EVIDENCE INFORMED PRACTICE
like closing a gap by shifting the sides together (Fig. 3).
By mechanically offloading
myofascial tension and reducing the myofascial tension via the Golgi organs (neuronal pathway), the myofascial tension will be reduced and normalised immediately. Due to the normalised tension the myofascial system works efficiently again, and the most important effects are significantly reduced pain, increased (normalised) ROM, restored muscle function with improved movement patterns, and increased maximum muscle force.
Figure 3: The MyofascialTape® is applied with stretch from left to the right. Starting at the muscle insertion as depicted in Fig. 2(B), the tape is now applied with stretch to the distal part of the micro-injuries. Again the myofascial release technique is shifting all layers from left to the right.
The majority of these free
nerve endings functions as mechanoreceptors, responding to mechanical tension, pressure or shear deformation.
The tissue proximal to the tape is under reduced tension and the associated receptors ‘feel’ the decreased tension, thus changing their signals and adjusting their normal activity according to the changed myofascial tension. Some have a high, some have a low threshold. Depending on the threshold and the mechanical quality of the fascia, the stretch on the tape has to be adjusted to create the right effect. In practice, the tension on the tape for a myofascial release varies between 50 and 100%. If the myofascial tension has been relatively high, the range of motion (ROM) is often restricted according to the amount of myofascial tension. Interstitial receptors (free nerve endings) acting as mechanoreceptors will be stimulated less than usual in a neutral position and they will also be stressed less and later during movement and stretching positions. This mechanism works within a split a second, as fast as the Golgi organs and interstitial receptors transmit the stimulation. Accordingly, after applying the tape and creating a myofascial release, the restriction in ROM and pain will decrease significantly, which is the reason why Myofascial Taping is so popular in elite sports. The effect is
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maintained during every movement, even preventing further injury.
MYOFASCIAL RELEASE FOR FASCIA WITH MICRO- INJURIES
The procedure and taping application for fascial structures with micro-injuries is the same as with non-injured fascia, but the tissue-shift will not only be at the point of muscle insertion affecting the Golgi organs but will also continue to the painful spot – the micro-injuries – and possibly even 2–3cm further. Again, the tissue is shifted towards the micro-injuries, so mechanically offloading the myofascial tension from the muscle insertion (Golgi) to the injury. The torn fibres are offloaded,
Please note that the direction of shifting of the fascia can vary. It depends on several parameters that need to be determined from specific fascia diagnostics.
Beginners should stick to one rule:
never shift or pull fascia away from the pain or an injured fascial structure! If fascia is pulled away from the place where micro-injuries are present, the receptors will be stressed more and will increase nociceptive signals (eg. pain).
MYOFASCIALTAPE®: AN IMPORTANT FACTOR The effects of Myofascial Taping can only be achieved using a tape with a very strong adhesive (as a lot of stretch is used on the tape) and a lower recoil effect (to allow fascia to be shifted in the direction it is pulled) than kinesiology tapes. Flexotape® or MyofascialTape® has been specifically developed for Myofascial Taping to give optimal myofascial release (Fig. 4).
Figure 4: Flexotape® – MyofascialTape® – is a self-adhesive and elastic tape, designed for Myofascial Taping. Flexotape® has properties similar to kinesio tape but has a much stronger adhesive and allows fascia to be shifted in the same direction as the tape is pulled. Flexotape® is latex-free, made from 100% high quality cotton, and is water resistant.
PART 2: THE PRACTICE MYOFASCIAL TAPING: DIAGNOSTICS AND TAPING APPLICATIONS Myofascial Taping works reliably and therefore can be used not only for treatment but also as a powerful diagnostic tool. In practice, the most meaningful parameters are pain and ROM. If someone has restricted ROM and pain, due to a high myofascial tension at a certain spot, the ROM will increase and the pain will decrease immediately after a myofascial release treatment.
Using ROM and the visual analogue scale (VAS) (where 0 = no pain and
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