The Massage Therapist’s Guide to Myofascial Release

2_12_MyofascialCornerstone (1) Myofascial release involves slow, sustained pressure applied by the hands to areas where fascial tissue restricts mobility and may cause pain.

The movement stretches the skin and fascia underneath, freeing up fluid within layers of tissue. The pressure used is gentle yet is believed to reach deeper layers of muscle and nerves than deep forms of bodywork.

Chronic pain is threatening our quality of life, with approximately 50 million sufferers in the U.S. alone. These latest statistics released by the U.S. Centers for Disease Control and Prevention leads us to explore a modality within massage that has had positive results in pain relief in recent studies.

MASSAGE Magazine spoke to leading experts in the field of myofascial release, and what they reveal about fascia and pain relief could persuade massage therapists to incorporate this gentle technique that affects deep layers of connective tissue. The mechanisms behind myofascial release’s effects on pain are not well understood. More research is needed to understand the physiological (as well as its psychological or other) mechanisms of this form of bodywork.

However, Til Luchau , author of Advanced Myofascial Techniques and lead trainer of Advanced Trainings, said that one clue might be the nerve endings embedded in fascial tissue.

“Anywhere there is a nerve in the body there is fascia,” Luchau said. The ability of a nerve to respond to its environment is related to the qualities of the fascial tissue that surrounds it, he explained.

Tom Myers , coauthor of Fascial Release for Structural Balance and international speaker on myofascial techniques, considers myofascial release a form of therapy and education between client and massage therapist.

“Most people create pain for themselves by having inefficient, accumulated patterns of movement,” Myers said. With myofascial release, “we are helping them move differently.”

The effectiveness of the myofascial release technique on pain relief depends how far along an individual is in that process. The sooner a client starts the process of recovery, the easier that journey will be.

“In relieving things like sciatica, lower back pain and shoulder pain, if it is in the beginning of that process you have a good chance of relieving it with myofascial release,” said Myers. “If it’s been so long that the joint has degenerated or there has been tissue damage beyond a certain point, then myofascial release is not going to be as helpful.”

There is a mind-body component to how myofascial release works that floats around the edges of the energy body and physical body of a person. John F. Barnes , PT, who has been immersed in the field for over 50 years, said to understand myofascial release, one must observe the survival mechanism of our body which is composed of our feeling intelligence and thinking intelligence.

“When things get too intense for us, too painful or too scary, we pull our feeling intelligence out of our body—which is very different from our thinking intelligence,” he said. “Our feeling intelligence is the wisdom of the energy body. And we do that to numb ourselves out, to be able to save our life.”

Barnes said that fascia becomes restricted from trauma, surgery and thwarted inflammatory responses that can produce up to 2,000 pounds per square inch of pressure. The equivalent of a full-grown horse standing on a nerve.

Here’s a way to understand this perspective: Imagine being in a car accident with a truck and how frightening that collision can be. Although the actual collision may last seconds, to the subconscious mind it is being replayed over and over. The body tenses up in response to this and enters a constant state of internal tension that solidifies the fascial system and continues to spread. The result is more and more symptoms and more and more pain. Barnes refers to it as the broken-record effect.

“It creates internal anxiety, internal tension, increased fascial restriction and creates chaos in our physiological system,” he said. “When we do myofascial release, the memories express themselves. And the subconscious perceives you are safe and can let go of its iron grip on you. And it is like an iron grip. [With myofascial reelase,] now the healing can occur.”

As with virtually all systems of bodywork, there is room for various approaches and evolution. For example, Walt Fritz, PT, believes the myofascial release technique is using light to moderate touch and pressure, and gently stretching the skin and holding until he feels a change. While others in the field consider the feeling of tissue softening a sign of fascia releasing, Fritz sticks to what he is certain of and that’s the skin he is touching.

“I am stretching the skin and trying to reduce pain and improve movement quality. I call what I do myofascial release as it is what I have done with my hands in my physical therapy practice since 1992,” said Fritz. Tom Myers Fascia is the connective tissue that forms a matrix of support around the body and within every layer of the body from our muscles and bones to our muscle cells.

“Fascia surrounds every muscle, every bundle within muscles, groups of muscles, it surrounds every nerve, every artery, every vein, all the lymph vessels. These are all embedded in envelopes of fascial tissue. Fascia is also forms large envelopes around the whole body,” Luchau said.

Magnified under a microscope, fascia looks like spider webs. It has six times more sensory nerve endings than muscle. Like many other systems of the body, fascia is adaptive and responds to stress both externally (environment) and internally (within the body).

Some experts believe that there is an emotional element to fascia that can be further studied in Candace Pert’s book Molecules Of Emotion: The Science Behind Mind-Body Medicine.

Barnes explained, “Due to the intimate relationship with the nervous system, the three-dimensional web of the fascial system and the fluidity that flows through its microtubules appears to carry emotions as neuropeptides that become trapped within the collagenous barriers of the fascial system.”

Despite more research being needed to fully understand fascia and it’s mind-body connection, the importance of fascia in our overall well-being is recognized in the field.

Years ago, fascia was regarded as packing material within the body and thrown out by anatomist during cadaver dissections. The more accepted belief today is fascia is its own system. Medical research and tests are lagging behind evident in that fascia does not show up on MRI scans, CT scans or X-Rays. Many experts believe that fascia is the missing piece of the puzzle to chronic pain and illness. Til Luchau Recent research on the effects of myofascial release for rehabilitation and pain treatment is promising.

• Blood flow, pain and quality of life improved in postmenopausal women with venous insufficiency with a combination of myofascial release and kinesiotherapy. Venous insufficiency is a condition where the walls of the leg veins do not effectively pump blood back to the heart from the legs. Complementary Therapies in Medicine 2012 Oct 20 .

• Fibromyalgia is a chronic condition associated with widespread pain and fatigue that affects approximately 3.7 million American with the majority between the ages of 40 to 75 years old, according to the Arthritis Foundation.

The condition does not affect one system rather is made up of symptoms that also include joint discomfort, sleep disorders, anxiety and depression. Studies have shown that myofascial release improves pain and and quality of life in patients with fibromyalgia. Evidence-based Complementary and Alternative Medicine 2010, Dec. 28 .

• Myofascial release improved shoulder movement, functionality and perceived pain in women breast cancer survivors post surgery.

• Myofascial release was found to increase muscle activity, reduced pain and improved the range of motion on patients with total knee replacement post surgery. Journal of Bodywork and Movement Therapies , 2018, Oct. 22.

• Patients with neck pain and referred pain in the arms had faster rate of improvement with myofascial release than those treated with hot moist packs, transcutaneous electrical nerve stimulation, stretching and strengthening exercises. This study suggested that myofascial release should not be seen as only complementary or alternative therapy.

Myofascial release is not limited to massage therapists. Sports professionals and trainers are using tools such as balls, foam rollers, rods and massagers to apply pressure and stretching for what’s called self-myofascial release . This method lends itself to increasing performance as well as rehabbing an injury. Results have been positive.

A study published in the Journal of Sport Rehabilitation evaluated 14 men who exercised at least twice a week for 45 minutes. They were given a short and long term protocol for self-myofascial release of the ankle and hip.

The results showed that regardless of the protocol self-myofascial release increased ankle dorsiflexion by 11 percent and hip flexion by 6 percent.

Whether it’s anecdotal or evidence based, the promise that myofascial release has in understanding and treating pain is steadily climbing. A search in the National Center for Biotechnology Information database found 235 articles mentioned myofascial release with 50 peer-reviewed articles published between January 2018 and 2019.

Barnes, who has trained over 100,000 therapists in myofascial release, sees a fascia as the link between people […]

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