Class 1

Question 1

What is superficial fascia?

Answer 1

Houses fat and water. Provides path for nerves and vessels sometimes contains striated muscle that controls movement of the skin.

Question 2

What is Deep Fascia

Answer 2

Relatively thick, dense and discrete fibrous tissue layer.
Acts as base for superficial fascia and as an enclosure for muscle groups.

Question 3

What are the primary functions of deep fascia?

Answer 3

Allow muscles to move freely, carry nerve and blood vessels, fill space between muscles and provide an origin for muscles.

Ex. Apponeuroses, retinacula, and interosseous membranes are all deep fascia.

Question 4

In areas in which there is no muscle, the investing layer of the deep fascia is continuous with the _________________.

Answer 4

periosteum

Question 5

Deep fascia exists in ___________________.

Answer 5

*synovial joints
ex. synovial membrane and extrinsic ligaments are modified connective tissues.

Question 6

What is connective tissue?

Answer 6

• Provides strength and stability
• Maintain positions of internal organs
• Provides routes for blood vessels, lymphatic vessels and nerves

Question 7

What is fascia?

Answer 7

• The body’s framework of connective tissue
• Layers and wrapping that support or surround organs

Question 8

What are connective tissue techniques?

Answer 8

Massage techniques that palpate, lengthen and promote remodeling of connective tissue

Question 9

What are the 4 types of connective tissue techniques?

Answer 9

• 1. Skin Rolling
• 2. Myofascial Techniques
• 3. Direct Fascial Techniques
• 4. Frictions

Question 10

What is skin rolling?

Answer 10

• A gliding stroke in which the tissue superficial to the investing layer of deep fascial is continuously lifted and rolled in a wave-like motion.
• Can be used as an assessment to check for mobility of
superficial fascia and skin.
• When done continuously it becomes a treatment

Question 11

What is MYOFASCIAL RELEASE (MFR)?

Answer 11

• Techniques that combines a NON-GLIDING fascial traction with varying amounts of orthopedic stretch to produce moderate, sustained tension on the muscle and it’s associated fascia that results in a palpable viscoelastic lengthening (CREEP)
• CREEP – gradual lengthening of connective tissue that reflects the viscous or plastic behaviour of dense connective tissue under tension.
• The elastic and plastic response of connective tissue to tensile forces can vary with the RATE and DURATION of the force that is applied.
The best way to lengthen CT permanently, without compromising their
structural integrity is to apply prolonged low-intensity forces

Question 12

What is creep?

Answer 12

Gradual lengthening of connective tissue occurs because dense connective tissue stretches slowly and permanently when tension is applied, showing its viscous or plastic behavior.

Question 13

What is DIRECT MYOFASCIAL?

Answer 13

• Slow GLIDING technique that applies moderate,
sustained tension to superficial fascia or to deep
fascial and associated muscle.

Question 14

What are FRICTIONS?

Answer 14

A repetitive, non-gliding technique where a specific contact, such as fingertips or thumb, used to penetrate dense connective tissue and produce small movements between its fibers

Question 15

What are some USES/INDICATIONS?

Answer 15

• Scars and adhesions
• Postural changes
• Contractures and chronic after affects of trauma
• Restore fascial mobility
• Lengthen different fascial layers
• Increase extensibility of connective tissue
• Promote remodelling and realignment of collagen fibres
• For Frictions : repetitive strain injuries

Question 16

What are some CONTRAINDICATIONS/CAUTIONS?

Answer 16

• Malignancy
• Cellulitis
• Fever
• Osteomyelitis
• Healing fractures
• Osteoporosis
• Anticoagulant therapy
• Hypersensitivity of skin
• Flaccid paralysis
• Unstable joints

Question 17

What is the TECHNIQUE APPLICATION FOR MFR AND DIRECT MYSOFASCIAL?

Answer 17

• Tissue must be appropriately prepared
• Make sure you are in a biomechanically sound position
• Tissue must be at the appropriate tension
• Engage the tissue at the appropriate depth
• Carefully monitor the effects of treatments, both during and after treatment.
1. Compress into the patient’s tissue to engage the 1st layer of restriction
2. Glide slowly wait for release (creep) repeat
3. Can be applied in any direction can be general or specific
4. Complementary modalities include heat, and stretching, active exercise with the full range of motion(see outcomes text)
• For large areas, use general strokes; for small areas, use specific strokes.
• Techniques can be static or with glide.
• Monitor effects of massage treatment with postural scan before and after

Question 18

What are TECHNIQUE APPLICATION FOR FRICTIONS?

Answer 18

• Inform client that this is painful technique.
• Pain and tissue resistance serve as primary guidelines. Pain should be about 5/10 on pain scale
• Prepare the tissue with heat or with GST/ dry petrissage or rhythmic compressions (approx. 5 minutes)
• Make sure all oil is removed
• Stabilize the structure
• Direction of friction should be perpendicular (Cross- fiber) to muscle, ligament or tendon
• Use reinforced finger-tips or thumbs
• Force of the friction to be effectively isolated from normal tissues but not so stretched that you are unable to penetrate the tissue. Rule of thumb: The deeper the tissues the less stretch needed
• Sheathed tendons should be treated in a stretched position.
• Tissue is moved as one unit to the “stretch point” without ever sliding over the skin (to stretch and separate fibers) this is why we remove the oil.
• Accurate palpation
• Use short strokes less than 1-2 cm (think using an eraser)
• Check in with client before one minute is up to see if the pain is lessening or increasing. Make necessary adjustments to stop or continue frictions
• Palpable softening or 1-2 minutes
• Stretch
• Ice if inflammation response is initiated