Myofascial Release Therapy
INTRODUCTION
Background
Pain is one of the most frequently observed conditions by sports medicine providers when treating injured athletes (Brewer, Raalte 1991). In todays world of modern medicine, there are many different techniques medical professionals use to aid in the treatment of there patients. When specifically looking at the collegian athletic population there are many different manual therapies are used by clinicians, Physical therapist (PT), certified athletic trainers, (ATC) or chiropractor in todays field of modern medicine. Myofascial release therapy (MFR) and instrumented assisted soft tissue mobilization (IASTM) are two commonly used manual therapy techniques by clinicians to aid in the recovery of a given injured population. …show more content…
Because the prevalence of the musculoskeletal injury rate increases with higher level athleticism, many college student athletes find themselves in the athletic training room working towards their optimal level of competition. Clinical efficacy of manual therapy treatments for mild musculoskeletal injuries is lacking sufficient evidence. The literature regarding the effectiveness of MFR as a treatment for orthopedic conditions was mixed in both quality and results (McKenney et al, 2013). There is no definitive research the suggest either course of treatment is a correlation in reducing pain leading to the objective of the following research proposal. The purpose of this project is to examine the effectiveness of IASTM in comparison to myofascial release therapy in reducing pain perception.
Thirty Division 1 National Collegiate Athletic Association Female Lacrosse players between the ages of 18 and 22 years of age who were on the active playing roster volunteered for this study. Pain perception will be measured using a pain scale one through ten and a questionnaire. The objective of this research is to determine and develop the best course of treatment for the athletic population for certain sport related injuries. Ultimately, the goal is to educate Certified Athletic Trainers, Physical Therapist, team physicians and athletic training students with the best course of treatment for their athletes in hopes of returning them to play in a safe and effective …show more content…
manner.
Purpose
The overall purpose of this study was to determine the effectiveness of manual therapy, both instrumented assisted soft tissue mobilization by means of Graston Technique and Myofascial release therapy, and the relationship among injured athletes on their pain perception. This study will assistant clinicians to better determine the effectiveness of GT and MFR as a treatment option for injured athletes.
Hypothesis
H0: μI – μF = 0 (There will be no difference in the pain perception between the two interventions.) H1: μI – μF > 0 (Graston Technique will show the greatest decrease in pain perception for athletes suffering from minor musculoskeletal injuries) Research Question: Will having weekly manual therapy treatments, Graston Technique or Myofascial Release Therapy make a significant impact on an athlete’s pain perception who is suffering from an orthopedic injury
Significance
Student athletes are under many stressors while in college, both academically and physically from the high demanding stressors that come along with playing at a higher level. By decreasing their pain perception in a musculoskeletal injury they sustained while playing, an athlete can lower their stress and focus on continued rehabilitation and treatment with a clear mind reinforce their trust in their clinician. It was hypothesized that Graston Technique would significantly decrease the athlete’s perception of pain. It was also hypothesized that GT would show the greatest increase in range of motion follow the course of the four-week study. The question this research looks to answer is in comparing both modality treatments, MFR and IASTM, which will effectively decrease pain as perceived by the athlete in their musculoskeletal injury.
Assumptions, Limitations, & Delimitations Assumptions of the study are the following. First, the patient’s reliability in providing the honest pain perceptions as a baseline and post intervention outcome measure. Participants will be asked to measure the pain using the Visual Analogue Scale (VAS) prior to the study. Limitations of the study include the following. Firstly, the findings of this research may not be generalized to the entire athletic population, such as applying to those who suffer from major injuries. Also, adherence to the specific protocol detailed in this study may be difficult for some athletes to follow, which may skew data analysis. In addition, manual therapy techniques can vary between patient and clinician, making it difficult to reproduce the treatment and can vary with comfort level of patient. Finally, a small demographic is covered in this study, which may skew data results as only Division 1 lacrosse players are going to be participants in this study. Delimitations of the study include excluding athletes under the age of 18, participating in only Lacrosse at the Division 1 level, as well as excluding participants who are caused increased pain due to sensitivity by either the Graston Technique or Myofascial Release Therapy technique.
Definition of Term
Instrumented Assisted Soft Tissue Mobilization (IASTM) – Various shaped tools that are used to augment the mobilization of soft tissue
Graston Technique (GT) – A form of IASTM, GT is a set of six stainless steel tools used to manipulate muscle fibers
Myofascial Release Therapy (MFR)- Form of manual therapy, used by clinician’s hands to reduce muscle tension by means of stretching
Range of Motion - the full movement potential of a joint measured by a goniometer in degrees
Myofascial Restriction - Restriction in normal muscle function caused by injury or biomechanical imbalance
Pain- Pain experience is a strongly modulated by interactions of ascending and descending pathways in the human body
Chapter 2 LITERATURE REVIEW
In a recent study aiming to show clinicians a comparison in IASTM and MFR, 1,004 patients were treated for either plantar fasciitis, carpal tunnel or fibromyalgia with IASTM and found successful results in reducing pain and improved function (McMurray, 2015).
Graston Technique
GT is an evidence based form of IASTM that enables clinicians to detect fascial restrictions and break down scar tissue to any muscular region, effectively reducing pain and increasing range of motion. GT involves the utilization of custom designed surgical steel instruments to augment a clinician’s ability to perform soft tissue mobilization (Miners, Bougie, 2011). Six stainless steel tools are utilized to treat muscular or connective tissue adhesions. These tools vary in both shape and size, as well as carry very specific beveled edges in order to provide specific and effective courses of treatment. It is theorized that GT can reduce abnormal post injury scar tissue by decreasing fibrous adhesions in a sub-acute or chronic injury (Miners, Bougie, 2011). There are eight different treatment strokes GT clinicians may use in multiple directions on the affected area: Sweeping, Fanning, Brushing, Strumming, J-stroke, Swivel, Scooping and Framing. Each stroke can vary in intensity based on the direction and the amplitude of the stroke. The steel tools are either convex or concave and both shapes specifically help to distribute pressure and force to the affected tissue. The angle at which the tools are held can directly effect the intensity of the force applied which is why the instruments should be help between 30-60 degrees (Looney et al, 2011). This angle will control the amount of either high intensity or low intensity force translated through the affected tissue respectively. A completion of M1 Basic Training 12-hour course of GT by a certified provider is required before use and implementation of the instruments. GT also provides clinicians, who choose to utilize this form of IASTM, a reduced imposed stress on their hands that is common with manual therapy treatment. Currently a specific treatment time for IASTM do not exist for specific dysfunctions, but generally are approximately 5–6 min (McMurray, 2015).
In one study conducted comparing two different manual therapy interventions, soft tissue mobilization and GT, both showed a decrease inpatient self pain rating for Carpal Tunnel Syndrome (CTS) after just one treatment. The treatment effects on improvements of pain ratings for the CTS wrist accounted for 39% of measurement variance (Burke et al, 2007). Immediately post treatments, there was a reduction in the severity of symptoms, which represented 6 clinical areas of CTS (symptom-severity scale: F2,40; time = 34.16; P b .05). The treatment effects on reductions of symptom severity accounted for 63% of measurement variance (Bg= 0.631), (Burke et al, 2007).
A study was conducted to assess the effectiveness of IASTM for the treatment of hamstring
Background
Pain is one of the most frequently observed conditions by sports medicine providers when treating injured athletes (Brewer, Raalte 1991). In todays world of modern medicine, there are many different techniques medical professionals use to aid in the treatment of there patients. When specifically looking at the collegian athletic population there are many different manual therapies are used by clinicians, Physical therapist (PT), certified athletic trainers, (ATC) or chiropractor in todays field of modern medicine. Myofascial release therapy (MFR) and instrumented assisted soft tissue mobilization (IASTM) are two commonly used manual therapy techniques by clinicians to aid in the recovery of a given injured population. …show more content…
Because the prevalence of the musculoskeletal injury rate increases with higher level athleticism, many college student athletes find themselves in the athletic training room working towards their optimal level of competition. Clinical efficacy of manual therapy treatments for mild musculoskeletal injuries is lacking sufficient evidence. The literature regarding the effectiveness of MFR as a treatment for orthopedic conditions was mixed in both quality and results (McKenney et al, 2013). There is no definitive research the suggest either course of treatment is a correlation in reducing pain leading to the objective of the following research proposal. The purpose of this project is to examine the effectiveness of IASTM in comparison to myofascial release therapy in reducing pain perception.
Thirty Division 1 National Collegiate Athletic Association Female Lacrosse players between the ages of 18 and 22 years of age who were on the active playing roster volunteered for this study. Pain perception will be measured using a pain scale one through ten and a questionnaire. The objective of this research is to determine and develop the best course of treatment for the athletic population for certain sport related injuries. Ultimately, the goal is to educate Certified Athletic Trainers, Physical Therapist, team physicians and athletic training students with the best course of treatment for their athletes in hopes of returning them to play in a safe and effective …show more content…
manner.
Purpose
The overall purpose of this study was to determine the effectiveness of manual therapy, both instrumented assisted soft tissue mobilization by means of Graston Technique and Myofascial release therapy, and the relationship among injured athletes on their pain perception. This study will assistant clinicians to better determine the effectiveness of GT and MFR as a treatment option for injured athletes.
Hypothesis
H0: μI – μF = 0 (There will be no difference in the pain perception between the two interventions.) H1: μI – μF > 0 (Graston Technique will show the greatest decrease in pain perception for athletes suffering from minor musculoskeletal injuries) Research Question: Will having weekly manual therapy treatments, Graston Technique or Myofascial Release Therapy make a significant impact on an athlete’s pain perception who is suffering from an orthopedic injury
Significance
Student athletes are under many stressors while in college, both academically and physically from the high demanding stressors that come along with playing at a higher level. By decreasing their pain perception in a musculoskeletal injury they sustained while playing, an athlete can lower their stress and focus on continued rehabilitation and treatment with a clear mind reinforce their trust in their clinician. It was hypothesized that Graston Technique would significantly decrease the athlete’s perception of pain. It was also hypothesized that GT would show the greatest increase in range of motion follow the course of the four-week study. The question this research looks to answer is in comparing both modality treatments, MFR and IASTM, which will effectively decrease pain as perceived by the athlete in their musculoskeletal injury.
Assumptions, Limitations, & Delimitations Assumptions of the study are the following. First, the patient’s reliability in providing the honest pain perceptions as a baseline and post intervention outcome measure. Participants will be asked to measure the pain using the Visual Analogue Scale (VAS) prior to the study. Limitations of the study include the following. Firstly, the findings of this research may not be generalized to the entire athletic population, such as applying to those who suffer from major injuries. Also, adherence to the specific protocol detailed in this study may be difficult for some athletes to follow, which may skew data analysis. In addition, manual therapy techniques can vary between patient and clinician, making it difficult to reproduce the treatment and can vary with comfort level of patient. Finally, a small demographic is covered in this study, which may skew data results as only Division 1 lacrosse players are going to be participants in this study. Delimitations of the study include excluding athletes under the age of 18, participating in only Lacrosse at the Division 1 level, as well as excluding participants who are caused increased pain due to sensitivity by either the Graston Technique or Myofascial Release Therapy technique.
Definition of Term
Instrumented Assisted Soft Tissue Mobilization (IASTM) – Various shaped tools that are used to augment the mobilization of soft tissue
Graston Technique (GT) – A form of IASTM, GT is a set of six stainless steel tools used to manipulate muscle fibers
Myofascial Release Therapy (MFR)- Form of manual therapy, used by clinician’s hands to reduce muscle tension by means of stretching
Range of Motion - the full movement potential of a joint measured by a goniometer in degrees
Myofascial Restriction - Restriction in normal muscle function caused by injury or biomechanical imbalance
Pain- Pain experience is a strongly modulated by interactions of ascending and descending pathways in the human body
Chapter 2 LITERATURE REVIEW
In a recent study aiming to show clinicians a comparison in IASTM and MFR, 1,004 patients were treated for either plantar fasciitis, carpal tunnel or fibromyalgia with IASTM and found successful results in reducing pain and improved function (McMurray, 2015).
Graston Technique
GT is an evidence based form of IASTM that enables clinicians to detect fascial restrictions and break down scar tissue to any muscular region, effectively reducing pain and increasing range of motion. GT involves the utilization of custom designed surgical steel instruments to augment a clinician’s ability to perform soft tissue mobilization (Miners, Bougie, 2011). Six stainless steel tools are utilized to treat muscular or connective tissue adhesions. These tools vary in both shape and size, as well as carry very specific beveled edges in order to provide specific and effective courses of treatment. It is theorized that GT can reduce abnormal post injury scar tissue by decreasing fibrous adhesions in a sub-acute or chronic injury (Miners, Bougie, 2011). There are eight different treatment strokes GT clinicians may use in multiple directions on the affected area: Sweeping, Fanning, Brushing, Strumming, J-stroke, Swivel, Scooping and Framing. Each stroke can vary in intensity based on the direction and the amplitude of the stroke. The steel tools are either convex or concave and both shapes specifically help to distribute pressure and force to the affected tissue. The angle at which the tools are held can directly effect the intensity of the force applied which is why the instruments should be help between 30-60 degrees (Looney et al, 2011). This angle will control the amount of either high intensity or low intensity force translated through the affected tissue respectively. A completion of M1 Basic Training 12-hour course of GT by a certified provider is required before use and implementation of the instruments. GT also provides clinicians, who choose to utilize this form of IASTM, a reduced imposed stress on their hands that is common with manual therapy treatment. Currently a specific treatment time for IASTM do not exist for specific dysfunctions, but generally are approximately 5–6 min (McMurray, 2015).
In one study conducted comparing two different manual therapy interventions, soft tissue mobilization and GT, both showed a decrease inpatient self pain rating for Carpal Tunnel Syndrome (CTS) after just one treatment. The treatment effects on improvements of pain ratings for the CTS wrist accounted for 39% of measurement variance (Burke et al, 2007). Immediately post treatments, there was a reduction in the severity of symptoms, which represented 6 clinical areas of CTS (symptom-severity scale: F2,40; time = 34.16; P b .05). The treatment effects on reductions of symptom severity accounted for 63% of measurement variance (Bg= 0.631), (Burke et al, 2007).
A study was conducted to assess the effectiveness of IASTM for the treatment of hamstring