trigger points shorten and weaken muscles, it is vital to stretch the tissues after each pressure treatment session. Each stretch should be held for 1 to 1 1/2 minutes, go slow and don't over do it. As explained earlier properly applied trigger point therapy with the Fenix Rehab Systems you actually change the myofascial tissue. You actually stretch the collagen fibers and release its cross-linkages that form in the trigger point region. Also with sustained pressure you change the ground substance from a gelatinous state to a more fluid soluble state.
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All these tissue changes with trigger point therapy allow you then to slowly release the contracted muscle fibers in the taut band of the trigger point with a sustained stretch. It is this combined effort of applying trigger point therapy to all the active and latent trigger points in a muscle region, followed by a sustained stretch of the myofascial tissue that actually will rehabilitate a chronic myofascial pain syndrome.
21. If someone has myofascial pain what usually happens when someone goes to a clinician for care?
If an individual in pain is lucky enough to find a clinician who does myofascial therapy generally the following happen: The doctor or therapist will generally go in and find one or two major trigger points, pressure treat them somehow and than move on to other aspects of their care. The patient tends to feel better immediately, but because all the latent and satellite trigger points are not methodically searched out and released, their continued presence reactivate the primary active trigger points again causing the pain and stiffness to return.
There are very few clinicians that actually take the time to have the patient stretch each muscle they have released trigger points in. It is time consuming to have the patients stay in a room stretching each muscle. That's if the clinician is even aware of the importance of stretching the tissue after trigger point therapy.
22. If trigger point therapy to active and latent TPs; combined with sustained stretching of the treated myofascial tissue is so effective, why is it not utilized more?
There are many reasons as explained before; first most clinicians do not understand the full power of properly done trigger point therapy. Second, in this era of managed health care about the only way for a healthcare provider to make a good living is to see a high volume of patients. Also insurance generally does not pay much or at all for extensive myofascial therapy. So economically a doctor or therapist can not spend a great deal of time searching and treating all the active, latent, and satellite TPs and then take time to have their patients sustain stretch each muscle treated.
But, you as an educated individual utilizing an effective self-care system, such as the Fenix Rehab Systems, can take the time to properly self-treat yourself over a period of time. This is exactly why I invented this system of self-care and feel so passionate about getting it out to the 86 million adults in the U.S. suffering with chronic myofascial pain.
Its just too easy to hand out and take drugs for myofascial pain, but over 17 million are hospitalized and 17, 000 bleed to death from NSAIDs drugs. Why not start a program of self-care with one of the Fenix Rehab Systems, a program of proper trigger point therapy and sustained stretching.
23. Dr. Fors are there products out there to help people effectively stretch their myofascial tissues and relieve their chronic pain?
One very helpful product that can make your sustained stretch more effective is Biofreeze. Biofreeze works best when used after applying trigger point therapy or pressure massage to pain-causing trigger points. Either spread the greaseless, stainless gel over the muscle or utilize the spray formula to apply a mist over the muscle. Once the Biofreeze has been applied and begins to cool the tissues employ a sustained stretch to the involved muscles as per instruction included with the Fenix Rehab System.
Biofreeze is a fast-acting, deep-penetrating lone lasting herbal formula that gives pain relief from arthritis, sore-muscles, back pain and stiffness. Biofreeze contains the pain relieving exotic herb Ilex from a South American holly shrub. So effective is Biofreeze for chronic muscle pain, that FRE, Inc has included samples with each purchase of a Fenix Rehab System. For around $10.00 to $12.00 you purchase a 3 oz Roll-on Biofreeze, 4 oz tube or a 4 oz spray bottle.
There are also a couple of products that I recommend to help you fully stretch involved myofascial tissues. The StretchRite product allows you to control the tension in each stretch and adjust length to accommodate your body's length and flexibility. The StretchRite comes with an instructional manual with 20 different stretches and stretching guidelines that help you stretch safely and efficiently.
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| StretchRite |
Another product called the Stretch-Out Strap with multiple position grips allow deep, gradual stretching of major muscle groups with greater safety and effectiveness. It comes complete with illustrated guide booklet of 30 stretches. I personally like the design of the Stretch-Out Strap, but I recommend both of them. They both sell for under $30.00.
24. Dr. Fors, you have mentioned that myofascial trigger points not only cause pain, but also weaken muscles. Is it important to strengthen these muscles?
Yes, many times if the myofascial trigger points in a muscle are multiple and long standing it may be necessary for the individual to re-strengthen the muscle; after a program of trigger point therapy and sustained stretching. Usually, I have found that once you release the active and latent trigger points in a muscle, its strength returns. But if an individual finds they are having a hard time rehabilitating their long standing myofascial pain; it may be helpful for them to re-strengthen the muscles. As always home care is only done after you have had a qualified physician rule out fractures, tumors, infections, and other pathologies as a possible cause of your chronic pain.
25. Are there also products that can assist individuals with strengthening their muscles?
There are many products on the market today called resistance tubing or exercise tubing kits. These products usually come with a flexible rubber tube of various lengths with handles attached at each end. The kits generally come with a video and/or instruction sheet showing you how to strengthen a shoulder, elbow, hip or knee joint by exercising the muscles around that joint. These products run anywhere from about $20.00 all the way up over $100.00.
There are a couple of products that I recommend for muscle rehab that are of good quality and reasonably priced. One I like that has been around about the longest, is the "Lifeline Deluxe Gym in a Bag." It come complete with a lifting bar, cable with rotator handles, door attachment, treadmill belt, carrying case, instructional poster and award-winning video. It can be purchased for around $55.00.
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| Lifeline Deluxe Gym in a Bag | Valeo Portable Fitness | DynaflexExcerflex Kit |
You can get just resistance tubing with cushioned handles and a simple instruction sheet for joint exercises made by Valeo, video instructions are not included. Not as complete a system as the Lifeline Deluxe Gym but generally sells for around $20.00, making it more affordable for those on a tight budget.
So let's say you have had a very long standing rotator cuff shoulder problem, or a chronic hip problem. You would acquire one of these exercise kits and familiarize yourself with their instructions for strengthening your shoulder or hip point. Its best to begin this strengthening program after you released most of the active and latent trigger points in the muscles involved.
26. Well, that's sounds good for extremity problems, like shoulder, elbow, hips, and knees, but what about the huge problem of chronic low back pain?
In chronic low back pain there is usually a problem with the "core stability" of the lumbar spine and pelvis. With poor core stability the muscles that need to be strengthened are the quadratus lumborum, and erector spinea muscles of the lumbar spine, along with the abdominal muscles in front. Also included in your core stability are the pelvis muscles, primarily the gluteal muscles.
The best way to strengthen these core muscles is to utilize the ever popular exercise ball with an instructional video. One of the products I recommend is the Dynaflex Exerflex Kit. This product comes with a durable exercise ball, air pump and extensive exercise video that specifically targets the core muscles. The Dynaflex Exerflex Kit sells for around $30.00.
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