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Treating Connective Tissue Conditions with Muscle Release Techniques, 2nd Edition: Summary
Adhesions are a common phenomenon whereby tissues and cells become abnormally bound together, inhibiting their normal, independent movement. They can develop due to inflammation, injuries, chronic postures, repetitive stress, or individual trauma. Adhesions can be identified by tenderness, labored range of motion (ROM), and palpable tightness. Over time, adhesions can have significant consequences, particularly when they limit the movement of muscle fibers, leading to myofascial pain syndrome, altered movement patterns, and stiffness. EVIDENCE-BASED PRACTICE Adhesions go beyond localized pain. In the case of fibromyalgia, a chronic condition characterized by widespread muscle pain and tenderness, adhesions contribute to muscle stiffness and discomfort. This is a great example of how the body’s muscles and tissues are intricately interconnected ( kinetic chain ) . If adhesions develop in one area, they can transmit tension and discomfort throughout, affecting overall movement and posture. The terms adhesions and trigger points are frequently used interchangeably to describe any kind of muscle stiffness, but they’re actually different concepts. As we’ve discussed, adhesions are fibrous bands of scarlike tissue that form between tissues and lead to restrictions in mobility. A trigger point, on the other hand, is a highly irritable area within a muscle that causes intense pain when touched or pressed. Typically, a trigger point manifests as a palpable nodule within a taut or tight band of muscle tissue. Trigger points are correlated with pain from multiple manifestations such as headaches, back pain, and restrictive movements of muscles. At the molecular level, trigger points involve the interaction of two specific proteins, actin and myosin . These proteins work together to
generate muscle contractions and facilitate movement. In the case of trigger points, the sarcomere , which is the basic functional unit of muscle contraction, remains persistently contracted and doesn't relax as it should. This results in the muscle fibers having shorter sarcomeres, contributing to the formation of trigger points and the associated discomfort. | HEALTHCARE CONSIDERATION Another term that is wrongly but frequently associated with trigger points is acupressure . Acupressure originates from Chinese medicine and centers around the concept of qi, universal energy that flows through the body. According to this paradigm, maintaining uninterrupted energy flow along pathways called meridians is essential for good health. While some studies suggest a correlation between trigger points and acupressure points, it remains a subject of debate. While the exact causes of trigger points are not yet fully understood, several factors are believed to contribute to their development. • Injury • Sympathetic nervous system activity • Tension • Anxiety • Nutritional deficiencies, particularly vitamins C and B12 Trigger points are always accompanied by a phenomenon known as referred pain. With referred pain, the actual trigger point is located in one area of the body, but the pain it causes is felt in another location. If referred pain is not present, the condition is not considered a trigger point, but rather a muscle knot or related issue. Electromyography (EMG) exams of trigger points show a high correlation between areas of perceived tenderness and tightness.
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