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Suzanne Harrison

Recreational golfer James Lim had tried many different forms of therapy over a six-month period to fix his frozen shoulder. Then he gave myotherapy a go, and was soon back in the swing of things.
'We set a treatment plan and it took a little time to gain full function, but I was playing golf within a month,' says Lim, a property consultant in his mid-50s.
The term 'myotherapy' references myo - Latin for 'muscle' - and 'fascia', which are thin, fibrous sheets of connective tissue that cover muscles. It's a form of physical therapy used to treat or prevent soft tissue pain and restricted joint movement caused by muscle fascia dysfunction.
Relatively well-established in the US and Australia, it falls under the umbrella of massage therapy, which is considered complementary and alternative medicine. Although relatively unknown in Hong Kong compared to  popular treatments such as physiotherapy and osteopathy, awareness of myotherapy is growing.
When Liam Fitzpatrick, a physiotherapist and myotherapist trained at Australia's Royal Melbourne Institute of Technology, moved to Hong Kong in 2004, he was consulting about 20 to 25 patients a week - 15 for golf training and about five to 10 for myotherapy. These days, about 90 per cent of the some 30 patients he sees a week are specifically for treatment, he says.
 Fitzpatrick, director of MyoActive Back and Sport Injury Clinic  in Central,  believes many professionals are high-functioning type-A personalities who ask a lot of their bodies and therefore suffer overuse injuries and poor musculoskeletal habits. 'Myotherapy addresses this lifestyle exceptionally well, through its clinical assessment and focus on soft-tissue retraining,' he says.
Myotherapy stems from trigger point therapy, pioneered in the early 1940s by the late Dr Janet Travell, who used the technique to treat late president John F. Kennedy's bad back.
Trigger points are the most tender points in a taut band of muscle fibres, and can cause pain and strain in the muscle. The pain from a point may travel a  long distance; pressing on a trigger point in the calf, for example, can reproduce  pain and tenderness in the lower back. By deactivating the trigger points, Travell often found the pain  vanished immediately.
In 1976, Bonnie Prudden,  a US fitness expert, began to theorise that trigger points could be  released by applying manual pressure to the muscle for several seconds with the fingers, knuckles and elbows. She reported that  many patients saw big and fast improvements. Over 10 years, she gradually developed the system now known as myotherapy.
Myotherapy uses  other techniques including massage, passive stretching, hot or cold therapy, myofascial dry needling (acupuncture) and transcutaneous electrical nerve-stimulation therapy. The goal is to avoid future problems by retraining muscles that have been under- or over-functioning.
Katie Palmer, a myotherapist at Physio-Central who also trained at RMIT, says the most common problems she sees are sports injuries, in particular those of the shoulder or elbow, as well as problems with the jaw, head and neck region, and back pain.
Other problems that myotherapists can treat, says Fitzpatrick, include oedema  (swelling of the feet, especially during pregnancy), stiffness and pain associated with poor posture, headaches and migraines, tennis elbow, arthritis, knee, foot and leg pain, shoulder pains, and chronic fatigue syndrome. 
 Abby Yek Cheung, a physiotherapist at PhysioMotion  in Central, says myotherapists play an important dual role with a physio in rehabilitating a patient.
'As physiotherapists, we do a  lot of joint and muscle work ourselves, but if we feel the problem is predominantly muscular, we will refer the patient to a myotherapist to rehab them quicker,' she says. She believes myotherapy can be effective, and that those who practise in Hong Kong have a good reputation among physiotherapists.
Lim, back on the fairway, seconds that. He says: 'I was happy  with the myotherapy approach  and  recommend it.'



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