Functional Range Release
SPECIFIC ISSUES REQUIRE TARGETTED TREATMENT:
Swedish massage, stretching out or foam rolling a large area of tightness is great. IF it is a gross, broad area of tightness, then a generalised treatment can really help. Because it will pretty much always hit the mark.
But if it is a specific tissue at a specific depth that is only problematic in a specific position or movement, then specificity is required. Alternatively, if flexibility is the goal, then no amount of rubbing will work.
This is where functional Range Release comes into its own.
Which is a system of soft-tissue treatment aimed at targeting the epi-centre. It is based upon sound principles, identified in scientific research studies, ensuring that it is an effective form of treatment. That is ultra-focused towards the epi-centre of a tight tense tissue.
It has to be felt to be believed!
FUNCTIONAL RANGE RELEASE INVOLVES IN-DEPTH ASSESMENT
Being an an in-depth, comprehensive system, that treats specific areas of aberrant tension, that many are not even be aware that they have. An area is indicated as requiring treatment when aberrant abnormal tension occurs when there should be a low level of resting tension. Apparent tension, being an excessive amount of tension, within the range of motion.
This abnormal tension can occur in all connective tissues. Which is why Functional range release assessments, don’t just check muscles, but ligaments and tendons as well.
The purpose of the assessment process is to identify specific lines of tension. It is a process of palpating for tension that is restricting the connective tissue relaxing when it is lengthened passively.
It does not involve assessing active movement. As active assessments only highlight obvious areas of tension, and it is very hard to ascertain as to whether the inherent tension in active movements is in fact completely functional. My friend John Hardy calls functional tension, neural notches, as it is like a notch on a belt. Functional range release does not assess muscles in normal day-to-day function. Functional range release uses passive tension tests
Tension stands out in passive assessments, as the tissue need not tense up, so when it does it is noticeable. A passive test being where the therapist does the movement, and the muscles do not technically need to tense up. Being an in-depth assessment it assesses different angles at different ranges of motion (levels of stretch/lengthening). It assesses through palpating the connective tissue, at different layers/depth, feeling of an out of place kick in the tissue. An unnecessary contraction, where instead of a low level of resting tension being present throughout the assessment, there is what Dr Spina calls aberrant tension. Aberrant being a divergence from an accepted standard. The accepted standard in this case is the resting muscle tension.
Most systems out there either focus on how much a muscle can stretch. Which is totally appropriate if the client's goal is to be a gymnast. But focusing on one part of a motion, means that the problematic apparent tension in the mid-range of the tissues passive range, gets ignored. At the true end point of the range of motion, a muscle should tense up to stop it being torn, which makes it hard to identify aberrant tension at the end of the range.
Another issue with stretching assessments is that the range of motion is NOT linked to how much pain there is!
How aberrant tension can cause pain is examined later in this article.
We are taught that there are 4 different causes for aberrant tissue in connective tissue:
1- Central Nervous system:
This is where the kick in tension comes from the nervous system. It is probably the most common cause of tension as tension is controlled by our nervous system. It is not just the structural length of our muscles that restricts how much we can move.
2- Peripheral nervous system:
Nerve entrapment is incredibly common. It is where a nerve gets pinched after it exits the spinal cord. The compression on the nerve activates it, so that the nerve starts to tell the muscles that it supplies to tense up, thus creating aberrant tension.
3- Injury protection:
The body doesn’t always go wrong. When we tear a muscle our nervous system helps to keep us safe, by splinting the area, by tensing up the muscles that surround the tear. This reduces the risk of it re-tearing, giving the tissue time to heal up. The body coils up the muscle spindles at the site of an injury, so that the tissue can reflexively, prematurely contract. Resulting in a more sensitive stretch reflex threshold, so muscles contract faster when stretched, to reduce risk of further tearing.
4- Mechanical adhesions:
This is tension that we would have when we are not conscious. Adhesions are places of restriction, and dysfunction, that have taken a long time to build up. Being areas of disorganised scar tissue, adhesions move as a block, instead of the layers of tissue sliding past one another. The lack of tissues ability to segment in the areas of connective tissue, causes an inappropriate kick in the tension. This lack of gliding can develop as a result of an acute injury, or cumulative trauma from a repetitive strain injury. Mechanical adhesions, differ from neurological tension, as:
- the tissue does NOT pre-emptively contract before a stretch.
- Mechanical tension, also remains switched on, it stays tense even whilst we sleep.
- It tenses up along a very specific line, as opposed to tension along the whole muscle.
Please note that if movement is solidly blocked, at the end of the motion, it could be 2 bones approximating, this indicates a potential joint issue. Which should be assessed by a professional.
WHY ABERRANT TENSION IS A PROBLEM:
Unnecessary tension doesn’t just stop the joint from moving, it stops motility, the movement of fluid. Fluid motility is essential for our connective tissue as blood and interstitial fluid brings nutrients to our tissue, whilst lymph helps to drain waste products away.
If fluid motility is blocked by aberrant muscle tension then the area surrounding the muscle and connected ligaments and tendons become stagnant. This stagnation results in:
> Inflammation naturally accumulates in stagnant connective tissue.
> Fibrosis building up, as in the absence of nutritional resources that woul normally flow into the area. The body lays down fibrotic scar tissue instead of replacing tissue that has died with fully functioning tissue.
> Stagnant areas become toxic, as dead tissue decomposes within the tissue.
> Loss of relative motion between layers, and even between muscles themselves. If scar tissue builds up in the epimysium groove, which is the space between the muscles.
> A vulnerable area, of disorganised connective tissue. This disorganised tissue is weaker tissue, and prone to tearing.
> Mechanical compensations, as the body has to compesate for an area of connective tissue moving as a block. Mechanical compensations are also called biomechanical dysfunctions, as we do not just compensate physically.
> Increased amount of pain, due to the areas around the pain receptors on the end of nerves accumulating inflammation that can irritate our pain receptors.
If the stagnation in the tissue that causes the ache is not addressed then eventually it will fibrose. Being a process of “misrepair… where collagen fibres are used to replace dead cells.” (Michelitsch, 2015), if you google fibrosis you will find pulmonary (lung) fibrosis. But a variety of different tissues misreplace dead cells, through the process of fibrosing.
This misrepair is caused by the accumulative effect of collagen fibres being payed down. In essence the formation of a mini-scar. Where instead of elastic fibres, resulting in the the tissue losing its ability to tolerate stretching. The most obvious example of tissue fibrosing is when our skin develops wrinkles and creases up, being less able to tolerate stretching. This happens because the chemical deprivation of nutrients, results in the physical tissue slowly having to “make do”, without the resources to replace like with like. So rather then laying down elastic fibres and replacing damaged elastin tissue it creates a fixed physical restriction, out of collagen.
The ongoing accumulation of fibrosed connective tissue. But it can casue us to feel a chronic ache, especially after activity. A prime example of a symptomatic connective tissue in an area of stagnation, that is riddled with fibrosed tissue, is repetitive strain.
IT MIGHT NOT BE A KNOT
Aberrant tension is not only caused by mechanical “adhesions/knots” in the tissue itself. For it is our nervous system, which controls and governs muscle length/tension. The amount of tension in any given muscle, tunes the tension in the ligaments, capsules and tendons are are not passive pieces of connective tissue. They are dynamic, and respond to tensile forces from nearby contractile tissue.
Aberrant tissue tension in our connective tissue, is usually driven by our nervous system, as opposed to the tissues being stuck. In other words, oftentimes it is the nervous system not the muscle that restricts mobility.
Our nervous system is a system that in essence sends information, it communicates messages. It is these messages that influence the amount of movement our nervous system will allow tissue to exhibit.
For a message to work it requires a stimuli, something to send the message. Most people think that it is a one way System, where the brain sends messages to our muscles. Muscle are not sensationless, they constantly flood our nervous system with information. There is a constant bi-directional flow of neurological information between our muscles and brain. For the muscles stimulate sensory nerves to rely messages back to the brain. It is what our connective tissue feedbacks that tells the nervous system, when and how much to tense up.
The issue is when the nervous system is left in the dark. It is then that it goes back to its default of defensively tensing up, just in case. Ongoing neurological abarent tension, is not usually our nervous system protecting a vulnerable tear. Rather it is our nervous system reacting to being left in the dark.
Our nervous system gets left in the dark when, an area doesn’t move. Because movement is not just an effect, it also informs our brain as to how capable it is. Without novel movement the nervous system does not get the information, that it asks for. So everything tends to defensively “lock up”. We all tend to tense up when we are threatened.
HOW FUNCTIONAL RANGE RELEASE TREATS NEUROLOGICAL TENSION:
Just like any single session of stretching a muscle does NOT make it longer. Any single functional range release treatment does not change the tissue. But our nervous system feels lines of forces and responds to the sensation of treatment. The nervous system responds by changing when and how much it tells the connective tissue to tense up. F.R.R practitioners, do not fix the body, so much as alter the canvas.
Functional range release, informs the nervous system through passive movement, the safest type of movement. This reduces neurological tissue tension as it feedback to the nervous system that the amount of tension in the muscle supersedes the required amount.
Functional range release informs, by placing “safe” tension along a particular line. The safe amount of tension, sends messages through the nervous system, thus allowing for this range of motion. In terms of posture and movement the nervous system works by communicating messages of force.
Neurological aberrant tension is treated through active contractions on the part of the client. Dr Spina, calls this descendant of Muscle Energy Technique and Post Neuromuscular Facilitation:
> PAILS: Progressive Angular Isometric Loading
> RAILS. Regressive Angular Isometric Loading
(Having been trained in both MET and PNF. I personally really like the fact that PAILS and RAILS is so simple to understand.)
PAILS and RAILS are very appropriate for the clinical setting. As isometrics:
- dont shear joints
- cause little to no tearing, like eccentrics, and so are less provocative.
- safe mechanotransduction.
- guides tissue remolding.
HOW FUNCTIONAL RANGE RELEASE TREATS MECHANICAL TENSION (ADHESIONS)
Treating/re-training structural adhesions, the FRR way, is similar to how FRR treats neurological tension. Both trigger message of force to ripple through the body. They also both focus on treating the worst line of unnecessary tension
Force is so important. It is the language of cells, force influences whether and how the cells will adapt. Force dicatates cell turnover. Functional range release uses messages of directional force to inform the body to lay down new tissue, in areas of disorganised connective tissue, that has been pulled in multiple directions.
If you wanted to dive deeper into the science of force, look into the terms tensegrity, piezoelectric effect, and mechanotransduction.
To apply the right amount of force, along the specific line, and influence how the body deals with an “adhesion”. In other words to guide the way the tissue heals. Compression has to be just right, to get to the level of at the epi-centre of aberrant tension. Wheras tension has to perfectly match the tissue tension. Most importantly, this depth and tension has to be maintained, and held. The amount of disproportionate tension has to be constantly monitored.
Applying appropriate compression and tension requires a skill-set that only experience can give one. To compress, without bruising, one has to melt down to the level. Tension requires that the downward compression becomes more wedge like, being perfectly in line with the aberrant tension. This tensile stretch has to be kept at the right level, as nobody wants a skin burn.
The biggest difference between the nervous system and the tissue responding to functional range release. Is how long the response takes before proof of change becomes noticable. Structural adaptations take longer, for structure is slow moving function. The response from treating the nervous system can be almost instant, whilst it takes time for tissue to heal.
Andreo Spina told me on the course that remoulding over time, is probably a better way of wording it then release. Remoulding is more accurate as it does not imply that anything instant will happen. For treating fibrosis requires patience. As tissue that has spent years fibrosing up, will not instantly uncoil. The tissue will only remould if the tensile message is intense enough, and repeated at an appropriate frequency, usually 6 sessions. To change the structure of tissue takes a multiple sessions.
TRAINING OF THERAPIST:
Requiring the precision of a highly trained professional, to identify problematic tissue through palpating the tissue, before applying a specific stretch.
Stretching the right tissue by being at the appropriate:
- depth, by being able to melt into the tissue
The appropriate stretch can only be done by those who know the origins and insertions of muscles inside-out, can effectively carry out Functional range release. For knowing where a muscle starts and stops means that the therapist knows what angle will place force along the line of the muscle.
Applying the appropriate type of stretch by:
- Using the best amount of force to match the tissue tension.
- Holding the force for long enough, until it releases.
- Being uber- controlled with ones hands
- Ensuring that the directional line of force is applied along specific angles that need it the most.
- Tissue fibrosis: a principal proof for the central role of Misrepair in aging, Michelitsch, 2015
Neck pain (Kim JW,2015)
Plantar fasciitis (Kate,2015)
Tennis elbow (Harneet, 2012) (Trivedi,2014)
Buttock pain (Tak, 2013)
Repetitive Strain Injury (Trivedi, 2014)
COMMONLY ASKED QUESTIONS ABOUT FUNCTIONAL RANGE RELEASE
> What conditions does Functional Range Release NOT work for?
- It does not fix degenerative conditions.
- Any major trauma, such as a break.
> Who should NOT get hands on functional range release?
- Anyone who does not want to do some form of physical exertion.
- People who are unable to do a form of physical exercise due to a health condition
> Is this treatment better then gentle massage?
Yes- Unlike gentle massage, Functional Range Release stretches the segments that are tight and restricted.
Yes- It is a more specific technique in that it targets the epi-centre of the issue better then gentle massage.
No- Gentle Massage is much better at increasing the blood flow to an area.
> How long does a typical treatment last?
The first treatment including multiple questions about injury takes 40 minutes.
Any follow-up treatments last for 20 minutes.
> Will getting functional range release treatment hurt?
Like any form of relatively tough treatment it can “stir things up”. But 99% of the time the benefits out weight the side-effects. You can be rest assured that every effort will be made to reduce any side-effects.
> Can I get Functional Range Release payed for by the N.H.S?
- At the moment no, but this may change in the future.
> Can I get my insurance company to fund this?
Although joint healthcare does not have any arrangements with to recieve payments directly from insurance companies. Many clients pay us directly and recieve reimbursement from their insurer at a later date.
> How much does a treatment cost at Joint Healthcare?
For the 1st treatment including a full case history it is £40
Any follow-up sessions are £32
Servicing the following Areas:
> Near Wellington TA21
> Near Taunton TA1, TA2
> Near Ilminster TA3
> Near Tiverton EX16
> Near Collompton EX15
> Near Wellington TA21
> Near Taunton TA1, TA2
> Near Ilminster TA3
> Near Tiverton EX16
> Near Collompton EX15