Massages are an absolute miracle for chronic pain
"Muscle is like a raw piece of steak. If you have a raw piece of steak, you can take your thumb and push it straight through," Dr. Chris Stepien explains.
Woah. That's an analogy I hadn't heard before, but the description clicked. Healthy muscles should feel firm but pliable.
Stepien, D.C., C.S.C.S., C.A.P.P., strength coach for Heroes Journey, wasn't just giving me a lesson on the cookability of my soft muscle tissue — he was making a point about pain. "When you cook a steak, you can no longer push your thumb all the way through. When a person has fascial adhesions on their muscles, any soft tissue practitioner will tell you the muscles feel like a well-done steak. These fascial adhesions are like glue on the muscles — the glue causes the texture of the muscle to become thick."
So what's the big deal? According to Stepien, the chronic pain you experience in your low back when you wake up and the kink in your shoulder that just won't go away are most likely traced back to this type of muscle adhesion. "No one talks about it, but the missing link to chronic pain and structural problems is fascial adhesion."
Think about it like plaque buildup in your arteries. As plaque builds, your arteries become more stiff, which ultimately leads to cardiovascular disease. In the same light, the stiffer your muscles become (due to these fascial adhesions), the more problems you're going to have. Your range of motion becomes limited, structural imbalances become probable, pain develops, which then contributes to even more muscle adhesions... and the cycle continues.
The good news is you don't have to resign yourself to chronic pain or functional limitations. Nor do you have to lay out hundreds or thousands of dollars on therapy or fancy pain-relieving contraptions. According to Stepien, all you have to do is start prioritizing soft tissue health by working your muscles and joints through their full range of motion.
"When you want to restore the mechanics of your body, start doing full range of motion functional movements, such as 'ass to grass' squats. Look for a reputed CrossFit coach or yoga instructor — these are two forms of exercise that focus on moving the body through their full range of motion," says Stepien.
But if your range of motion starts plateauing and remains stagnant for a month — for instance, you hit a point of pain or you feel weakness at a certain point during a functional movement that you can't seem to work past — that's when you should start looking for help. "There's no single type of provider that has a monopoly on relieving fascial adhesions — sometimes an excellent massage therapist or strength coach can help you through it. But the best of the best, the cream of the crop, have been trained in manual adhesion release." Sepian cautions that MAR providers can be difficult to find, so you can also look for providers trained in active release therapy.
For now, though, Stepien coaches that "the biggest bang for your buck is to start squatting. Do it at home. You don't even have to do a workout. If you're a beginner, aim for 10 squats, moving as far as you can in your range of motion with good form. If you're intermediate, aim for 25, or more advanced, aim for 40. Work on alignment principles. Let your butt go down as far as it can behind you."
Of course, not all fascial adhesions occur in the lower body, so to help preserve range of motion in the upper body, it's time to work on push-ups. You might hate the thought, but Stepien puts it this way: "Elderly people who fall often can't get back up off the ground. The ability to do a push-up isn't about building muscle mass, but about maintaining use."