Investigation of the Effect of Myofascial Release Applied to Thoracolumbar Fascia on Flexibility, Muscular Endurance and Balance in Healthy Young Adults: A Pilot Study

Fascia, muscles, bones, organs, nerves, it refers to all fibrous ligament tissue under stress that both encompasses and surrounds blood vessels and other structures, and stretches from head to foot in a continuous, three-dimensional network. Fascia is the most sensitive and vital structure in our bodies, linked to systems in the whole body, as vital as blood. This structure is a system of a single tissue fiber that is located directly below the skin. Fascia stretches through the whole body in lines for a locked-in feel. Thoracolumbar fascia (TLF) is an important structure that connects the lower extremity to the gluteus maximum and the upper extremity to the latissimus dorsi. The thoracolumbar fascia allows trunk stabilization in kinetic chain activities including movements such as throwing. The thoracolumbar fascia surrounds different trunk muscles, such as the multifidus, erector spines, and quadratus lumborum and provides support when these muscles contract. It also attaches to the internal oblique, transversus abdominis, latissimus dorsi aponeurosis and serratus anterior inferior muscle. Contraction of these muscles increases tension along the fascia and stabilizes the trunk by providing 3-dimensional support to the lumbar spine.

The fasciae of the transversus abdominis, internal oblique and quadratus lumborum muscles are surrounded by the thoracolumbar fascia. The transversus abdominis muscle stabilizes the lumbo-pelvic region by stretching the thoracolumbar fascia and increasing intra-abdominal pressure. Thoracolumbar fascia, lower extremity and upper extremity acts as part of a pulley around the body, which provides a connection. Fascia disorders are often associated with adaptive misuse of muscles. For this reason, myofascial treatment is usually supported by appropriate exercises that the person will do. In this way, while creating a conscious awareness of the normal function of the patient in that muscle, it can reprogram the brainstem to incorporate the newly restored full-scale muscle capacity into the patient's daily activities.

In recent years, the popularity of training has increased with the foam roller, which is one of the myofascial treatment methods. Foam roller massage is a relatively new technique and a common form of self-myofascial training performed by participants themselves and not by a clinician. The foam roller is a solid foam cylinder available in different stiffness and size. Athletes or patients are encouraged to rotate their body weights to operate each muscle group and loosen tight areas of the muscle. A possible effect is better moisturizing of tissues. While applying the foam roller massage, the soft tissue is squeezed like a sponge and then wetted with liquid, which improves the movement between the different layers of the fascia. This method, which affects the muscle and myofascial structures by increasing the compatibility and extensibility of the fascia, reduces passive muscle stiffness. It can also reduce delayed onset muscle soreness after intense exercise. Self-myofascial release has been shown to provide a wide range of positive gains in physical performance. The best-known positive effect of self-myofascial release is a gain in flexibility as assessed by increased range of motion in sports and rehabilitation contexts. Scientifically, many positive effects of foam roller massage are assumed, but in most cases unproven. Most studies of self-myofascial release techniques address the acute effects, while there is limited clinical research on the training effects of foam roller massage. The sample will be adults between the ages of 18-40. Investigators will announce the research via social media and invite volunteers to work. Participants who are willing to participate will be explained the study and participants who agree to participate and who meet the work criteria will be included in the study. Participants will be divided into 3 groups as Myofascial Release and Exercise Group, Exercise Group, and Control Group using the computerized randomization method. Since the study is pilot operation, no power analysis has been performed to determine the sample size. Investigators aim to have at least 12 people in each study group. The first evaluation of the participants will be made before starting the 4-week program. Final assessments will be made within 2-3 days after the 4-week training ends. Evaluations will include flexibility measurements, muscular endurance measurements, balance evaluations. The study will have a single-blind design. The investigator making the evaluation will not know which group the participant is in.