One year ago, I started seeing a practitioner for myofascial release therapy to help alleviate pain from Ehlers Danlos Syndrome (I was diagnosed with hypermobile EDS in 2015). The treatments were unlike any massage I’d had before. I’d consider it a mix of physical therapy, massage, and magic. After a few treatments, the headaches I’d had every single day for over a year disappeared. My hands no longer hurt when I pushed a shopping cart. I didn’t have to walk around all day with a heat pack on my shoulders.
According to my practitioner’s website:
Myo (muscle) fascial (fascia) – A band of fibrous membrane covering, supporting and separating muscles. Fascia may be a superficial covering permitting free movement of the skin, or it may be deep, enveloping and binding the muscles.
For a good visual and description of fascia, check out this video.
As I continued to see my therapist every other week, I started talking to him more about my digestive issues. My gastroparesis symptoms had already mostly resolved at that point but I was struggling with really significant reflux… especially as my diet became more and more “normal.”
I’d also been struggling for months with abdominal tenderness, which at one point had gotten so bad that I’d gone to the ER. I’d been thoroughly checked, from my pancreas to my ovaries, and nobody could find a cause.
My therapist explained to me that the symptoms I’d experienced for so many years with gastroparesis, especially abdominal pain and bloating, had likely caused my abdominal muscles and fascia to tighten more and more over time.
The pain response made sense to me. I could picture myself tensing up and curling over my stomach when in pain. Bloating was a bit more confusing. But he explained that men with big beer bellies have some of the tightest abdomens out there. Why? Because its role is – quite literally – to hold your guts in! Think about it, there are no bones there. The bigger the belly, the harder that fascia has to work to hold everything in and the tighter it gets over time. Same for chronic bloating.
Something he pointed out to me that illustrated how tight my abdomen was… you could see my pulse in my belly. I had been asking doctors about this for a decade! The answers ranged from, “I don’t know” to “because you’re so thin.”
Well, the first time he worked on my stomach, that pulse disappeared and it hasn’t returned. My abdomen was apparently so tight around my aorta that it was reflecting my pulse.
So why is myofacial tightness in the abdomen problematic? This is not my area of expertise but I’ll relay it as I understand it. For one, it can cause pain. As this Huffington Post article explains:
Ideally, your fascias should be supple enough to slide, glide, twist and bind like long, thin sheets of rubber. When they’re not functioning properly, signals from the nerve endings are muffled or muted (so you don’t feel comfortable in your own body) or they’re interpreted by your brain as pain and discomfort.
Abdominal pain is a significant and difficult to treat problem for people with gastroparesis. While much of it is certainly related to digestive dysfunction, it makes sense to me that at least some of it maybe due to inappropriately tight muscles and fascia.
The other issue is that these muscle surround our digestive organs and constrictions in the fascia may affect how those organs function. Alleviating reflux and constipation are two things that my practitioner has had good success with in his practice. Again these are often really difficult symptoms for those with gastroparesis to manage and the increasing tightness around the digestive organs might be playing a role.
While I was hesitant to have my stomach worked on at first, as I’ve had horrible experiences with abdominal massage in the past, I’ve gotten near complete relief from both the reflux and the tenderness as a result of these treatments.
Just like everything else, this type of treatment is not appropriate for everyone and not every practitioner will provide the same experience or results. As I said, I’ve had abdominal massages from well-meaning acupuncturists and massage therapists that have left me in agony.
This is a very particular kind of treatment for the abdomen, one that is often referred to as visceral manipulation. You can find a trained VM practitioner here. Click Advanced Search and choose Visceral Manipulation. The results will show you how much training the practitioners have in each specialty.
If it’s something that you’re interested in, I suggest finding someone who is both highly trained and willing to work very slowly with you. Interview various practitioners and choose the one with whom you feel the most comfortable. Here are some tips on selecting complementary therapy practitioners that I share with members of Living (Well!) with Gastroparesis Online Program.
I’m personally a bit weary of practitioner who guarantee that they can cure a particular symptom or problem. Our bodies are all so unique; I prefer an optimistic practitioner who looks at each client as an individual and considers them self a facilitator that assists the body in functioning as well as possible.
My practitioner started very gently with me, not going very deep or using much pressure at all. We progressed slowly from there. I’ve never had more than 10-15 minutes of work on my abdomen per session (it’s done as part of a full-body trigger point therapy treatment) and I imagine that a full hour session might be too much for most people with significant digestive problems. I’d be sure to discuss before treatment so that you know what to expect and whether a shorter session might be more appropriate.
As always, talk with your doctor about all complementary and alternative treatments you receive. While it’s not right for everybody and, to my knowledge, it has not been studied as a treatment for digestive symptoms, if you’re struggling with reflux, pain, and/or constipation, it might be worth looking into.