Hands-on treatment for pain
After pinching a nerve during a fall, Carol Smith's arm hurt so much she couldn't raise it or even hold a teacup.
“I suffered for over a year,” said Ms Smith, 61. “My daughter, Stacey, went to Sunday school and I couldn't go with her; I had to stay home in bed.”
Then a friend suggested she try myofascial release.
“I was going somewhere else for physical therapy and I wasn't getting any better,” she said.
Myofascial release is a soft tissue therapy for the treatment of skeletal muscle immobility and pain. The aim is to relax contracted muscles, improve blood and lymphatic circulation, and stimulate the stretch reflex in muscles.
Ms Smith went to see physical therapist, Shirlene Dill at Hands-on-Therapy in Warwick. Other physical therapists on the Island use myofascial release techniques, but Ms Dill believes she is the only one specialising in it.
Fascia are the fibrous tissues that surround muscles and organs throughout the body. Through injury or scar tissue from surgery, the fascia can become tight and pull painfully on organs, muscles and joints in the body and sometimes interfere with their functioning. All fascia in the body is connected, so pain in one part of the body might be related to fascia issues in another part.
“Your fascia is a sum total of your life since you were conceived,” said Ms Dill. “Everything that has ever happened to your body is the sum total of where you are right now.”
Treatment involves coaxing the fascia around muscles, ligaments and tendons to relax through sustained, gentle pressure. The pressure may be exerted anywhere from 19 seconds to two minutes. Depending on the nature of the problem, the client may be asked to hold out their arm or leg for a length of time until the body's natural stretch reflex kicks in. Ms Dill may press on fascia in the neck, or she may press on the pelvic floor vaginally, or she may go into the mouth and press on the jaw muscle.
Ms Smith said sometimes the prodding and pulling of her injured arm and shoulder hurt, a lot.
“Sometimes I cried,” she said. “Afterward I would just go home and get in bed.”
Sometimes her arm was already in such pain when she arrived that Ms Dill would just hold her warm hands over the area.
“It took a couple sessions before it started to work,” said Ms Smith. “I would go to her in pain and leave pain-free.”
She said it made her a life a lot better and was soon able to raise her arm again.
In recent years she has also suffered from fibromyalgia, a chronic disorder characterised by widespread musculoskeletal pain, fatigue and tenderness in localised areas.
“I have also been to Ms Dill for this and it has helped,” Ms Smith said. “I am thrilled that I can go to church with my daughter again. I still have bad days, but I'm a lot better than I used to be.”
Ms Smith said she had never heard of myofascial release before her friend told her about it. Ms Dill said many of her patients come to her through word-of-mouth.
“Some of my clients say, ‘if my girlfriend hadn't told me about this technique for pain, what would I have done'?” she said. “A lot of women don't realise we can help a lot of female-related problems, such as pain related to episiotomy scars. Sometimes a C-section scar can cause back pain because the scar tissue is pulling on the spine.”
She sees patients for a wide range of problems — from chronic bladder infection, incontinence and painful sexual intercourse to chronic back, shoulder and neck pain.
“I have known someone who thought they would never be able to do sports again, and now he is back doing what he loves,” said Ms Dill. “He needed work on his ankle. There are people who come in to me after accidents who have had conventional therapies after a month or more and they come in walking like a zombie. With several treatments they walk out feeling a whole lot better.”
Ms Dill started working as a physical therapist more than 30 years ago.
“I was working at the hospital and when people came in with chronic back pain or neck pain, I would shy away from those cases, because I didn't think there was much I could do for them.”
She learned about myofascial release through a lecture put on by a local dentist about how it could help patients with a common jaw joint problem.
“It was like a no-brainer to me,” she said. “It just made so much sense. I wondered how I ever did physiotherapy without it. Since 1992 I have specialised in this technique although I still maintain my regular physiotherapy training.”
There are different schools of thought when it comes to myofascial release techniques. Ms Dill trained with American myofascial release technique pioneer John Barnes. She said most of the techniques do not hurt, but a small percentage do, particularly those involving the neck.
“And most people need that small percentage of technique that hurts,” she said. “Many have neck pain related to small traumas like not sitting right at work, and some related to major trauma such as accident. Most people get better. There are a percentage of people who will get better slowly with treatment, but a lot of my patients get way better after the first one to two treatments but getting rid of that last ten per cent of problem takes more time. Healing is a process not an event.”
Myofascial release is covered by insurance, and in most cases the co-pay is about $22. Patients also do not need a referral from their doctor to make an appointment, although many patients are sent toMs Dill through referral.