Saturday, October 25, 2008

Stretching Your Fascia Using "The Permanent Pain Cure"

If you have muscle and joint pain then I have found a new book that might interest you. I read a review of "The Permanent Pain Cure" by Ming Chew in a magazine and then checked it out on Amazon. I decided to buy it at a local bookstore so I could read it quicker rather than waiting for an Amazon order to arrive. It has some very good stuff in it, is easy to read and follow, and explains a method of restoring lost physical function in a way that is different from other books out there. Ming Chew calls his therapy "The Ming Method". He works on professional athletes but has written this book for the rest of us. What I found in the book was a mix of different therapies and an organized plan as to how to use them.

The target of Ming's pain relief is to work on the body's fascia to improve movement and bring pain-relief. Fascia is often a misunderstood or unrecognized source of many problems that athletes suffer from. Unless you get plantar fasciitis or have problems with your ITB illiotibial band you don't hear much about the body's fascia. Yet fascia is all around you (literally). It is sheets of connective tissue that wraps around all of the structures of the body: muscles, nerves, organs, bones, and blood vessels. They hold together these body structures and separate them from each other. It also connects the body together as it runs through it like a web. I notice the effect of this when a shoulder problem affects my opposite hip or a pain somewhere is relieved when I press or massage another muscle far away from the pain. I was first introduced to what fascia is when I went through rolfing sessions a couple of summers ago. Rolfing is where your fascia is stretched and molded back to its original or optimal placement so that your body works in its ideal position. It removes tightness in your body and gives your muscles and joints "space" to move correctly. It worked wonderfully for me, but unfortunately I was given no idea of how to keep my fascia in good health or how to keep my body in the great posture I had achieved after the Rolfing sessions were over.

When I saw there was a book that was dedicated to working on the fascia I decided it was worth checking out.

Here are the seven components to the Ming Method:

1. Hydration (the fascia needs to be hydrated fully)
2. An anti-inflammation diet (bye-bye sugars and trans-fatty acids)
3. Supplements to improve joint health (bye-bye money!)
4. Spinal decompression stretches to separate the vertebrae and release pressure on compressed nerves (I thought my gravity inversion table might do this but the book explains why these stretches do something different).
5. Fascial stretches
6. Strengthening exercises (he likes the use of kettlebells)
7. Self-therapy techniques

I started with the hydration last night. I am drinking a ton more water than I usually do. This might become problematic at school when I can't leave my class some days for over 4 hours to use the restroom. The dieting is sound advice, but the supplementation may be something I just ignore for the most part. Ming Chow suggests you do these for over 10 days before you begin the stretching as you have to get your fascia in a healthier state. I did try some of the spinal decompression stretches to see how they went. They are tough but you did feel whole body stretches as you lengthen your fascia.

The fascial stretches look similar in form to other stretching techniques but the directions help you get the correct positioning while stretching. In order to stretch the fascia it has to be anchored at both ends of the muscle (this is not static stretching). I like the resistance stretching I am doing so if I like this it would be in conjunction and not instead of resistance stretching.

The strengthening exercises would come into play later in the program as your fascia and body should be in the correct posture or otherwise you would be strengthening an imbalance. This makes sense as I enjoyed doing kettlebells last winter but noticed that if my hips were off then I felt imbalanced and did not enjoy the routines. I have kept away from the kettlebells because I didn't think they were helping my inefficiencies. I would like to be balanced enough to do them again.

The self-therapy techniques are really good and worth the price of the book (even though there are only a few and this section is very short). I believe these are based the ART (Active Release Technique) and the author did study under and credits Dr. Michael Leahy, the founder of ART, in this book.

The hamstring release shows you how to use a tennis ball to release the hamstring. His techniques is not just rolling your loose hamstring on a ball or foam roller. It involves moving the leg as in an ART treatment. The ITB release shows you how to use the foam roller to release the ITB band. Again movement from the involved leg is required not just a rolling over the ITB. The quadriceps release shows you how to use your own elbow to hold the muscle and fascia in place so as you move your leg you can target and stretch the fascia. This is all good stuff and I liked the effect they had on my leg. There is also a sole of the foot release that I have not tried yet, but will as the bottom of my right foot has been stiff and sore for months.

The book is an easy read. The directions are clear for the stretching (there could be more pictures of each stretch) and I particularly like the "What it should feel like" box that goes with each stretch. I think the fact that the book makes it easy to understand the role of the fascia in the body and details a method to easily improve your fascial health makes the book unique among all of the books I have seen or read. Doing his techniques and program should not take that much time out of your day. He says about 15-20 minutes. This book is informative and I intend to continue exploring it further.

I have not had a good week of running. Wednesday I started feeling a little off and did my first treadmill run of the year (3 miles on a treadmill seems like forever!). Then I think I had a minor fever or infection. It wasn't bad but kept me from running. Today, however, I went for an 8 mile run on my usual loop. I ran one minute faster than my best time of the year. I wasn't even running hard. My legs were feeling loose. My stride felt long. I didn't even push. It was an easy run. What happened? Was it a break from running? the water I had been consuming? the hamstring release I tried last night? I think the biggest difference was the quadriceps release from the book. I did it right before the run.

Since doing the resistance stretching my muscles have become much looser. The problem has been that my left knee continues to buckle in. I think it is tightness within my inner hamstring, but for a few weeks I have had a tightness in my outer left quadriceps too. I can't seem to stretch the tightness out. I did the quadriceps release and it felt so much better. Maybe this helped make my left leg stretch out better on today's run? Anyhow it was a great run that felt very effortless.

As this running year draws to a close I feel that I have some good techniques in place to get my body to the point where I can have great runs most of the time and not worry about imbalances and tight muscles and joints. Maybe next year I will have a year of running where everything goes right and I can hit the times I know that I can run if my body works correctly. I will use resistance stretching to get my muscles loose and strong. I will use the sacrum adjustment when my sacrum gets stuck (I have found this doesn't seem to be a daily adjustment-it works when needed though). This is what Kalidasa wrote me in regards to how the release works:

"The sacrum release on that video uses the piriformis muscle. It attaches to the sacrum and to the top of the thigh bone. When you draw the back leg hip is drawn forward the piriformis is pulled and so is the sacrum. The arch picks up the sacrum where it is (out of alignment) and moving forward brings it along with piriformis."

I am going to continue to check out "The Permanent Pain Cure" and work on stretching the fascia and keeping it healthy. I need to make a concerted effort to work on my diet with the "Precision Nutrition" and not eating too much this winter and to eat healthy. I need to keep my left leg, knee, and hip in alignment (this is the toughest one) and then just keep running. Hopefully the coming winter will bring me more ways to to recover my stride.


Anonymous said...

Thanks for this article!

I also ordered the book and look forward to starting the stretching regime.

The only problem is that the book is a little confusing in some points.

The author says that the spinal stretches are best done right before bed. The fascial stretches can be done anytime.

He specifically states the warm up is required before doing the fascial stretches. He doesn't say anything about warming up before the spinal stretches.

So, I wonder whether you need to warm up before doing the spinal stretches. Later in the book he says that you shouldn't do any stimulating activity two hours prior before going to bed.

So if you have to warm up before doing them, you are breaking the later rule to do nothing stimulating before going to bed.

Can you help me with this?

Jim Hansen said...

Good question. My philosophy is that we are all expeiments of one. We have to find out what works best for us. Conventional wisdom may not be true for all. Experiment and find out what works best for you. If if works, use it! When I did the stretches I did them before going to bed. I had restful sleeps those nights! But then again, I have had success running late at night and then going to sleep soon afterwards! Sorry, I didn't see your question any earlier. I'd love to know how the stretches have worked for you.

Anonymous said...

Thanks for your answer!

I agree that it's best to find out what works for oneself.

I in the experimenting phase atm.
I'm trying the stretches one by one, and only when I have tried them all I will do them in sequence and daily.

Some stretches are though to get the technique right and with others I don't feel anything at all.

I can tell that they are very sophisticated stretches, though.

Thanks for your help!

arie said...

I just started reading the book and I enjoyed reading about your experiences. What is your longterm assesment of the value of the Ming method after about half a year?

Jim Hansen said...

Hi Arie,
I think that these stretches are very stong and I find them fascinating. I think they would work best with guidance from someone who is skilled in them. I could tell things were happening when I use them, but then again I couldn't tell if the right things were happening. Someone with a better awareness of how their body works might do better.

I have found what has worked best for me came about when I lucked into going to physical therapy and having a PT who did something called Postural Restoration. The exercises were given to me for my condition and imbalances. I do think one specific stretch (out of my four key stretches) seems very much like a fascial stretch such as these stretches and I found that interesting.

I also like the self active release routines in this book. When I get my body settled down (I have been on my own without PT for over a month and am still improving and getting my muscles and alignment corrected) I would like to explore these fascial stretches some more.
Good luck,

mc said...

interesting. i'm guessing you've looked at anatomy trains already? really good overview of fascial systems - one model anyway.

from the research side of the house, there doesn't seem to be a lot to show that focusing on gross level fascial stretching does much.

hydrating of course is good for lots of stuff
good quality movement and staying mobile - that's lots of good stuff.

global stretching as an activity - not so much

doing an assessment to see if one has performance restrictions that MAY be related to fascial or dermal restrictions or scarring great - checking to see if the fascial winding is related perhaps to visual or vestibular challenges - may be way more important such that one can do all the stretching one likes, but if the higher order systems are not addressed, that problem will keep recurring.

i guess i've moved to a place where if i can't test a claim and its effectiveness or not right away; if it's global rather than specific to a particular issue i'm less inclined to take it up whole cloth.

eg sufficient hydration of skin/fascia is pretty easy to test with palpation - so you may not need to be taking on more water. without that assessment, how do you know?

just some thoughts.
thanks for the reference to the book.