Valence Massage and Physical Therapy

Imagine if treating stiffness and pain required snapping bands of corrective tissue! Good luck with that. Massage, manual therapy, and myofascial techniques are about interacting with the nervous system and brain of the patient. If someone tries to break up your anything, run. https://www.facebook.com/100063836049326/posts/1619131813558005/?mibextid=rS40aB7S9Ucbxw6v

🤔 CAN FASCIA WITHSTAND 2,000 PSI AND STILL BE “BROKEN UP” BY A THERAPIST?

You may have heard the claim that fascia can withstand around 2,000 pounds per square inch. It is often used to explain how powerful fascial restrictions are and why they might contribute to pain. Yet therapists are also told that they can break up those restrictions or scar tissue using their hands, cups or tools.

Both claims cannot comfortably sit together.

📚 The 2,000 psi figure comes from Katake’s 1961 study. Lower limb fascia taken from four cadavers was clamped and pulled along its fibres until it eventually failed and ripped apart. The figure describes the tensile stress the tissue tolerated as it was pulled towards breaking point. I actually have a copy of this paper from Kyoto University and it's just over 4 pages long.

This paper does not show fascia producing 2,000 psi inside someone’s body. It does not tell us that fascia compresses other structures with this pressure, and it certainly does not give us a treatment pressure that therapists must overcome.

But let’s imagine for a moment that we do accept the figure as evidence of how incredibly strong fascia is. How could a therapist then physically break it apart using manual pressure without also injuring the skin, nerves, blood vessels and other tissues around it - or themselves?

🔬 Chaudhry and colleagues explored this problem using a three dimensional mathematical model. Their calculations suggested that forces outside normal physiological ranges would be needed to produce even 1 per cent compression and shear in dense fascia lata and plantar fascia. They concluded that the feeling of tissue 'releasing' beneath a therapist’s hands could not be explained by directly deforming these firm tissues, although softer superficial tissues could change shape more easily.

This does not mean nothing happens during manual therapy. Of course something happens. Living tissues temporarily change shape whenever we touch, move or load them, but temporary deformation is not the same as breaking collagen fibres, removing adhesions or permanently releasing fascia.

Scar tissue can also change over time through biological remodelling, particularly during healing and with appropriately graded movement and loading. A therapist may help someone feel more comfortable, move more confidently or tolerate contact and movement more easily. These are valuable outcomes, but they do not prove that scar tissue has been physically broken apart.

We do not need to dismiss what therapists feel beneath their hands or what clients experience. We simply need a better explanation for it. Changes in sensation, attention, movement tolerance and protective responses can all alter how an area feels during and after treatment. Softer superficial tissues may also deform temporarily without dense fascia being permanently changed.

💡 So the problem is quite simple. We cannot use the 2,000 psi figure to show how incredibly strong fascia is and then claim that routine manual pressure can break it up.

People may genuinely feel and move differently after treatment. The change is real, but that does not make a story about breaking, melting or releasing fascia true.

👉 The technique describes what the therapist does. The outcome belongs to the client.

📖 Katake, K. (1961) ‘The strength for tension and bursting of human fasciae’, Journal of Kyoto Professional Medical University, 69, pp. 484–488.
📖 Chaudhry, H., Schleip, R., Ji, Z., Bukiet, B., Maney, M. and Findley, T. (2008) ‘Three-dimensional mathematical model for deformation of human fasciae in manual therapy’, Journal of the American Osteopathic Association, 108(8), pp. 379–390.

https://valencemassage.janeapp.com/

Here is the most current online schedule!

valencemassage.janeapp.com

https://www.facebook.com/reel/986144984439292/

Just a reminder, you don't have to chase profitability and productivity; there are other options:

How long should it take to heal?

Exercise is medicine: https://www.facebook.com/100049680654059/posts/1580220183643988/

I believe firmly that moving in more diverse and complex ways enhances your movement vocabulary. Don't buy in to the idea of fragile bodies and specific "correct" patterns. It's just marketing. https://www.facebook.com/100063944655596/posts/1430606292414179/?app=fbl

Exercise and even just moving around more can have profound benefits far beyond just strength or weight loss. If you need help getting movement, I'm here to help!

Surgery does not seem to outperform "conservative care" in many musculoskeletal pain conditions. I wish to see every person made aware of this before they go under the knife! https://www.facebook.com/100064622535057/posts/1236777958486277/

Biomechanical explanations for pain and dysfunction often rely on old narratives that imaging and science has shown to be wrong. Moving more, increasing load tolerance, and training can help with pain, even spinal flexion.

Updating your narrative with research is absolutely necessary for a clinician. I have learned special tests for shoulder impingement in no less than 5 continuing education seminars, that's not to even mention physical therapy school. https://www.facebook.com/100063774721900/posts/1313334844135661/?mibextid=rS40aB7S9Ucbxw6v

The area between the humeral head and the acromion, coracoacromial ligament, and acromioclavicular joint is known as the subacromial (under the acromion) space. Within this space is the supraspinatus tendon, long head of the biceps brachii tendon, subacromial bursa (fluid-filled sac that reduces friction), and the capsule of the shoulder joint.

When most people discuss shoulder impingement, they are referring to these tissues being compressed in this space. 

The shoulder impingement theory was popularized by a surgeon in the 1970’s before he proposed a surgery to treat the issue. Since then, here’s what we’ve learned:

1. If symptoms were solely caused by compression of these overlying structures, we’d expect their removal to improve symptoms and function. However, research demonstrates that subacromial decompression is no better than placebo surgery.
2. Subacromial decompression also doesn’t seem to change the long-term prevalence of rotator cuff tears. Rotator cuff tears are present in asymptomatic individuals and are more common as we age, like many other imaging findings. 
3. Compression of tissues in the subacromial space is common, occurs equally in people with and without symptoms, and happens with normal, day-to-day tasks. 
4. A smaller subacromial space is not correlated with symptoms or disability. 

So shoulder impingement exists, but it’s not the bogeyman it’s been made out to be. 

To learn how to properly manage this condition, click the link in our bio or search “E3 Rehab Shoulder Impingement” on YouTube!



•YouTube: 
•Programs, Blogs & 1-on-1 Coaching: www.e3rehab.com