Why is stretching important for relieving muscle pain after physical exercise?
Research is currently delving into the intricate question of whether stretching is essential for muscles, and if so, whether it is solely the muscles that require this stretching, or if it is also the connective tissues and fascia that play a significant role in this process. This inquiry is critical because it may shift our understanding of flexibility, mobility, and overall physical health. The nuances of how stretching affects different types of tissues in the body are still being explored, and the implications could influence everything from athletic training regimens to rehabilitation protocols.
What is fascia?
Fascia is defined as "a sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the body." This definition underscores the importance of fascia not merely as a passive structure but as an active participant in the functioning of the musculoskeletal system. It is a complex network that plays a vital role in maintaining the integrity and organization of bodily tissues.
Fascia performs several physiological and functional roles related to joint stability, general movement coordination, proprioception, and nociception. It helps in maintaining the proper alignment of muscles and organs, thus ensuring that they function optimally. Additionally, fascia contributes to proprioception, which is the body's ability to perceive its position in space, allowing for coordinated movement. Moreover, it plays a role in nociception, the sensory perception of pain, which can influence how we respond to injuries or discomfort.
Most importantly, it is responsible for transmitting mechanical forces. This means that fascia is not just a passive wrapping around muscles; rather, it actively participates in the transmission of forces generated during movement, thus affecting overall biomechanics.
When it comes to muscle tension, research indicates that approximately 70% of the tension experienced in muscles is transmitted through the tendons, while about 30% is attributed to the connective tissue, which includes the fascia. This division highlights the significant role that fascia plays in the overall tension and elasticity of the muscular system.
The three areas of fascia can be categorised as follows:
(a) Superficial: This fascial layer is closest to the body’s surface and includes tissues such as the superficial fascia of the body and the subcutaneous fascia. This layer not only provides insulation and cushioning for underlying structures but also plays a role in the movement of skin and superficial muscles.
(b) Deep: This fascial layer is located deeper than the first layer and includes structures such as the deep muscle fascia and the epimysial fascia that envelop the muscles. The deep fascia is crucial for separating and organizing muscle groups, thereby facilitating coordinated movement and reducing friction between muscles during contraction.
(c) Visceral: This is the innermost of the three fascial layers and surrounds the internal organs, providing structural support and facilitating organ movements within the body. The visceral fascia plays a critical role in maintaining organ position and function, influencing how organs interact with each other during various bodily movements.
What is myofascial pain?
Myofascial pain syndrome is a complex condition characterized by the presence of muscle trigger points, which consist of numerous contraction knots. These trigger points are defined as highly sensitive areas within taut, discrete bands of hardened muscle, leading to localized and referred pain along with other symptoms. The pain can be quite debilitating and may affect daily activities.
An active trigger point causes a clinical pain disturbance. It is always tender and produces recognisable pain upon compression. This tenderness can inhibit the full extension of the muscle, weaken the muscle, and mediate a local contraction response of muscle fibers when adequately stimulated. Understanding the mechanics of these trigger points is essential for effective treatment and management of myofascial pain.
A latent myofascial trigger point (MTrP) is clinically asymptomatic, meaning it does not produce symptoms unless palpated with some force. This distinction is important for clinicians, as latent trigger points can become active due to various factors, including stress, overuse, or injury.
Let's discuss treatment ideas:
Fascial treatment - stretching
Many studies suggest treatments aimed at stretching the fascia, including manual techniques and stretching exercises. These approaches are designed to enhance flexibility and reduce tension within the fascial system.
The goal of these therapies is to modify the mechanical properties of the fascia, such as density, stiffness, and viscosity so that it can more easily adapt to physical stress. By improving the adaptability of fascia, individuals may experience enhanced mobility and reduced risk of injury.
In fact, manual therapists report a localized release of tissues following the application of slow manual force to abnormally tense fascial areas. This release can lead to improved blood flow, reduced pain, and enhanced range of motion, demonstrating the efficacy of targeted fascia treatments.
Chiropractors can also perform Proprioceptive Neuromuscular Facilitation (PNF) stretching, which involves a series of contract-relax techniques followed by agonist contraction. This method not only helps in stretching the fascia but also engages the muscles in a way that promotes greater flexibility and strength.
PNF stretching can lead to an increase in the range of motion, allowing individuals to perform activities with greater ease and efficiency. This technique is particularly beneficial for athletes and those recovering from injuries, as it fosters a more functional and resilient musculoskeletal system.
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Colonna S, Casacci F. Myofascial System and Physical Exercise: A Narrative Review on Stretching (Part I). Cureus. 2024 Dec 4;16(12):e75077. doi: 10.7759/cureus.75077. PMID: 39759740; PMCID: PMC11698533.
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