What is Myofascial Release?
Myofascial Release (MFR) is a very effective hands-on technique that provides sustained pressure into myofascial restrictions to eliminate pain and restore motion. The theory of Myofascial Release requires an understanding of the fascial system (or connective tissue). The fascia is a specialized system of the body that has an appearance similar to a spider's web or a sweater.
Fascia is very densely woven, covering and interpenetrating every muscle, bone, nerve, artery and vein as well as all of our internal organs including the heart, lungs, brain and spinal cord. The most interesting aspect of the fascial system is that it is not just a system of separate coverings. It is actually one structure that exists from head to foot without interruption. In this way you can begin to see that each part of the entire body is connected to every other part by the fascia, like the yarn in a sweater.
Fascia also plays an important role in the support of our bodies, since it surrounds and attaches to all structures. These structures would not be able to provide the stability without the constant pull of the fascial system. In fact, our bones can be thought of as tent poles, which cannot support the structure without the constant support of the guide wires (or fascia) to keep an adequate amount of tension to allow the tent (or body) to remain upright with proper equilibrium.
In the normal healthy state, the fascia is relaxed and wavy in configuration. It has the ability to stretch and move without restriction. When we experience physical trauma, scarring, or inflammation, however, the fascia loses its pliability. It becomes tight, restricted and a source of tension to the rest of the body. Trauma, such as a fall, whiplash, surgery or just habitual poor posture over time as well as repetitive stress injuries has a cumulative effect. The changes they cause in the fascial system influence comfort and the functioning of our body. The fascia can exert excessive pressure producing pain or restriction of motion. They affect our flexibility and stability, and are a determining factor in our ability to withstand stress and strain.
The use of Myofascial Release allows us to look at each patient as a unique individual. Our one-on-one therapy sessions are hands-on treatments during which our therapists use a multitude of Myofascial Release techniques and movement therapy. We promote independence through education in proper body mechanics and movement, through the enhancement of strength and flexibility as well as postural and movement awareness.
Look carefully at Fascia Man. Can you see how a restriction in the upper back could cause pain in the knee? Or a restriction in the low back could cause neck pain? A restriction in your right hip can cause pain in the left hip because the left hip is being pulled out of alignment from the opposite side of the body. When only your symptoms are looked at and treated, the cause of the pain will not be found. How many times have you had a pain and were told that there was nothing wrong?
Let me give you a simplified example: If I wrap a piece of duct tape around your ankle, I have created a restriction. If you were to run down the hall, this restriction will change the way your foot hits the floor. This will change the way your knee tracks and eventually may end up with causing your back to hurt. And usually, the weakest link is where you feel the pain first. Treating your back will not eliminate the pain because the restriction is still around your ankle.
Here's another example: Let's say that you fell when you were a child and landed on your right hip. Being a child, you got up and continued playing. But as time went on, the fascia in that area began to harden and tighten down. As this continued, your left (opposite) hip began to hurt. After suffering for a while, you go to your doctor and say, "My left hip hurts." Your doctor takes x-rays and performs any other test that seems appropriate and then tells you there is nothing wrong with your left hip. And your doctor is right! The problem isn't in your left hip but it continues to hurt and you are probably becoming quite frustrated.
When you come for Myofascial Release treatments, we will find your pain but we will look elsewhere for the cause! Many times, the cause of your pain is on the opposite side of your body. In the first example, when we release the restriction at your ankle, your foot will begin to hit the floor properly which will help your knee track correctly, which in turn will help alleviate your back pain. You might have some therapeutic pain after the treatments as your body begins to adjust, but as your body aligns properly, the pain should subside. In the last example, because the restriction is pulling on your left hip, when we release the restriction in your right hip, your pain should subside.
Myofascial Release (MFR) is a relatively new addition to treatment options in Arkansas. Because it is different from traditional therapy, many patients ask questions such as "What is it?" and "How does it work?" Myofascial Release is generally an extremely mild and gentle form of stretching that has a profound effect upon the body tissues. Because of its gentleness, many individuals wonder how it could possibly work. To help you understand, we are providing you with this article.
Fascia (also called connective tissue) is a tissue system of the body to which relatively little attention has been given in the past. Fascia is composed of two types of fibers: A) Collagenous fibers which are very tough and have little stretchability; B) Elastic fibers which are stretchable. From the functional point of view, the body fascia may be regarded as a continuous laminated sheet of connective tissue that extends without interruption from the top of the head to the tip of the toes. It surrounds and invades every other tissue and organ of the body, including nerves, vessels, muscle and bone. Fascia is more dense in some areas than others. Dense fascia is easily recognizable (for example, the tough white membrane that we often find surrounding butchered meat).
Because fascia permeates all regions of the body and is all interconnected, when it scars and hardens in one area (following injury, inflammation, disease, surgery, etc.), it can put tension on adjacent pain-sensitive structures as well as on structures in far-away areas. Some patients have bizarre pain symptoms that appear to be unrelated to the original or primary complaint. These bizarre symptoms can now often be understood in relationship to our understanding of the fascial system.
The majority of the fascia of the body is oriented vertically. There are, however, four major planes of fascia in the body that are oriented in more of a crosswise (or transverse) plane. These four transverse planes are extremely dense. They are called the pelvic diaphragm, respiratory diaphragm, thoracic inlet and cranial base. Frequently, all four of these transverse planes will become restricted when fascial adhesions occur in just about any part of the body. This is because the fascia of the body is all interconnected, and a restriction in one region can theoretically put a "drag" on the fascia in any other direction.
The point of all the above information is to help you understand that during myofascial release treatments, you may be treated in areas that you may not think are related to your condition. The trained therapist has a thorough understanding of the fascial system and will "release" the fascia in areas that he knows have a strong "drag" on your area of injury. This is, therefore, a whole body approach to treatment. A good example is the chronic low back pain patient; although the low back is primarily involved, the patient may also have significant discomfort in the neck. This is due to the gradual tightening of the muscles and especially of the fascia, as this tightness has crept its way up the back, eventually creating neck and head pain. Experience shows that optimal resolution of the low back pain requires release of the fascia of both the head and neck; if the neck tightness is not also released it will continue to apply a "drag" in the downward direction until fascial restriction and pain has again returned to the low back.
Muscle provides the greatest bulk of our body's soft tissue. Because all muscle is enveloped by and ingrained with fascia, myofascial release is the term that has been given to the techniques that are used to relieve soft tissue from the abnormal grip of tight fascia ("myo" means "Muscle").
The type of myofascial release technique chosen by the therapist will depend upon where in your body the therapist finds the fascia restricted. If it is restricted through the neck to the arm, he/she may apply a very gentle traction to the arm, very slowly moving the arm through range as restrictions are released. If it is restricted in the back (more superficial than deep) he may apply a very gentle stretch on the skin across the back, with the use of two hands. If the thoracic inlet, deep transverse fascia is suspected of being restricted, the therapist may place one hand on the upper back and one over the collarbone area in front and apply extremely gentle pressure.
A key to the success of myofascial release treatments is to keep the pressure and stretch extremely mild. Muscle tissue responds to a relatively firm stretch, but this is not the case with fascia. Remember the collagenous fibers of fascia are extremely tough and resistant to stretch. In fact, it is estimated that fascia has a tensile strength of as much as 2000 pounds per square inch. (No wonder when it tightens, it can cause pain.)
However, it has been shown that under a small amount of pressure (applied by a therapist's hands) fascia will soften and begin to release when the pressure is sustained over time. This can be likened to pulling on a piece of taffy with only a small, sustained pressure.
Another important aspect of myofascial release techniques is holding the technique long enough. The therapeutic affect will begin to take place after holding a gentle stretch and following the tissue three dimensionally with skilled, sensitive hands.
Myofascial Release is gentle, but it has profound effects upon the body tissues. Do not let the gentleness deceive you. You may leave after the first treatment feeling like nothing happened. Later (even a day or two later) you may begin to feel the effects of the treatment.
In general, acute cases will resolve with a few treatments. The longer the problem has been present, generally the longer it will take to resolve the problem. Many chronic conditions (that have developed over a period of years) may require three to four months of treatments three times per week to obtain optimal results. Experience indicates that fewer than two treatments per week will often result in fascial tightness creeping back to the level prior to the last treatment. Range of motion and stretching exercises given to you will, however, keep this regression between treatments to a minimum.
Frequently there is increased pain for several hours to a day after treatment, followed by remarkable improvement. Often remarkable improvement is noted immediately during or after a treatment. Sometimes new pains in new areas will be experienced. There is sometimes a feeling of lightheadedness or nausea. Sometimes a patient experiences a temporary emotion change. All of these are normal reactions of the body to the profound, but positive, changes that have occurred by releasing fascial restrictions.
It is felt that release of tight tissue is accompanied by release of trapped metabolic waste products in the surrounding tissue and blood stream. We highly recommend that you "flush your system" by drinking a lot of fluid during the course of your treatments, so that reactions like nausea and lightheadedness will remain minimal or nil.
If patients have any questions or concerns that arise concerning myofascial release, they should be encouraged to discuss them with their therapist.
Reprinted with permission of RPI
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