The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

Vigotsky, Andrew D.; Bruhns, Ryan P.

doi:10.1155/2015/292805

Cited by 59 publications

(48 citation statements)

References 74 publications

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“…40 Furthermore, analgesia induced by techniques such as self-massage could have been mediated by autonomic nervous system (ANS) activity; 41 that is, a shift from sympathetic to parasympathetic tone. The mechanism behind this ANS shift remains unclear, but it can be hypothesized that certain hormones and neuropeptides may be at play given that massage has been associated with changes in stress hormones 42 (e.g., cortisol) and neuropeptides 9 (e.g., endogenous opioids, oxytocin and endocannabinoids), and that the aforementioned hormones and neuropeptides that are associated with a sympathetic shift also play a role in descending modulatory pathways, 43,44 which could account for changes in ROM. In essence, descending inhibition may have a role in stretch tolerance and, due to its diffuse nature, may explain the non-local effects observed in this study and others.…”

Section: Resultsmentioning

confidence: 99%

“…These effects were hypothesized to be attributable to a central opioidergic response, which could also account for the improvements in ROM observed in this present study. 9 Specifically, in more noxious variations of massage therapy, such as selfmassage, a descending inhibitory response is elicited via endogenous opioids and other neuropeptides acting on the periaqueductal grey and rostral ventromedial medulla. 9 On a psychological level, such effects may be modulated by expectations, 39 which have been shown to affect force inhibition/facilitation still relevant.…”

Section: Resultsmentioning

confidence: 99%

“…1 Neurophysiological mechanisms can be divided into two primary submechanisms, 1 spinal -associated with mechanoreceptors within muscle and fascia 1,8 -and supraspinal -which include central pain modulation and descending noxious inhibitory control -both of which have been asserted to mediate perception. 6,9 While self-massage has been shown to increase ROM in the majority, 1 but not all, 6 of investigations, the degree of ROM increase has been variable. 1 These differences in outcomes may not only be due to the muscle group treated, overall volume of treatment, and differences in the applied pressure, but also the type of the tool used, 1 particularly since it has been suggested that even the type of foam roller can have an effect on pressure that is applied to the underlying area.…”

Section: Introductionmentioning

confidence: 99%

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Acute Effects of Different Anterior Thigh Self-Massage on Hip Range-of-Motion in Trained Men

Monteiro

Vigotsky

Škarabot

2018

Intl J Sports Phys Ther

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Background: Self-massage is a ubiquitous intervention similar to massage, but performed by the recipient him-or herself rather than by a therapist, most often using a tool (e.g., foam roller, roller massager). Self-massage has been found to have a wide range of effects. It is particularly known for increasing flexibility acutely, although not always. The variability of the results in previous studies may potentially be a function of the tool used. Recent findings also suggest that self-massage exerts global effects. Therefore, increased flexibility should be expected in the areas adjacent to the ones treated.Purpose: To investigate the acute effects of foam rolling and rolling massage of anterior thigh on hip range-of-motion (ROM) -i.e., hip extension and hip flexion -in trained men.Methods: Eighteen recreationally active, resistance trained males visited the lab on two occasions over a 4-day period separated by at least a day. Each session included two baseline ROM measures of passive hip flexion and extension taken in a randomized fashion. Recording of baseline measures was followed by the intervention of the day, which was either foam rolling or rolling massage of the anterior thigh as per randomization. Immediately post intervention, passive hip flexion and hip extension ROM were reassessed. In order to assess the time course of improvements in ROM, hip flexion and hip extension ROM were reevaluated at 10, 20, and 30 minutes post-intervention.Results: Hip flexion and hip extension ROM increased immediately following both interventions (foam rolling or roller massager) and remained increased for 30 minutes post intervention. Foam rolling was statistically superior in improving hip flexion and hip extension ROM immediately post intervention. However, immediately post-intervention was the only time point that measurements exceeded the minimum detectable change for both interventions. Conclusion:Both foam rolling and rolling massage appear to be effective interventions for improving hip flexion and extension ROM when applied to the anterior thigh, but the observed effects are transient in nature. Level of evidence: 2b

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Effects of Different Anterior Thigh Self-Massage on Hip Range-of-Motion in Trained Men

Monteiro

Vigotsky

Škarabot

2018

Intl J Sports Phys Ther

Self Cite

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“…Neste cenário, é possível observar três pontos: 1) presença de mecanorreceptores dentro do tecido muscular e fascial, os quais exercem efeitos inibitórios 14,29,30 ; 2) modulação central da percepção de dor 28,31 ; 3) analgesia induzida pelas técnicas de terapias manuais, principalmente, pelo aumento da liberação hormonal, como do canabidiol endógeno. Todos esses pontos destacados permitem que o indivíduo aumente a sua percepção/tolerância ao estiramento, o que consequentemente permite um maior arco articular.…”

Section: Discussionunclassified

Efeitos da Liberação Miofascial Sobre a Flexibilidade: uma Revisão Sistemática

Silva¹,

Monteiro

Neto

et al. 2017

J. Health Scie.

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ResumoAs evidências contemporâneas sobre os ganhos de flexibilidade em função da técnica de liberação miofascial ainda apresentam resultados inconclusivos. Portanto, o objetivo do presente estudo foi revisar, de forma sistemática, as evidências sobre os efeitos da liberação miofascial sobre os ganhos de flexibilidade. A busca dos artigos foi realizada no Google Acadêmico até maio de 2017, com a aplicação dos seguintes descritores: "liberação miofascial", "flexibilidade" e "foam roller". Foram encontrados 22 artigos e após a aplicação dos devidos critérios de inclusão e exclusão, quatro investigações apresentaram elegibilidade para compor a presente revisão. As evidências encontradas, de maneira totalitária, apontam a eficiência da liberação miofascial em promover aumento nos ganhos de flexibilidade, seja de forma aguda ou crônica. Sendo assim, sob a égide das evidencias em tela, sugere-se a liberação miofascial como uma estratégia pertinente e eficiente, em sua aplicação, no que diz respeito aos ganhos de flexibilidade. Palavras IntroduçãoA liberação miofascial -LMF -é uma técnica similar às demais técnicas de terapia manual, possuindo característica passiva, a qual é realizada por profissionais da área da saúde, utilizando as mãos, cotovelos, dedo ou instrumentos específicos como o stick 1 . A sugestão é que esta técnica seja realizada em movimentos de cisalhamento entre a pele e a fáscia 2-4 . A fáscia é entendida como uma rede tensional de tecido conjuntivo, que envolve todas as estruturas do corpo humano, como os músculos, vísceras e endotélio 2,3,[5][6][7][8] . Como os demais componentes articulares moles tendem a acumular tensões provocadas interna e externamente e vagarosamente começam a perder sua funcionalidade 9,10 . Então, a principal finalidade da técnica de LMF é diminuir as adesões fibrosas nas redes fasciais 11 e, por consequência, reverter a perda de energia da estrutura, após forte estresse mecânico (histerese), possibilitando o retorno da funcionalidade das redes fasciais 10,12,13 . Uma das principais místicas, que envolve as técnicas de terapias manuais é acreditar que as mesmas são capazes de remodelar os componentes fasciais e permitir uma maior complacência do tecido e, consequentemente, aumento na flexibilidade. Entretanto, até o presente momento, a literatura não sustenta essa afirmativa [14][15][16] .

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“…These effects appear to be mediated by the autonomic nervous system, with modulation of sympathetic and parasympathetic tone [18]. The autonomic nervous system mechanisms are not clear enough, but massage has been associated with changes in stress hormones (cortisol and neuropeptides), endogenous opioids, oxytocin, endocannabinoids, dopamine and serotonin [19,20].…”

Section: Short Communicationmentioning

confidence: 99%

Self-massage and Autonomic Response: Future Direction

Monteiro¹

2017

JESO

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Self-massage (SM) is an active technique where participants use various instruments to apply pressure to soft tissue with an attempt to mimic manual therapy techniques. Within the literature, there are many techniques associating positive responses to the phenomena controlled by the central nervous system (i.e. stretching and manual therapies). The purpose of this short communication is to present the literature regarding similar techniques to SM and their effects on the central nervous system. Furthermore, there is no research investigating the safety of performing SM techniques prior to performance. Considering SM is non-invasive and practical, findings of such research would be applicable in clinical and performance settings. Thus, the authors encourage further research that satisfies the needs of these gaps.

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The Role of Descending Modulation in Manual Therapy and Its Analgesic Implications: A Narrative Review

Cited by 59 publications

References 74 publications

Acute Effects of Different Anterior Thigh Self-Massage on Hip Range-of-Motion in Trained Men

Acute Effects of Different Anterior Thigh Self-Massage on Hip Range-of-Motion in Trained Men

Efeitos da Liberação Miofascial Sobre a Flexibilidade: uma Revisão Sistemática

Self-massage and Autonomic Response: Future Direction

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