Easing Chronic Pain: Exploring Myofascial Release Therapy with Dr. Roome
Mar 31, 2024Season 2Episode 10
Aubrey Jacobson
Learn about a relatively new treatment for pain! Join Dr. Roome, a South African family practitioner who proactices Myofascial Release Therapy in Canada BC. Myofacial Release Therapy can alleviate everything from post-concussion migraines to persistent back pain and even anxiety tension. Dr. Roome, compares the body's fascia to the connective tissue of an orange, revealing insights into the root causes of pain and discomfort.
Venture further into the realm of physical healing as we unpack what Myofascial release is and how it differs from other needle-based therapies such as Acupuncture and IMS.
After surviving a 4 car pile up and being in pain for 7 years. I discovered this treatment over the past year, it's my newfound freedom from pain. I’ve suffered for years from post concussion migraines, back stiffness, less mobility and sharp back pain. Im absolutely shocked at how much release I have gotten from just one treatment. I could have used this years ago! Im here to spread the word about Myofacial Release because well I have tried EVERYTHING! This treatment has worked more than any massage, IMS, Acupuncture, Chiropractor or Physiotherapy could ever give me!
**This treatment is covered by MSP in Canada with Dr. referral.
Learn about a relatively new treatment for pain! Join Dr. Roome, a South African family practitioner who proactices Myofascial Release Therapy in Canada BC. Myofacial Release Therapy can alleviate everything from post-concussion migraines to persistent back pain and even anxiety tension. Dr. Roome, compares the body's fascia to the connective tissue of an orange, revealing insights into the root causes of pain and discomfort.
Venture further into the realm of physical healing as we unpack what Myofascial release is and how it differs from other needle-based therapies such as Acupuncture and IMS.
After surviving a 4 car pile up and being in pain for 7 years. I discovered this treatment over the past year, it's my newfound freedom from pain. I’ve suffered for years from post concussion migraines, back stiffness, less mobility and sharp back pain. Im absolutely shocked at how much release I have gotten from just one treatment. I could have used this years ago! Im here to spread the word about Myofacial Release because well I have tried EVERYTHING! This treatment has worked more than any massage, IMS, Acupuncture, Chiropractor or Physiotherapy could ever give me!
**This treatment is covered by MSP in Canada with Dr. referral.
Welcome, Dr Ruhm. Thank you so much for being here. It's actually a really big honor to have you on my show because myself I've seen so much release and also benefits from myofacial release, so I'd love if you could introduce yourself and tell me how you got started with myofacial release.
Speaker 2:
Yeah, sure, with pleasure. So I am a family practitioner from South Africa and I was working in a full service family practice in Parksville and I had a locum come in who did trigger point in myofascial release and my patient started demanding that I learn what this doc had learned, and so initially I thought this can't be anything because it's with saline. But the more I delved into it and the more persistent my patients got, the more I ended up doing some research and then realized no, there's something to this, and ended up becoming more and more passionate about it because of how instantaneous the effect is and how much difference you can make, which, in medicine, is something you don't often see yeah, it's incredible.
Speaker 1:
I'm seven years into my concussion and I noticed when I came in for this treatment I wasn't sure what to expect and, like today, I saw you today actually for treatment because my back had like seized up and I walked out of there and I was like, oh my god, I actually feel like a full release, which is incredible because I haven't had that for so many years. So can you, can you explain what myofascial release is and how it works?
Speaker 2:
Sure, um it's, it's a modality where you're using a needle to release tissues.
Speaker 2:
Um it's, it's focused on the soft tissue. So you are releasing muscles that are too tight, scar tissue and fascial lines that have also tethered and become too tight and are not functioning well, and you are looking for the areas that are causing the restriction and pain and the true source. So often, if, for example, a person does come in with back pain, often the origin is not and the true source. So often, if, for example, a person does come in with back pain, often the origin is not in the back itself. It's in muscles that are antagonistic to the back muscles and to the normal alignment of where the back should be. So, for example, if a hip flexor is too tight on one side, it will kind of twist you down, it will bring you forward, which will make the back start to ache, and so having treatment in the back can give temporary relief, but most of the time the problem is not really coming from there, so you have to, or you find then that it keeps on coming back.
Speaker 1:
Yeah, I was actually quite shocked when I came in to get treatment with you because I told you about my migraines going on in my forehead and then I believe you were treating my stomach at the time and I was kind of nervous because you're coming at me with needles in my stomach and I'm not used to that. But I definitely felt the release afterwards.
Speaker 1:
So yeah sorry if somebody is not familiar with what fascia sorry, I'm not sure if I'm saying it right what fascia is. Can you explain a little bit more about what that is?
Speaker 2:
Sure. So fascia is like the connective tissue that binds everything in your body together. If you take another example, like an orange, you've got the peel and then you've got the segments, and then you've got the tiny segments inside the segments when you open them, and those white bits or the pith that would be seen as fascia. So around your muscles and flowing into the tendons and then flowing over the bone and then into the next muscle. These fascial lines are continuous, so it basically puts you in a onesie and if it gets distorted somewhere then that onesie doesn't move right and it doesn't allow other areas to move right.
Speaker 1:
That's incredible. Yeah, I've felt it too with all the different treatments. You know you, I tell you I have neck pain and then you're treating me in a completely different area of my body, and you know it's. It kind of made me like realize how much we're connected very much so. I know migraines can be a big problem as well after concussion. Do you see a lot of people come in that have had concussion?
Speaker 2:
Yeah, it's one of the common things that end up having people send in, as well as whiplash, shoulders, the backs, concussion, though there's a number of components. There's not only the brain injury but there's also the musculature, often that got really strained, often there's whiplash components to it and there's also the core strain. That happens because the body's trying to protect its vital organs and when the core strains then it pulls on these fascial lines that go up and over the head. They go into the neck, into the shoulders. So you find often addressing these core muscular areas will release large tracts that go all the way up into the head and around the neck and so on.
Speaker 1:
It's incredible. So many people need this. Honestly, we need to speak more about this. I'm curious too, like how often would someone need to come in for treatments if they were to? You know, never try this before, and what is the maintaining treatments?
Speaker 2:
So it can vary a lot and I would say that there isn't a have to kind of protocol that we follow.
Speaker 2:
Generally we try and especially if someone is really debilitated to try and get them in once a week for three weeks that we start to really just get them moving and and and release to a degree that they have some functionality back, and then we start shifting the appointments about a month apart because in the initial time we're asking them please don't do a lot, don't overexert yourself, don't get the muscles tired while they're trying to recover and your body's trying to reorganize and not to do strengthening.
Speaker 2:
But once they've got some functionality and symmetry back, then they can start to strengthen again. And then we see them about once a month and then try and catch what's got snagged along the way. Do have patients coming up from from quite far up island, from Campbell River in Port Alberni, and some, some of them can only come in once a month and so then we just adapt to whatever their their ability is to come in and there's some clinics on the mainland that have different kind of scheduling protocols that they follow. So it would also just depend on where people are located and what the clinics around them can offer.
Speaker 1:
Okay, amazing. And I'm curious too, because in the beginning I actually thought that myofacial release was IMS and I'm just wondering how it's different from IMS.
Speaker 2:
And I'm just wondering how it's different from IMS. So the way of identifying where to treat is very different from IMS, because we use a postural assessment, a specific postural assessment and also movement tests that we call base tests, and these tests are designed to help us identify the true source of where things are not functioning right, where IMS is very often used in an area that's painful and so for something that's pretty simple and the origin of the problem is really where it's being felt, then IMS will be highly effective. But if, for example, a shoulder is aching because of an external oblique muscle, for example, that's pulling too tight into the fascial lines that run all the way up, then just releasing the shoulder or working on the shoulder is not going to give them any relief. So this is really about trying to identify where the true source of pain is coming from I.
Speaker 1:
You know I actually noticed that too from having ims before, as I noticed a new area sometimes would almost pop up when I had ims. Um, but I felt like there was only about 70 percent release when I had ims and I always felt like there I needed more. So I still always had a little bit of lingering pain and also the migraines wouldn't completely go away as well. So I'm curious how long has the treatment been available for recognized for?
Speaker 2:
Dr Greg Sirin started this methodology and he started two clinics in 2010. One was called Change Pain in Vancouver and the other one was the Mayo Clinic on Taiyi Road in Victoria. So this treatment has been around since about then it started to become a lot more formalized in the sense of a training program with actual modules and workshops. So we have four levels of workshops. Each of these focus on different body areas. So if a physician comes in and wants to do training, in the first session they would learn about the needling technique and how to treat a back and how to treat for knee pain, for example. And then we move to more risky areas and more finicky areas in the next levels up of these workshops. Now there are multiple faculty members in different specialities all involved in developing the learning material and all kind of contributing to it, but Dr Greg Surin was the star or the innovator of this methodology.
Speaker 1:
Amazing. Do you have to be a doctor to practice this, or can you be a chiropractor?
Speaker 2:
There are some regulations around who is allowed to give needles, so we have nurse practitioners that are doing myoactivation and then, obviously, physicians. Some of the physiotherapists will use IMS needles but use this methodology to identify where to treat. We've also had some naturopaths wanting to learn and having gone through the program and some acupuncturists, but we haven't had any actually come through the program.
Speaker 1:
We've also had yeah, I think I said physiotherapists before yeah.
Speaker 2:
Amazing. And so what conditions or issues can myofascial release therapy help with? It's so broad it would take a long time to actually mention all of it, but really, from head to toe, anything that has to do with how things move, any ache or pain that you have. So the reason why I say that is, for example, people were coming with a label say now arthritis. Say now it's arthritis in the hip, and the reason we can help with this is if the musculature has gotten tight around that joint, it compacts the joint, it accelerates the degeneration, it increases the inflammation and the pain around the joint. So if we release that, there's more space in the joint, it moves more freely and there's less pain in it, even though we haven't solved the the problem of having had degeneration in that joint.
Speaker 2:
Problems with neck stiffness or whiplash very commonly are things that we treat shoulders, frozen shoulders, sore backs, obviously knees, plantar fasciitis. Then there's things like anxiety, which also gets helped, and also respiratory issues, and this will make some of my colleagues hair rise. But anxiety, for example, often there's two components there's the emotional component and then there's also a muscular component with muscles tightening up because of that anxiety. It's often over the top of the sternum and on the chest wall and it makes the chest compress and then that gives a sensation of suffocation which adrenalizes people and makes them feel even more anxious wow, um, yeah, that's incredible.
Speaker 1:
Yeah, we're. We're also interconnected and, you know, sometimes we can get treated like it's just one specific area, when it's, you know, our whole body as a whole.
Speaker 2:
The whole system.
Speaker 1:
Yeah, yeah, exactly Right, that's amazing. I love that you're looking at that too with anxiety, cause I actually know a lot of people that have had anxiety, so I'm going to tell them about this too, cause I didn't realize that. I just noticed for me when I came in it was mostly for headaches and the whiplash pain which is. It's incredible, like I just can't believe how much release I have, so I love it yeah, no, that's awesome.
Speaker 2:
I'm so happy that we could have able to help you yeah, but I needed you, like years ago. That's. The other thing is people always feel angry when they do get a quick release with a simple procedure that's not very risky, and then they often will say why didn't you do something 10 years ago? But it is a new modality, not that many people know about it. It's really mainly available in BC in the world. So we're very privileged to be where we are.
Speaker 1:
Wow, that's incredible. So I'm living in a good place then. Are there any specific techniques or methods used in myofascial release that you find more effective?
Speaker 2:
Is more effective than my activation. I haven't seen any. I mean you pressure release and myofascial release. Techniques with massage are also used and I haven't seen that it delivers the same kind of release, because that spinal reflex doesn't fire the same as what you get with the hypodermic needle.
Speaker 1:
And I agree to everything you've just said, because I've tried everything under the moon for pain relief, you know. Are there any misconceptions about myofascial release that you'd like to address?
Speaker 2:
Well, I think this fear is the one thing people often come in quite, quite scared of how painful is it going to be and what are the possible side effects? And most of the time people will say after a few treatments you know, this is, this is pinchy and it can be painful, but it's a few seconds and then the release is really a huge relief and it's worth that, just that minute or a few seconds if one can get long-term relief, because one's coming in with constant pain anyway and not being able to sleep but not being able to function. So it's a small price to pay. From a side effect profile it's really very low risk. We we use a small gauge needle. There's a possibility of a bruise and, like any procedure, to feel a bit achy. On average, about a 24-hour period one can feel you've had a treatment. Things just feel a little bit tender and your body can feel tired because you've had a procedure. But as far as procedures go, this is pretty minimal and the body does recover pretty quickly.
Speaker 1:
That's amazing. Yeah, I've noticed. I've been a little bit sore afterwards and just had a hot bath and that seems to help and I feel more tired, but the release is worth every bit of tiredness. So how does myofascial release differ? Also from acupuncture? How is it different?
Speaker 2:
So they are coming from two totally different philosophies. Acupuncture is an Eastern medicine methodology based on energy meridians and energy flow. The needles are left in and sometimes manipulated or tweaked or twisted, and sometimes electricity is put on them to get energy flow to be restored, whereas myofascial release is working on anatomic trains and physical tension lines, so it's more like a type of anatomic engineering. So it's much more on the on the physical side of what's working with what and what's working against what, rather than the, the energy system in the body. And yeah, and myofascial release, or my activation, is based on western medicine okay, amazing.
Speaker 1:
And so how can someone find a qualified practitioner?
Speaker 2:
oh sure, um, if you go onto the anatomicmedicineorg website, there isa practitioner directory. You just click on the little button for the practitioner directory.
Speaker 1:
Amazing. Is there any self care techniques or exercises that individuals can do at home to complement the therapy?
Speaker 2:
For sure and we try and spend enough time on preparing people for this.
Speaker 2:
But after having release and having a treatment like my, activation to move frequently, because if we stay in a posture for too long our bodies stiffen in that posture and after release it tends to stiffen easier. So one wants to move enough that your body's staying supple, but not so much that you tire things out and restrain them. There's a fragile component to the releases that we get and if you then fully exert that muscle or fully contract it, it can go right back into that contracted state. So one has to be careful with what you do for a few days after the treatment and be mindful you know, if you've suddenly got a bunch of gardening to go and do, to do one little section for 15 minutes and then go and sort out some things, be in a different position using different muscles and then come back to it so that you're alternating muscle groups and giving them a rest and not just tiring things out. So that does become a priority after treatment, to try and keep that release and get the body to progress on recovery.
Speaker 1:
Awesome, and then. So I guess, if you're a weight trainer, you want to wait. What is it? 24, 48 hours or?
Speaker 2:
At least 48 hours and then, when you start again, to start at about 30%. So to understand that when muscles are in the state of constant contracture they're working all the time, so they get tired, but they also are weakened because they haven't been working with you. They've been stuck, so now you release it and those muscles are actually not as conditioned as you think they are. So one has to then start lower so that you get those parts of the muscles that have been really stuck and are now released to start working with you and build up some stamina without restraining them.
Speaker 1:
What are some ongoing research that's happening on myofascial release?
Speaker 2:
We have quite a bit. Also, if you look at the anatomicmedicineorg website, there are research papers on there. There's a study from the GATE lab with Dr Gillian Lauder. She works at BC Children's and so they measured movements before and after treatment and you could see the changes in ranges of motion, which was really lovely to see. As it's measured. Um, there is a quantitative and qualitative study in process and they're going to be published this year. Then there is a chapter in a book that's also. You can click on the link on on the on that website and you can read the chapter um and and the papers that we have are already in there. The other thing to realize is that there's been decades of research on trigger point injections in general, as well as on myofascial release techniques and the outcomes that they have, and this puts those two modalities together. So when looking at a modality that incorporates the research that we know of what works with trigger point and with myofascial release and how it affects the body but this is just more powerful using a needle.
Speaker 1:
This is incredible. I really value being here and sharing this information because I really feel like so many people really need this and so if you want to give it a try, go check out the website and take a look at this, because I know that you know myself is suffering with pain for so many years. It's just, it's like a dream come true, honestly, having this type of treatment. So thank you so much. It's been a pleasure to have you absolute pleasure.