Thoraco-lumbar fascia (TLF), is composed of dense, fibrous connective tissue layers that are separated by thin layers of loose connective tissue; these thin layers normally allow the dense layers to glide against one another during trunk and limb motion.
Thoraco Lumbar Fascial Release Techniques
What is Fascia?
- The term fascia(from Latin “band”) generally applies to the fibrous connective tissues covering, connecting, and investing muscles, tendons, bones, organs and nerves. Researchers generally agree that all of the tissues are composed of the same basic elements (fibers, cells, and a matrix of ground substance) in varying proportions and arrangements, and that all of these tissues interconnect.
- Fascia is the tissue that gives your body it’s structural form or shape. How the skeleton is positioned, how the muscles are shaped and the body’s general posture is determined by fascia. Superficial fascia lies under the skin and connects to the deeper fascia. Between the two layers of fascia is a potential space. Superficial and deep fascia merge at bony margins and tend to be very sensitive areas.
- Some fascia has the strength of approximately 2000 lb. per square inch. Within 19 minutes of assuming a poor posture, the body will begin to lay down extra tissue (collagen) to support that position. Trauma or postural distortion inhibits the fascia and can create chronic pain patterns as the tissues literally become glued together.
Things to Consider when doing fascia:
- These techniques should be performed first, before muscle work, and with out any oil.
- Go in very slowly and try to sense what the body needs and wants. By moving very slowly, you can go in deeply and yet not override the patient's system.
- Work with the breath and at the clients pace.
- Don't go deep, think deep. How much pressure should you use? The short answer is as much as you need to elicit a softening of the fascial tissue, but not so much that you bombard the sympathetic nervous system.
- If you go in too quickly or too hard, not only will the patient resist you, but you will cause the fascia to become harder-exactly the opposite of what you want. Less is more.
- Because of the nature of the work, it is extremely important to explain the therapeutic nature and reasons for the work to your patients.
- Contraindications: Pain is your guide line. You will have to adjust your speed, pressure and time in accordance with what you are presented clinically.
- Side Effects: Like any other soft tissue manual therapy, patients may experience one or all of the following: tenderness, redness, or slight discoloration (bruising).
- Post Treatment Protocol: Tell your patients they may feel sore for two to three days after treatment. Explain that any bruising will only be temporary and that their body is remodeling and going through major changes. Instruct them to drink lots of water and apply ice as needed.
Thoracolumbar Fascia’s (TLF) Role in Low Back Pain (LBP)
Multiple layers wrap three-dimensionally around the various structures of the low back, and extend from the base of the neck, to the sacrum and iliac crests of the pelvis.
- Deep cervical fascia
- Ribs and diaphragm
- Spinal ligaments
- Lumbar vertebrae sp’s & tp’s
- Transverse abdominis and obliques
- Iliac crest
The TLF is composed of dense, fibrous connective tissue layers that are separated by thin layers of loose connective tissue; these thin layers normally allow the dense layers to glide against one another during trunk and limb motion.
Recent research indicates the TLF is 25 - 125% thicker in those with LBP than in those without. There is also less gliding between the deeper layers of the TLF in people with LBP.
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