SJMT therapists combine 3 seperate modalities to deliver an integrated deep tissue massage that focuses on the following areas.
Myofascial release is a soft tissue therapy for the treatment of skeletal muscle immobility and pain. This alternative medicine therapy aims to relax contracted muscles, improve blood and lymphatic circulation, and stimulate the stretch reflex in muscles.
Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. Osteopathic theory proposes that this soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension, and corresponding diminished blood flow. Although fascia and its corresponding muscle are the main targets of myofascial release, other tissue may be addressed as well, including other connective tissue. The underlying theory is not supported by medicine, and myofascial release has not been demonstrated effective for any condition.
Background and terminology
The approach was first described by osteopath Andrew Taylor Still and his early students. The term "myofascial" was first used in medical literature by Janet G. Travell in the 1940s in reference to musculoskeletal pain syndromes and trigger points. In 1976, Travell began using the term "myofascial trigger point" and in 1983 published the reference Myofascial Pain & Dysfunction: The Trigger Point Manual. The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with Ida Rolf, the originator of Rolfing. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release. 
Some practitioners use the term "myofascial therapy" or "myofascial trigger point therapy" referring to the treatment of trigger points. The phrase has also been loosely used for different manual therapy techniques, including soft tissue manipulation work such as connective tissue massage, soft tissue mobilization, foam rolling, and strain-counterstrain techniques.
Myofascial techniques can be described as passive (patient stays completely relaxed) or active (patient provides resistance as necessary), with direct and indirect techniques used in each.
Direct myofascial release
The direct myofascial release method claims to engage the myofascial tissue "restrictive barrier" (tension). The tissue is loaded with a constant force until "release" occurs. Direct release is sometimes called "deep tissue work", a misnomer as some of the important tissues are quite superficial. Practitioners use knuckles, elbows, or other tools to slowly stretch the fascia by applying a few kilograms-force or tens of newtons. Direct myofascial release is an attempt to bring about changes in the myofascial structures by stretching or elongation of fascia, or mobilizing adhesive tissues. The practitioner moves slowly through the layers of the fascia until the deeper tissues are reached.
Robert Ward suggested that the intermolecular forces direct method came from the osteopathy school in the 1920s by William Neidner, at which point it was called "fascial twist". German physiotherapist Elizabeth Dicke developed connective tissue massage (German: Bindegewebsmassage) in the 1920s, which involved superficial stretching of the myofascia. Ida Rolf developed structural integration in the 1940s, a holistic system of connective tissue manipulation and movement education, with the goal of balancing the body. She proposed that she could improve a patient's body posture and movement by bringing the myofascial system toward its optimal pattern. Since Rolf's death in 1979, over a dozen structural integration schools have split off from Rolfing with minor variations on the theme from her original teachings. Rolf's schools maintain that their lineage is distinct from the massage profession, but myofascial release and the larger massage profession have been significantly influenced by her ideas and methods.
Michael Stanborough borrows principles from Rolfing which can be applied for direct myofascial release technique:
Indirect myofascial release
The indirect method involves a gentle stretch, with only a few grams of pressure, which is said to allow the fascia to "unwind" itself, guiding the dysfunctional tissue "along the path of least resistance until free movement is achieved."
Carol Manheim summarized the assumptions underlying the practice of myofascial release:
The indirect myofascial release technique, according to Barnes, is as follows:
Trigger Point Therapy
Trigger points, also known as trigger sites or muscle knots, are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers.
The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns which associate pain in one location with trigger points elsewhere. There is variation in the methodology for diagnosis of trigger points and a dearth of theory to explain how they arise and why they produce specific patterns of referred pain.
Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. The local twitch response is not the same as a muscle spasm. This is because a muscle spasm refers to the entire muscle contracting whereas the local twitch response also refers to the entire muscle but only involves a small twitch, no contraction.
Among physicians, many specialists are well versed in trigger point diagnosis and therapy. These include physiatrists (physicians specializing in physical medicine and rehabilitation), family medicine, and orthopedics. Osteopathic as well as chiropractic schools also include trigger points in their training. Other health professionals, such as athletic trainers, occupational therapists, physiotherapists, acupuncturists, massage therapists and structural integrators are also aware of these ideas and many of them make use of trigger points in their clinical work as well.
The term "trigger point" was coined in 1942 by Dr. Janet Travell to describe a clinical finding with the following characteristics:
Pain related to a discrete, irritable point in skeletal muscle or fascia, not caused by acute local trauma, inflammation, degeneration, neoplasm or infection.
The painful point can be felt as a nodule or band in the muscle, and a twitch response can be elicited on stimulation of the trigger point.
Palpation of the trigger point reproduces the patient's complaint of pain, and the pain radiates in a distribution typical of the specific muscle harboring the trigger point.
The pain cannot be explained by findings on neurological examination. Practitioners do not necessarily agree on what constitutes a trigger point.
A 2007 review of diagnostic criteria used in studies of trigger points concluded that there is as yet limited consensus on case definition in respect of MTrP pain syndrome. Further research is needed to test the reliability and validity of diagnostic criteria. Until reliable diagnostic criteria have been established, there is a need for greater transparency in research papers on how a case of MTrP pain syndrome is defined, and claims for effective interventions in treating the condition should be viewed with caution.
Myofascial pain syndrome
The main innovation of Travell's work was the introduction of the myofascial pain syndrome concept (myofascial referring to the combination of muscle and fascia). This is described as a focal hyperirritability in muscle that can strongly modulate central nervous system functions. Travell and followers distinguish this from fibromyalgia, which is characterized by widespread pain and tenderness and is described as a central augmentation of nociception giving rise to deep tissue tenderness that includes muscles. Studies estimate that in 75–95 percent of cases, myofascial pain is a primary cause of regional pain. Myofascial pain is associated with muscle tenderness that arises from trigger points, focal points of tenderness, a few millimeters in diameter, found at multiple sites in a muscle and the fascia of muscle tissue. Biopsy tests found that trigger points were hyperirritable and electrically active muscle spindles in general muscle tissue.
Qualities of trigger points
Trigger points may be classified as potential, active, or latent and also classified as key versus satellite and as primary versus secondary.
There are a few more than 620 potential trigger points possible in human muscles. These trigger points, when they become active or latent, show up in the same places in muscles in every person. That is, trigger point maps can be made that are accurate for everyone.
An active trigger point is one that actively refers pain either locally or to another location (most trigger points refer pain elsewhere in the body along nerve pathways). A latent trigger point is one that exists, but does not yet refer pain actively, but may do so when pressure or strain is applied to the myoskeletal structure containing the trigger point. Latent trigger points can influence muscle activation patterns, which can result in poorer muscle coordination and balance.
A key trigger point is one that has a pain referral pattern along a nerve pathway that activates a latent trigger point on the pathway, or creates it. A satellite trigger point is one which is activated by a key trigger point. Successfully treating the key trigger point will often resolve the satellite, either converting it from being active to latent or completely treating it.
In contrast, a primary trigger point in many cases will biomechanically activate a secondary trigger point in another structure. Treating the primary trigger point does not treat the secondary trigger point.
Potential causes of trigger points
Activation of trigger points may be caused by a number of factors, including acute or chronic muscle overload, activation by other trigger points (key/satellite, primary/secondary), disease, psychological distress (via systemic inflammation), homeostatic imbalances, direct trauma to the region, collision trauma (such as a car crash which stresses many muscles and causes instant trigger points) radiculopathy, infections and health issues such as smoking.
Trigger points form only in muscles. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles. The integrated hypothesis theory states that trigger points form from excessive release of acetylcholine which produces sustained depolarization of muscle fibers. These sustained contractions of muscle sarcomeres compresses local blood supply restricting the energy needs of the local region. This crisis of energy produces sensitizing substances that interact with some nociceptive (pain) nerves traversing in the local region which in turn can produce localized pain within the muscle at the neuromuscular junction (Travell and Simons 1999). When trigger points are present in muscles there is often pain and weakness in the associated structures. These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for identification of the causative pain factor. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them.
The Raindrop Technique is a method of using Vita Flex, reflexology, massage techniques, etc., and essential oils applied on various locations of the body to bring it structural and electrical alignment. It is designed to bring balance to the body with its relaxing and mild application. It will help align the energy centers of the body and release them if blocked, without using hard pressure or trying to force the body to change, which should never be done.
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What Are Essential Oils?
Maybe you have heard the term "essential oils" but didn't know what was meant by it. Perhaps you had a vague idea that it was connected in some way with aromatherapy, but didn't know how. Now is as good a time as any to learn what essential oils are. Essential oils are made from different parts of plants. They can be made from leaves, like peppermint oil. They can be made from petals, like rose oil. Some are made from bark or wood, like sandalwood.
Others are made from other parts of plants. If a so-called "essential oil" has any animal products in it, it is not truly an essential oil. Also, true essential oils do not contain synthetic ingredients.
Essential oils are usually made by distillation to make the natural oils in a plant substance very concentrated. It takes an enormous amount of plant material to make just a small amount of essential oils. For this reason, they are very expensive. It only takes a few drops of these essential oils to have a powerful effect. Most essential oils are not used directly on the skin. Most are either inhaled or applied in a carrier oil. Sometimes the oils are put into a bath.
You can buy individual essential oils or you can buy blends. If you buy blends, it's up to the maker to decide what oils to mix together and in what proportions. You can save money this way, because you only have to buy one bottle of a blend rather than several bottles to mix yourself. If money is no object, you might like to have the choice.
Essential oils have been used for centuries to promote physical and mental well-being. There are many varieties of essential oils and there are different ones for almost every ailment out there. There are several choices of oils for many of the conditions. Essential oils enter the body through the sense of smell. This is why they are often inhaled in some way or another. However, they are also absorbed into the tissues of the skin and into the bloodstream. This is especially true when they are used in baths or massages.
When essential oils are inhaled, they reach the limbic system of the brain and go on to affect all the systems that it interfaces with. These include the circulatory system, the respiratory system, the endocrine system, and memory. In the bloodstream, they affect the organs as well. When you have had a massage treatment with essential oils, it is wise not to bathe or wash it off for a couple of hours. This is because the systems of the body take time to absorb the oils from the skin.
Both psychological and medical conditions have been treated with aromatherapy through the use of essential oils. Some can be very expensive, especially those that come from exotic plants. However, by using the few drops as recommended, a small bottle can last a long time. Essential oils are effective tools in controlling uncomfortable symptoms.