Sciatica Pain tips for Low Back Pain Relief

As a licensed massage therapist, I specialize in chronic pain and injury management using deep tissue massage therapy. Most of my clients come in with a common complaint: pain in the low back, hips (primarily on one side), and/or shooting pain or numbness down the back of the leg commonly referred to as sciatica pain. More than two million Americans suffer either from back pain or a form of sciatica that is often misdiagnosed and improperly treated.   Many suffer from pain for months or years without a proper diagnosis.  I work with these symptoms so frequently that I have noticed some common characteristics with this all-too-common pain complaint.

Pelvis with sciatic nerve and piriformis
Hip joint. Red: Piriformis muscle. Blue: Sciatic nerve.

The most common characteristics I find are aggravated myofascial trigger points (TrPs) in the piriformis muscle.  Piriformis trigger points are often confused for a herniated disc, sciatica, or other back issues, and many sufferers undergo unnecessary and costly tests, injections, and surgeries.

What is the piriformis?

The piriformis muscle is a small external rotator of the hip whose function primarily is to turn the knee and foot outward. It lies deep within the gluteal muscles, originates from the sacral spine, and attaches to the greater trochanter of the femur — the big bony “bump” on the outside top of the thigh.  The sciatic nerve passes beneath through an opening called the sciatic notch.

 

Hip abduction

Function

In non-weight bearing activities, foot unloaded and hip extended, the piriformis rotates the thigh outward. When the hip is flexed at 90 degrees it aids in hip abduction. Hip Abduction. In weight-bearing activities, foot loaded, the piriformis is often needed to control the rapid medial rotation of the thigh — for example, as the foot strikes the ground during walking or running, the knee turns inward.
Trigger point referral pain pattern from sciatica nerve impingement due to piriformis
Piriformis trigger points and referral pain pattern

 

Piriformis Trigger Points Symptoms

The myofascial sciatica pain component includes pain in the low back, groin, buttock, and hip.  A trigger point may cause the muscle to compress and irritate the sciatic nerve, causing the pain to travel along the course of the nerve. The pain may radiate down the back of the leg and into the hamstrings, the calf muscles, and possibly the foot. The pain may initially be confused with a hamstring strain or diagnosed as true sciatica. Weakness, stiffness and a general restriction of movement are also quite common. Tingling, numbness, or shooting pains down the leg can also be experienced.  Symptoms tend to be aggravated by prolonged sitting or by intense activity.

Causes
Piriformis trigger points are predominantly caused by a shortening or tightening of the piriformis muscle.  Piriformis trigger points are commonly associated with sports that require a lot of running, change of direction, or weight-bearing activity.  Piriformis trigger points can result from acute overload (as when catching oneself from a fall), from repetitive overload (as with the rapid internal rotation of the weight bearing experienced by walkers and runners with poor biomechanics),  or from sustained overload (as when holding the leg bent and turned outward for prolonged periods while driving a car or working at a desk).  Sciatica pain from piriformis trigger points is also a common complaint during pregnancy.
Pic of inflamed sciatic nerve due to piriformis impingement
Impingement of sciatic nerve from piriformis TrP

The piriformis muscle is responsible for the symptoms of pain by projecting pain from activation of the trigger points and by nerve entrapment upon the sciatic nerve.  Once trigger points are activated, the piriformis muscle begins to put pressure on the sciatic nerve.  The sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

Treatment and Prevention

The first two steps in treating piriformis trigger points can provide the most significant and immediate relief: deep tissue massage with stretching of the external rotators of the hip.  Deep tissue massage techniques such as myofascial release and trigger point therapy are highly effective at reducing active trigger points. Once the trigger point is released, there will be a significant reduction in pain.

GRIDXside
The Grid Foam Roller by Trigger Point Therapy

Following up the massage with flexibility training will help loosen the muscle and help prevent a return of the trigger point and sciatica.  I have found that it takes between four and ten massage sessions to move out of the acute pain phase from piriformis trigger points.  It may be shorter or longer depending on the cause and severity of the initial injury.

For long-term prevention of piriformis TrPs, self-myofascial release and flexibility will be your most invaluable tools.  Below are some pictures of how to relieve piriformis TrPs using a ball (preferably a tennis ball for beginners) and how to stretch the piriformis muscle and other external rotators of the hip.  With each stretch, it is important to breathe into the stretch and only stretch to slight discomfort … NOT PAIN.

Using a soft ball to release the piriformis muscle and gain relief from sciatic pain patterns.
Self-trigger point therapy using a ball. Find a painful spot in the glutes, relax your body into the ball, hold the position for 30-60 seconds or until you notice a significant reduction in pain. Move to the next painful spot. 5-10 minutes total.
Stretching the piriformis muscle in a supine figure four stretch.
Lying piriformis stretch. Place the leg you are stretching mid-calf on opposite knee. Pull opposite knee towards chest while at the same time pulling the knee of stretching leg towards opposite shoulder. Hold 30-60 seconds.
Seated gluteal stretch. Cross the leg being stretched over opposite leg. Wrap opposite elbow around the knee and pull towards opposite leg. Keep your back straight. Hold 30-60 seconds.
Seated gluteal stretch. Place ankle of the leg being stretched on opposite knee. Throw both hands over your leg, take a deep breath, and, as you exhale, allow your chest to drop toward the floor. Hold 30-60 seconds.
Modified pigeon pose. Place leg being stretched on a table, couch, or bed with knee bent and opposite leg resting on the floor. Drop your chest toward to table. Hold 30-60 seconds.

Other suggestions to prevent Piriformis TrPs

Get assessed by a qualified movement therapist. The exercises shown here are a guide to provide temporary relief. They are not a permanent fix. The underlying movement issues that are causing your piriformis to impinge your sciatica nerve need to be addressed. Find a highly skilled movement therapist in your area who can assess muscle function and gait mechanics.

Our bodies were designed to move.  It is important to keep moving.  Try not to sit down for more than an hour at a time. Stand up, take breaks, go for a walk, and move your body throughout the day. Lack of movement causes muscle dysfunction. Proper movement is key to an active healthy life. With an exercise program that focuses on functional movement patterns with core strength and stabilization, regular full body massage (self-massage or professional), and full body flexibility you will reduce your chances for chronic pain and injuries.

Running/walking

Change the way you walk and run. Heel strike is the most common dysfunction in running/walking gait. As soon as the heel strikes the ground, the knee rapidly moves into external rotation followed by rapid inward rotation. This places repetitive trauma on the piriformis muscle and leads to TrP formation and activation. I suggest hiring a coach who instructs forefoot or midfoot strike running form.

Replace your shoes. Modern running shoes promote heel strike. I advocate shoes with as little cushion and arch support as your body can handle.

Be smart with a shoe and form transition. Your body has adapted to how you walk and the shoes you wear.  A fast transition without proper instruction and training raises your risk of significant injury.  Below is a great article about what is wrong with your running/walking shoes.

What Happens to Our Foot When We Wear Traditional Running Shoes

This is the foam roller I recommend: The Grid by Trigger Point Therapy. This is an affiliate link. If you click it and make a purchase, The Art of Fitness will receive a small commission. These commissions help support TAO-Fit to continue producing life-changing content. Thank you for your support.

Chronic Pain and Trigger Points

According to a new report by the Institute of Medicine, “Chronic pain affects an estimated 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined.” Chronic pain is defined as “severe pain that lasts 30 to 60 days or more and taxes one’s professional and private life.” (Time)  What is the cause of so much pain and suffering?  There is a good chance that myofascial trigger points may be to blame.Trigger Points are the cause of many types of pain (WebMD Video)

 

 

 

 

 

 

Myofascial Trigger Points

 

What is a myofascial trigger point?
Myofascial trigger points are hyper-sensitive knots in skeletal muscle and fascial tissue.  The spot is painful with pressure and can cause referred pain–pain that manifests away from the trigger point site.  Trigger points are extremely common and are a primary cause of chronic pain.What causes a trigger point?
A trigger point forms in fascial tissue affected by mechanical stress or overload, which may be due to acute trauma, poor posture, repetitive movement, over-training, or inadequate sleep.  The affected tissue contracts (shortens) and blood flow can become restricted, leading to a metabolic backup; poor nutrient delivery and waste product build up within the tissue.  The build up of waste forms a toxic glue that adheres to surrounding tissue causing joint and movement restrictions, neurological impingement, and pain.

Referred pain from SCM trigger point
Trigger Point Symptoms
Trigger points cause motor dysfunction, stiffness, and restricted range of motion; resulting in overload to the central nervous system.  The neuromuscular system becomes stressed, causing weakness, fatigue, numbness, tingling, balance problems, headaches or migraines; chronic pain and injury; less efficient motor skill performance, and a long list of other symptoms. 

“The severity of symptoms caused by myofascial trigger points ranges from agonizing incapacitating pain caused by very active trigger points to the painless restriction of movement and distortion of posture due to latent trigger points that are so commonly overlooked.” (Travell & Simmons’)
Active trigger points can cause headaches, neck and jaw pain, or low back pain.  Often symptoms are misdiagnosed as arthritis, tendinitis, bursitis, carpal tunnel syndrome, or a ligament injury.  Trigger points can also cause symptoms such as dizziness, earaches, sinusitis, nausea, heartburn, false heart pain, heart arrhythmia, genital pain, and numbness in the hands and feet.  Even painful disorders such as fibromyalgia have been connected to myofascial trigger points.

There is also an emotional toll to chronic pain.  Anxiety, stress, depression, anger, and fatigue often accompany chronicpain and affect one’s ability to cope in their daily life.
For a visual guide to trigger points check out The Trigger Point & Referred Pain Guide

Prevention and treatment of chronic pain is often “delayed, inaccessible, or inadequate.” (ABC News)

 

Ischemic Compression

Trigger point therapy
Trigger point therapy is a specialized form of massage therapy.  Treatment consists of ischemic compression: concentrated pressure placed directly on a specific myofascial trigger point to break cycles of pain and spasm.  Passive stretching and corrective exercises are also utilized.  Trigger point therapy restores muscle tone and balance; enhances the function of muscle and joint biomechanics; improves blood flow and lymphatic drainage; and reduces painful spasms.  Trigger point therapy can be part of a comprehensive program complementing all other health care modalities.Among steps to improving care, healthcare providers should increasingly aim at tailoring pain care to each person’s experience and self-management of pain should be promoted. (Institute of Medicine)

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 

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Self Massage Using A Foam Roller

Self Massage Using A Foam Roller

Deep tissue massage therapy modalities, such as myofascial release, improve flexibility, function, and performance; speed up the recovery process; and reduce chronic pain and injury risk. Regular deep tissue massage therapy breaks down adhesions and scar tissue that form in the fascia. With the use of a few simple, inexpensive tools (foam roller and a soft ball), you can perform daily self massage and receive much of the same benefits as weekly professional bodywork.

The Grid Foam Roller by Trigger Point Therapy - self massage calf muscles.How does self massage work?

Fascia is a three-dimensional fibrous matrix interconnected throughout the body from the top of the head to the bottom of the feet. Fascia surrounds muscles, bones, and joints providing the body structural integrity and strength. Dysfunctional fascia is a leading cause of chronic pain, reduced flexibility, and decreased athletic performance.

Located within the muscle and tendon tissue are two sensory receptors called the muscle spindle and golgi tendon organ. These sensory receptors monitor muscular and tendon tension from the surrounding tissue and relates it to your nervous system.  They are highly sensitive to changes in muscle tension and rate of change.  Stimulation of the golgi tendon organ leads to a decrease in soft tissue tension.

golgi tendon organ Located within the muscle and tendon tissue are two sensory receptors called the muscle spindle and golgi tendon organ. These sensory receptors monitor muscular and tendon tension from the surrounding tissue and relates it to your nervous system.  They are highly sensitive to changes in muscle tension and rate of change.  Stimulation of the golgi tendon organ leads to a decrease in soft tissue tension.

Placing pressure directly on tight or overly toned muscle tissue using deep tissue massage therapy or self-myofascial release techniques stimulates the golgi tendon organ to relax tension in the soft tissue. The decrease in soft tissue tension can be used to reduce pain, reduce scar tissue adhesions, increase joint mobility, and improve overall function.

BENEFITS OF SELF MASSAGE

  • correct muscle imbalances
  • increase joint range of motion
  • decrease muscle soreness and relieve joint stress
  • decrease tight or overly toned muscle tissue
  • increase extensibility of muscle and tendon tissue
  • increase performance
  • maintain normal functional muscular length

The Grid Foam Roller by Trigger Point Therapy - self massage gluteal muscles.What to do
Self massage techniques are very simple to learn. One of the best tools for self massage is the foam roller.

Place your body weight on the foam roller over taut bands of muscle tissue that need to be released. For the best results, begin near the center of the body and slowly work away from the center of the body. Breathe, relax your body, and slowly roll through the length of the muscle.  If you find a painful spot, stop and visualize the soft tissue as melting butter and the foam roller as a hot knife. Allow the pressure into the tissue and within 30-60 seconds you will notice a significant reduction in pain. Repeat this until you have reduced all the painful tissue.

The first couple of weeks of foam roller therapy more than likely will be painful.  It is important to be diligent. The payoff is well worth it. If you use the foam roller every day, within a couple of weeks you will begin to notice not only does the exercise not hurt as much but also it will begin to feel really good.

Self massage on a foam roller offers an effective, inexpensive, and convenient way to both reduce scar tissue and adhesions. For the most effective self massage techniques, I offer a foam roller therapy session geared towards beginner, intermediate, and advanced users.

Check out Foam Roller Massage Therapy For Beginners for more details on how to begin self massage.

The Grid foam roller by Trigger Point Therapy for self massage

This is the foam roller I recommend: The Grid by Trigger Point Therapy

What is causing your pain?

There are usually multiple factors that lead to pain: 

• how much you move

• the way you move

• how you manage stress

• what kind of shoes you wear
• your history of injuries

Each of these things play a role in how you feel.

What is causing your pain?

This is a question I attempt to answer many times each week.  My most common answer is:

duration x repetition = pain

When movement hurts, it can usually be traced back either to a repetitive movement pattern or a repetitive lack of movement pattern — how much time you either repeat a single movement or maintain a specific position.  Both repetitive movement and lack of movement create stresses within the fascial system.

Fascia is a three-dimensional continuous web of connective tissue that wraps around your body from the bottom of your feet to the top of your head. Fascia surrounds your muscles, tendons, ligaments, bones and organs. Fascia is the organ system that gives your body shape and plays a fundamental role in your posture.

The way you move each day determines the shape and well-being of your fascia and the structure it supports, your body. If, for instance, you sit for long hours each week (duration and repetition), the fascia in your hips, shoulders, and neck will begin to form adhesions at the folds of your fascia in these positions.  These adhesions impinge upon your body’s “working parts;” bind the head, shoulders, and pelvis into a forward position; create trigger points; and restrict range of motion.

Over time and repetition, these adhesions become semi-permanent obstructions that change your body’s shape. The change in shape shifts the balance of the body, placing stress and strain throughout.  This leads to the tightness, discomfort, and pain that many people feel in their back, knees, neck, or shoulders.

Given enough time and repetition, it may lead to more serious structural injuries, i.e., tears of the soft tissue in the shoulder, herniation of vertebrae, or wearing down of the cartilage in the knees and hips.

Below is a short list of tools that you can utilize to help remove adhesions, restore joint mobility, improve circulation, and reduce chronic injury and pain.

1. Deep tissue massage therapy is one of the most effective methods of breaking down painful adhesions in the body. Deep tissue therapies such as myofascial release and trigger point therapy can remove painful trigger points, restore functional range of motion, speed the healing process, and reduce chronic pain.  Recommended weekly, bi-weekly, or monthly deep tissue therapy session.

2. Foam roller therapy is a fantastic tool for breaking down restrictive fascia, improving flexibility and functional range of motion, aiding the recovery and healing process, and reducing chronic pain.  A foam roller is, in my opinion, the best investment for your fitness and health.

3. Corrective exercise is vital to regain and maintain full movement patterns. The body is designed to move with great ranges of motion with agility, stability, speed, and power. It is important to use your body in the way it was designed to move.

 

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 

[email_link]

Deep Tissue Massage Therapy

Are you suffering from chronic pain in your back, neck, shoulders, or knees?  Deep tissue massage therapy can help.  Deep tissue massage utilizes a variety of techniques designed to alleviate symptoms of chronic pain, increase functional range of motion, and improve posture.

The goal of deep tissue massage therapy is to break down adhesions in the fascial tissueAdhesions are fibrous bands of scar tissue that bind together normally separate tissues.  Adhesions restrict the flow of blood, oxygen and waste products; limit joint range of motion; and are the primary cause of most soft-tissue pain and discomfort.  It is common for adhesions to form between fascial tissue and to the muscles, tendons, ligaments, bones, or organs that it surrounds.

Adhesions are commonly caused by inflammation or injury due to an accident such as a fall or car crash; poor bio-mechanical movement patterns such as walking, running, or other highly repetitive activities; scar tissue from an old injury or surgery; lack of movement from sitting for long hours each day; or even the day to day stresses of life.

As adhesions are broken down, you will experience an increase in joint range of motion; reduction in the symptoms of pain and discomfort; and an improvement in the ability to maintain a healthy pain free posture.

Deep tissue massage can benefit anyone who is suffering from chronic pain, tight muscles, restricted range of motion, or stress.

Feel better with deep tissue massage therapy with Jesse James Retherford.

Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

 
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Getting in Touch With Your Pain

Pain is not a bad thing.  It is not a good thing either. Pain is a form of communication our bodies have with us to tell us something is going on.  Sometimes it is from pushing ourselves to the extreme, the burn in our lungs and legs with a hard run or the two-day soreness from an intense strength training workout.  At other times, pain is telling us something is wrong.  The problem we encounter is not pain – it is our cultural disconnection from it.  We cushion ourselves from pain every day: with our shoes, in our beds, with our chairs, and with pharmaceutical pain relievers.  The moment pain enters our bodies we are searching for immediate ways to not feel it anymore.  This cultural disconnection has removed us from our greatest line of defense against experiencing unneeded pain over the length of our lives… the ability to listen and learn to what pain is telling us.

Pain may be a sign of underlying issues.

I have experienced a great deal of physical pain in my life.  The work I do today is founded from learning to manage the pain I felt in my life.  In the beginning, I would ignore pain, continue to push myself harder and overcome it.  This direction only led to more pain.  As I grew older and more experienced in my practice I learned a simple lesson: I could not run away from my pain.  The more I tried to ignore it, the larger it grew until I was absolutely forced to deal with it head on.  The longer I let the pain fester, the greater the injury I found beneath it and the longer it took to heal and recover from that injury.  I learned that pain is a signal of an underlying issue.  Pain does not happen without reason; there is always a root cause.  Find and fix the root cause of pain and the pain will be gone.  Fix the injury beneath and there is no reason for pain to exist.  Let the problem fester and the injury grows and the recovery becomes more challenging.  The sooner one focuses on their pain, the sooner they are on the fast path to recovery and living pain free.

Most pain comes from postural dysfunction.  It is the movements in our lives, or lack of movement, that causes pain.  Our bodies were designed to move with great ranges of motion; with power, strength, and endurance.  As a culture we do not use our bodies design purpose.  We lay or sit motionless for most of our lives.  We sit for long hours each day: in school, college, work, in our cars, on our couches and then in our beds.  This lack of movement wreaks havoc on our posture.  Over time our posture molds to the movement patterns, or lack thereof, we utilize the most.  By not utilizing the functional design of our bodies we create injury within our posture.  Over time this postural injury creates pain to let us know that something is wrong.  Or bodies use pain to signal that something needs to change in our lives or the problem will get worse.

The tools to treat most pain are inexpensive and readily available.

With a foam roller, softball (or other massage tools), full body flexibility program, and an exercise program that incorporates functional movement patterns, the chronic pains associated with postural dysfunction can be managed very effectively.

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Jesse James Retherford is a certified personal trainer and licensed massage therapist.  For over 12 years, Jesse has been passionate about helping his clients reach their fitness and health goals.

Jesse specializes in chronic pain and injury management, movement assessment, corrective exercise, and advanced sports conditioning.

Jesse offers personalized programs designed to improve performance and efficiency, reduce chances of injury, and allow you to move pain free so you can re-engage fully with your life.

Reposting is permitted as long as it is posted in its entirety, including links, and author’s bio.

Fascia and its relationship with pain

What is Fascia?

Fascia is a continuous web of connective tissue that exists throughout your body. Your muscles, tendons, ligaments, bones, and organs are connected through this web, binding these structures together and creating a three-dimensional matrix that connects you from the top of your head to the tips of your toes. It consists of several layers: a superficial fascia, a deep fascia, and a subserous fascia. For the purpose of this discussion, I will talk about deep fascia.

Deep fasciae are tough, dense connective tissues surrounding individual muscle fibers, muscle bundles, and groups of muscles. Fascia shares many of the same properties as muscle, allowing it to contract, relax, and hold tension, just like muscle tissue. Fascial tissues are full of nerves — including sensory receptors to detect pain — and also play an important role in movement derived from muscles, tendons, and joints (proprioception).

Imagine plastic wrap. Your muscles are wrapped tightly in multiple directions by these fasciae. The interconnected nature of fasciae means tightness in one area of your body can be directly connected to painful areas in a completely different area.

What is fascial pain?

Healthy fasciae are relaxed, pliable, elastic and flexible. When you are healthy, your fasciae can absorb the forces that are created when you move.

With trauma or repetitive use injury, adhesions and scar tissue form in the fasciae. When you experience trauma — from a fall or accident or through repetitive strain — the surrounding areas become tight and restricted, affecting range of motion and stability throughout the body. Points of restriction in the fasciae place pressure on nerves, bones, muscles, and adjacent fasciae, causing chronic pain.

Fascial pain is probably the most common cause of musculoskeletal pain (Imamura et al 1997 as cited by Starlanyl and Copeland 1996, Starlanyl 2003, and Javaid 2010). If you are experiencing acute or chronic pain, fascial dysfunction may be the underlying cause of your symptoms.

Deep Tissue Fascial Massage

Deep tissue fascial massage therapy is a form of soft tissue therapy used to treat pain and restore range of motion. This is accomplished using traction, stretching or direct pressure; relaxing contracted muscles; increasing circulation; increasing venous and lymphatic drainage; and stimulating the stretch reflex of muscles and overlying fasciae.

The end result is fasciae that are softened and stretched, with the release of painful knots.

References

Imamura, S.T., T.Y. Lin, M.J. Yriyrits, S.S. Fischer, R.J. Azze, L. A. Rosgano and R. Mahar. 1997. The importance of myofascial pain syndrome in reflex sympathetic dystrophy.” Physical Medicine and Rehabitation Clinics of North America. 8:207-211.

Javaid, Ahmad. Myofascial pain: Understanding the Injury Process. 2010. http://ahmadjavaid.com/myofascial%20pain.htm

Starlanyi, Devin J., and Mary Ellen Copeland, Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual. 2001. Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual. http://www.friendswithfibro.org/mps.html

Starlanyi, Devin. 2003. Fibromyalgia and Chronic Myofascial Pain: Keys to Diagnosis and Treatment. http://homepages.sover.net/~devstar/physinfo.htm

Ward, Patrick. 2010. Notes on Fascia. http://optimumsportsperformance.com/blog/?p=133
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