– Myofascial Release

hand therapy – Myofascial Release is a manual massage technique (using no oil, usually clothed) for releasing bonds between fascia and integument, muscles, tendons, ligaments and bones, in order to reduce pain and increase mobility, fluidity and range of motion. For some techniques, client is best clothed, and for others unclothed without or with oil. Light to strong force may be used with various techniques, frequently beginning distally of where symptoms are prevalent- the problems may be elsewhere from the pain and stiffness. Methods may include sustained or effleuraging shear, tension (pulling), compression, skin rolling, and barefoot deep tissue, sometimes coupled with active or passive joint motion, with or without stretching.

Myofascial release is one of the modalities used by sports massage therapists and physical therapists, and exists in many different forms. Most clinical therapists use direct pressure methods, such as Rolfing®. Lighter or slower techniques, such as Bowen Technique, use more time to release the layers. Paul, with a background in sports massage and Trigger Point Therapy, trained under John Harris, David Dallmeyer, P.T. and Lamar Bush.

The goal of myofascial release is to release fascial restrictions and allow the layers to move freely, thus allowing the muscles to shorten as well as to lengthen, as they should in a healthy human body. Surprisingly, a muscle may appear tight due to the opposing muscle being restricted from shortening. This modality is sometimes confused with Myofascial Pain Syndrome and Trigger Point Therapy, which is a completely different modality. However most myofascial pain and dysfunction can be attributed to fascial restrictions and/ or trigger points, thus the two modalities of Myofascial Release and Trigger Point Therapy are usually effective, non-invasive options for relief of various types of myofascial pain, including fibromyositis, fibrositis and other conditions which are sometimes labeled idiopathic fibromyalgia syndrome due to inadequate or erroneous diagnoses. Other modalities by Trisoma, such as Deep Tissue and Proprioceptive Neuromuscular Facilitation (PNF) also help release fascia.

Restricted fascia is a common contributing cause of seemingly tight and painful muscles, and restricted joint mobility. Although massage that affects muscles also affects fascia, the effects of myofascial massage specifically may be more potent.[4]The nervous system’s response to physical manipulation of the surface or underlying tissues of the body causes reflexive effects including:

  • increased blood and lymph flow
  • slowed heart rate
  • slowed respiration
  • increased immune response
  • muscle tonus reduced
  • pain reduction
  • stress reduction
  • general relaxation

Fascia are sheaths or bands of fibrous tissue that bind muscles and other organs. The main factors that induce fascial abnormalities are trauma, chronic strain, and immobility of fascial tissues.[1]Injuries, stress, overuse, dehydration and poor posture contribute to restrictions in the layers due to bonding of fascia. In response to physical stress, fascia may reorganize itself and thicken and shorten along lines of tension.[2] This affects motion of the neck, back, arms, legs, feet and elsewhere. Fascia can become more fibrotic when traumatized or overused, and it tends to web after periods of immobility, causing collagen molecules to tether together, leading to fibrosis. When muscle tissue, fascia and other tissues are damaged, the body tends to quickly patch the area with scar tissue which does not necessarily match the original composition; it becomes less elastic, less vascularized, less innervated, less oriented and thus poorer in performance, and possibly numb or painful. When a muscle is stretched, its fascia is also lengthened. If the muscle’s fascia is stuck to other layers of fascia, soft tissue, bone or other organs, tightness may be felt locally and in other areas, limiting muscle elongation, when muscle tightness may not be the actual problem. Myofascial stretching or release in one area of the body may be felt in, and may affect, other body areas. When one considers the many layers of broad tissue that the back has, it becomes clearer why myofascial issues can contribute to back trouble even when people do not feel overworked.

Fascia covers all organs, including muscles, of the body, and has two types. Superficial fasciais fibroareolar tissue and is found immediately beneath the integument over almost the entire surface of the body. It contains fat, and connects the skin with the deep fascia. Deep fasciais a dense, inelastic, parallel fibrous membrane, forming sheaths for individual muscles (epimysium) and internal organs and structures, and in some cases, such as intermuscular septa and tendons, affording them broad surfaces for attachment to aponeuroses or periosteum (bone). Examples are Tensor fasciæ latæ and Glutæus maximus in the thigh, Palmaris longus in the hand and Biceps bracchii and Biceps femoris. Targets of myofascial release include adhesions of superficial and deep fascia, integument, tendons, ligaments, retinacula, aponeuroses, bursae, bone, muscle and other organs.

Myofascial Release separates the layers of fascia from one another and from muscle and periosteum,

and it also increases the distance between the collagen fibers, allowing for increased hydration, nutrition and a decrease in capillary compression. Many people believe that lack of mobility is prima facie evidence of tight muscle strands. Trisoma believes that the muscle stretch reflex has an effect on the release of fascia. After myofascial release, many people, even highly mobile and flexible athletes, find that mobility may be improved by release of the fascia layers that can limit the extension and contraction of various muscles.

As with muscle contraction theories and muscles stretch theories, the exact mechanism for myofascial release is still disputed. Some theorize that there is a water bond or collagen bond between fascia layers. Some state that vibrational resonance or emotional unwinding affects consciousness and allows healing.[3] Paul analogizes Myofascial Release with pulling apart a chicken carcass, or pulling the body out of a shrimp tail. If one pulls with the proper force and technique for the situation, fascia and muscles (meat) will be separated; if one pulls hard, unknown results can occur; if one pulls slowly, it might happen… or you might go hungry.

Self-help is possible with one’s own hands, or tools such as Body Stick or foam rollers.
References
1. Lowe, Dr. John C. The Purpose and Practice of Myofascial Therapy, Houston, McDowell Publishing Co., 1989 (Return to Reference 1 in text)
2. Singer, D. W., Manual Therapy Techniques, Rehab Management, June/July 1994, 153-56 (Return to Reference 2 in text)
3. John F. Barnes, et al. (Return to Reference 3 in text)
4. Marian Wolfe Dixon, Myofascial Massage, Lippincott Williams & Wilkins, 2006, ISBN 0781748321, 9780781748322, 217 pages (Return to Reference 4 in text)

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