Yoga And Myofascial Pain

By Connie Alexander
Published on Aug 31st, 2012

Chronic myofascial pain disables the mind and body. Researchers now believe that chronic pain is encoded in the fascia of our body. The purpose of this paper is to gain knowledge of the properties on the fascia and the myofascial lines of connections that run throughout the body, and how the yoga asana affect these myofascial lines which can ease chronic pain.

Pain produces both a physiological and a psychological response. Pain, according to the International Association for the Study of Pain, is defined as “an unpleasant sensory and emotional experience associated with actual and potential tissue damage". It is a sensation that is triggered in the nervous system. The sensation may be sharp, dull, burning, deep or superficial. It may come and go, or it may be constant. A certain percentage of pain will not be resolved and is referred to as chronic pain.

Chronic muscle pain is called myofascial pain. The skeletal muscle pain accounts for about eighty five percent of chronic pain complaints. The most common muscles affected are the neck, shoulder girdle, low back and hip girdle. My experience with chronic pain is that it often is based on structural misalignment that causes the fascia to bind around joints. The muscular pain may involve a muscle or a group of muscles; however, it may originate from tightened fascia that is at a distant location. It is believed that the actual site of pain prompts the development of a trigger point that causes pain in other areas of the body. An example of this would be a rotation in the pelvis which could cause pain around the mid and upper thoracic area.

The fascia is a vast network of webbing that is responsible for connecting all parts of our body. Fascia in the body starts at the top of our head and ends in our toes. Fascia is like a honeycomb of connective tissue, providing a boundary for liquids and creates intercellular space for our visceral organs. It is a gelatin matrix of cells with collagen fibers hard or soft depending on the location in the body and its function. It covers our muscles, bones and organs and also wraps around and through them. This anchors organs to bones, bone to bone, bone to muscle and muscle to muscle. James Oschman in 2003 determined that the nervous system and fascial tissue are intimately combined forming the shared and communicative environment for all our cells. He theorized that pain is encoded in our fascia.

This inter-webbing is responsible for the tensile strength that supports and holds the body upright according to Thomas Myers. Thomas Myers demonstrated, by cadaver dissection, this fascial continuum. He identified twelve different Anatomy Trains which are based on direct fascial connections of bones to bones, bones to muscles and muscles to muscles. This is a three dimensional explanation of why movement in one part of the body is not isolated, but rather, when one part moves the whole body responds. These Anatomy Trains illustrates why pain in one part of the body can be caused by fascia restriction in distant areas of the body. They are longitudinal and diagonal straps and slings within the muscles. This three dimensional scheme for muscular-skeletal anatomy provides a way of looking at the body as a whole; not as separate parts. For example, lifting the arms involves not only shoulder muscles but muscles in the neck as well as the pectoralis , trapezius, and latisimus dorsi.

Figure 9.1The first anatomy train or myofascial meridians that Thomas Myers identifies are the Superficial Back Line (SBL). This line of muscles and fascia connects the entire back surface of the body from the foot to the top of the head, and toe to knee with a break and knee to brow (figure 9.1 is an example of an anatomy train) . The SBL supports the full upright extension and prevents the tendency to curl forward. The development of these muscles lifts the head up. Examples of asana that can help ease the rigidity of the fascia throughout the SBL are: the seated forward bend, standing forward bend, downward facing dog. Child's pose stretches the fascia of the erectors and scalp. For more advanced students the plow would be effective.

The second anatomy train identified is the Superficial Front Line (SFL). The SFL connects the entire front surface of the body from the top of the feet to the side of the skull. Also in two pieces, toe to pelvis and pelvis to head. The function of the SFL is to create flexion of the hips, extension at the knee and dorsiflexion of the foot. Yoga asana that positively affects this train can include the fish pose, the sphinx pose, bridge and back bend using a physioball for beginners. The SBL and the SFL are the reciprocal of each other. Stretch the SBL and you contract the SFL and vise versa.

The third anatomy train is the Lateral Line (LL). The LL runs from the side of the foot around the outside of the ankle and up the outside of the leg and thigh and weaving along the side of the trunk under the shoulder to the ear. The LL brackets the body on both sides creating balance front to back and left to right. The LL participates in lateral bending, abduction of the hips and preventing over lateral and rotational movement of the trunk. The lateral movement through the spine is a major foundation for walking. The side to side walking pattern indicates tightness in the LL around the waist. Side bends stretches the fascia on one side and contracts the fascia on the other side. Each side of the LL needs to be balanced. Tightness in one side may cause tension, pull or pain anywhere along the fascial track on the opposite side. The reverse triangle will assist with the LL and any asanas that include a spinal twist (making sure you twist both ways) would also balance them.

The fourth anatomy train is the Spiral Line (SPL) The SPL loops around the body like a double helix. Starting at the back of the skull or occiput, the SPL travels across the upper back to the opposite shoulder, around the rib cage crossing at the navel to the front of the hip down the outside of the leg forming a sling around the foot. From the foot the fascia runs up the inside of the leg to the ischium and up the middle of the back to the skull where it originated. This double helix helps to maintain balance across all planes. The SPL connects the pelvis with the arch of the foot and helps to stabilize the knee while walking. The myofascia of the SPL also overlaps other trains, the SBL, SFL, LL and the Deep Back Arm Line. Dysfunction in the SPL will affect the functioning of these other lines. The SPL functions to create and mediate spiral and rotations, to steady the trunk and leg. There again any of the spiral twist asanas will aid with this train.

Myers identifies four anatomy trains for the arms. These are the Superficial Front Line, the Deep Front Arm Line, the Superficial Back Line and the Deep Back Line. Human shoulders, arms and fingers are specialized for mobility. Dysfunction in these lines can lead to numerous hand and shoulder problems such as carpel tunnel, shoulder and elbow pain. Straining the elbow can affect the mid-back and shoulder misalignment can create neck and arm pain as well as shallow breathing. Inversion asanas that strengthen the upper back muscles and shoulders are very helpful in mediating this type of dysfunction.

The Back and Front Functional Lines involve superficial muscles that we use on a day to day basis and provide strong postural stabilizing function. Yoga asanas requiring stabilization of the upper and lower body affect this line. Examples would include standing poses such as tree, triangle and all the warriors poses.

The Deep Front Line (Fig. 9.1) makes up the body’s core. This fascial meridian is more three-dimensional than the other anatomy trains. The line starts deep in the underside of the foot, extends up the legs to the hip joints, pelvis and lumbar spine, while another section of track passes up the back of the thigh to the pelvic floor and rejoins the first at the lumbar spine. The DFL includes the psoas and diaphragm and then continues up through the rib cage to the cranium. This line connects our bones, muscles and visceral organs to our nervous system. Lack of support and balance in the DFL affects all the other fascial lines. Considering the connection between the diaphragm and the nervous system, the practice of deep breathing exercises can be very useful.

Strain, tension, trauma and movement are passed through the body structure along these Anatomy Train fascial lines. The fascia needs to be pliable for healthy body movement. Fascia hardens due to injuries, lack of muscle activity and/or stress. This prevents nutrients and oxygen to flow into the affected tissues. The harden fascia and lack of oxygen/nutrition then binds the muscle/organ movement. These restrictions can occur around joints and organs creating misalignments in the body structure. The misalignment and restrictions are a major source of myofascial pain.

Pain has multiple effects on the body. The physiological reaction to pain in the initial stage is an adaptive response and is useful to the body. It is the body's way of adapting and signaling there is a problem. However, this adaptive process can be detrimental if it is allowed to continue. When this process continues a series of physiological events occur that can include the fight or flight response, shallow breathing which deprives muscles of oxygen, and/or hydrogen bonding that can cause the fascia to harden. Then, the pain can become chronic.

The practice of yoga asanas coupled with the properties of the myofascial/connective tissue can mediate chronic pain. The deep breathing exercises expand the lungs, moves the diaphragm, which in turns brings heat into the tissue. This increases the fascia pliability. By paying attention to the energy lines which overlap with the myofascial lines, yoga affects the fascia from head to toes. Holding the asanas for 2 to 3 minutes allows the fascia to change state or to soften. This in turn allows the oxygen and the nutrients to flow into restrictive areas and feed the tissue, allowing the tissue to detoxify and to heal. The regular practice of yoga will help keep the fascia healthy. Healthy fascia decreases inflammation, increases mobility around joints and allows nutrients to flow freely into tissues; thereby reducing the pain cycle.


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