As an occupational therapist and myofascial release practitioner, I want to share something that gives me great satisfaction. I love treating all kinds of clients and all kinds of problems, but I genuinely feel like I’m living my purpose when I can help prevent a problem.
Over the past couple of years, I’ve helped clients avoid surgeries, which feels incredible to be able to help in that way. However, surgery can’t always be avoided. Sometimes the problem is such that surgical intervention is the best choice or even the only choice. I often suggest that the clients continue with myofascial work up until the surgery. Why continue if the pain or problem can’t be fixed with myofascial work? The reasons are numerous.
Fascia and Trauma
First, surgery is trauma. Your fascia is a body system that helps to protect you. Cutting into the body is trauma, even if that trauma saves your life or fixes a problem, like removing a tumor or replacing a damaged joint. There is a payoff, but the body doesn’t know that. The fascia will still tighten to protect the area that is being cut. You will still have to deal with scar tissue. And the “scars” are not just on the skin. They can be deep inside the body.
If you have ever had a large scar on your skin, you may have noticed how the scar doesn’t lay flat or blend nicely into the rest of the skin. You may have seen puckering and pulling into the surrounding tissue. The deeper the cut, the more likely the scar is to pull in different directions. If you were lucky and had a health professional teaching you scar massage, you probably worked on the scar and tamed it to become flat. If not, you may have a puckering and pulling scar on your skin.
Now imagine a scar that was left untreated underneath the skin. The fascia, the 3-D web inside the body, behaves similarly to a superficial scar. If it is regularly stretched and pulled in all directions, it will continue to stretch and move easily in all directions you want your body to move. When left untreated or unattended to, especially right after trauma, the pulling of the scar will be random and tight. Soon, you will have tightness and pain in areas that weren’t a problem before the surgery.
In the picture below, perhaps the figure had back surgery. You can see how the pulling from the back can spread into all areas of the body. Your pulls may be similar or completely different depending on how you’ve used your body and your movement habits after surgery.
This illustration represents how the fascia may pull into the body after a back surgery. Over time a lack of movement can create lines of tension that can pull into a variety of areas causing greater tension and pain in unexpected areas of the body.
Preparing for Surgeries and Other Invasive Procedures
No matter the issue, if you need surgery, you want to prepare your body for the experience. The surgical team will give you certain things you must do, like cleaning the area, not eating the night before, avoiding certain medications, etc. These commands help the procedure go as smoothly as possible and keep you safe. They want to get in, get the job done and get out. The less time your inner body is open and exposed, the less likely you will get an infection.
Showing up with a body that is ready for a successful surgery means bringing a body that is soft, balanced, and easy to cut into and navigate. It is also important to address inflammation by avoiding sugar and eating a balanced diet. Myofascial work or self-treatment can also help reduce inflammation that could complicate surgery.
A tense body is rigid, while a relaxed body is soft. Soft tissues can more easily be cut into and manipulated during the procedure. Imagine having a hip replacement. The surgeon wants to minimize cuts into the muscles and fascia around the hip, but they must move those tissues aside to get to the bones they are removing to install the new hip. The easier your tissues are to move aside, the safer they will be from the saw and the drill, and the less trauma they will endure from the pushing and pulling of the surgical team. Myofascial work removes tension from the body, making it soft for this process.
Alignment and Balance
My particular brand of myofascial work focuses on bringing the body into balance and physical alignment. Proper alignment can make a significant difference in your daily life and a successful surgery. People come in all shapes and sizes, but our bony alignment and inner alignment are standard issue. When you present your body for surgery, having it as close to proper alignment as possible is extremely helpful to the surgeons.
If you follow my blog, you may have read the one on turtle neck. You may also have read my blog on clavicles (collar bones). Imagine going in for neck or shoulder surgery, and your neck and shoulders are drastically out of alignment. It will be much harder for the surgical team to navigate. On top of that, if you are out of alignment, you are probably tight, too. Over time, improper alignment forces your body to lay down extra fascia to support it. If you don’t let your bones do the work, the fascia steps in and becomes the support causing tension and tightness.
In many cases, you have surgery to help fix a problem with pain. Minimizing other aches and pains in the body can help you recover and move better after surgery. While these surgeries are meant to address pain, they can sometimes amplify pain in other seemingly unrelated parts of the body. For example, let’s say you’ve been experiencing soreness in your feet, and you’re preparing for back surgery. The surgery may help with your back problems, but the soreness in your feet may increase. Adopting a myofascial treatment system to address all the issues beforehand can help you recover faster.
The trauma of surgery causes tension, as seen above in our fascia illustration. That increase in tension places pressure on other areas of the body and can also limit joint mobility. Have you ever heard of frozen shoulder? It is very common for people to get frozen shoulder after an injury or surgery in other areas of the body. For example, frozen shoulder is common after wrist injuries. Why? We tend to “baby” areas that have been injured, but this disuse only causes more problems. The injury, combined with the immobility, causes the fascia to tighten.
This also makes a good case for myofascial release therapy AFTER an injury or surgery. Most traditional approaches only work on the area of injury. Why? Because that is how our insurance model of healthcare works. The wrist hurts, so they fix the wrist and only the wrist. Insurance will likely deny working on another area of the body. But our whole body is connected via the fascia! Working on the wrist as well as the forearm and shoulders will help ensure a speedy recovery. Even better, work on the entire body through movement and myofascial release therapy.
Surgery is taxing on your body. There is likely an area of your body you will not be able to use for a while, and the rest of your body will need to compensate. Preparing the body to be balanced not just from a fascia perspective but also strength and mobility is very helpful.
Let’s look at an example. If you are having a surgery that limits your ability to use one leg, your opposite leg, hips, and core will have to function differently after surgery. This change and imbalance in your body can cause a whole new set of problems if you are weak, especially through your core. A myofascial practitioner can help you determine which areas will be most effective and help you prepare them.
Our fascia has two parts: the collagenous web and the free water that binds to and flows around it. This water has many essential functions, including providing nutrients to all our cells and funneling cellular waste into our lymphatic system. Tight areas in the fascia can limit the movement of the free water in the body and affect the health of our cells. The fascia is actually a vital part of the immune system. This is yet another reason for keeping it healthy before and after surgery.
Healthy Fascia, Healthy Body
Our bodies are brilliant and designed to heal themselves. However, we must create the right conditions. Our current way of being in our culture isn’t conducive to creating bodies that heal well. We need to move more and with greater variety. We need to live in a way that creates less inflammation in our bodies. We need to minimize our stress, get better sleep, and eat foods that promote healing. We need to maintain enough strength to minimize our risk of injury. I could keep going, but I’ll save it for another blog.
Healthy Fascia, Speedy Recovery
I have clients who told me they needed less pain medication during recovery and breezed through post-surgical therapy and back into life thanks to myofascial release and fascia-focused therapies. If you need surgery, create a body that will help you get the best results.
Before surgery, move as much as you are allowed. For example, if you need surgery on your left wrist, don’t stop moving your left elbow, left shoulder, your neck and the entire rest of your body. You’ll need your body functional and ready to help compensate for the temporary loss of use of your wrist.
After surgery, move as much as you are allowed in parts of your body that were not affected by the surgery. Follow any restrictions in movement you are given by your medical team. As soon as you are free of restrictions, move. Follow you intuition about what is safe for your body. Move in a pain-free range of motion and if you need it, work with a movement professional to guide you.
Attending to your fascia definitely supports the recovery process. Myofascial release therapy can help. My clients know that I love to follow research on fascia, posture, and movement. I believe we must integrate what we know about these areas into our health and wellness plan. I can help.
If you are considering surgical intervention, please:
- explore and try conservative options first if they is available to you. You cannot reverse a surgery.
- prepare your body well.
- don’t stop moving before and after your surgery. Move what is safe to move.
By Amy Mayer OTD, OTR/L, RYT