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Therapies

myofascial release therapy
What Is It?
How Does It Work?
What You Can Expect
Health Benefits
How To Choose a Practitioner
Cautions


What Is It?

A gentle blend of stretching and massage, myofascial release therapy uses hands-on manipulation of the entire body to promote healing and relieve pain. Just as its name suggests--myofascial comes from the Latin "myo" for muscle and "fascia" for band--therapists use the technique to ease pressure in the fibrous bands of connective tissue, or fascia, that encase muscles throughout the body. Sheaths of this dense and elastic connective tissue weave about blood vessels, bones, and nerves as well, forming an intricate, 3-D web that supports your organs and joints from head to toe and acts as the body's shock absorber.

According to practitioners of myofascial release, scarring or injury to this network of connective tissue is a major cause of pain and impeded motion. The therapy's easy stretches aim to alleviate these problems by breaking up, or "releasing," constrictions or snags in the fascia. People with longstanding back pain, fibromyalgia, recurring headaches, sports injuries, and a host of additional complaints (see Health Benefits, below) are all said to benefit from the technique.

The therapy itself is relatively new. Osteopathic physician Dr. Robert Ward of Michigan State University taught the first course entitled "myofascial release" at that school in the 1970s, and references to it first began to appear in the medical literature in the 1980s. However, as a holistic treatment that looks at the body as an integrated whole, its roots go back a long way, to the soft-tissue manipulations and stretches of osteopathy, which was first done in the nineteenth century. The therapy is also reflected in naprapathy, an offshoot of chiropractic and in the soft-tissue manipulations of Rolfing, a form of deep-tissue bodywork created by Ida P. Rolf in the 1930s.

Over the past two decades, physical therapists like John F. Barnes, director of the Myofascial Release Treatment Center in Paoli, PA and Sedona, AZ, have popularized the technique, training thousands of other physical and massage therapists, craniosacral therapists, osteopaths, and chiropractors, among other practitioners, in the method. Indeed, like many alternative therapies, myofascial release is part of a larger philosophy of healing that emphasizes the importance of mind-body interactions and preventive care. It may also be part of a pain management program that would include behavioral health techniques, acupuncture, drug therapy, nutritional counseling, and relaxation techniques.

(For more information on the related therapies mentioned above, see the individual entries in the WholeHealthMD Reference Library.)

How Does It Work?

Myofascial release therapy is based on the idea that poor posture, physical injury, illness, and emotional stress can throw the body out of alignment and cause its intricate web of fascia to become taut and constricted. Because fascia link every organ and tissue in the body with every other part, the skillful and dexterous use of the hands is said to free up, or "release," disruptions in this fascial network. Pressure on the bones, muscles, joints, and nerves is relieved in the process, and balance is restored.

Like a "pull" in a sweater, the effects of tension and strain are thought to snowball over time. Abnormal pressures may tighten or bind the fascia to underlying tissues, causing "adhesions," or dabs of scar tissue that cling to muscle fibers. Even though these adhesions do not show up on x-rays or other scans, they can stiffen joints or contribute to painful motions, such as rotator cuff injuries. If they occur near a nerve, they may cause numbness, pain, and tingling, as with sciatica or carpal tunnel syndrome.

The gentle and sustained stretching of myofascial release is believed to free these adhesions and soften and lengthen the fascia. By freeing up fascia that may be impeding blood vessels or nerves, myofascial release is also said to enhance the body's innate restorative powers by improving circulation and nervous system transmission.

Some practitioners contend that the method also releases pent-up emotions that may be contributing to pain and stresses in the body. In a variation of the technique that therapist John Barnes calls "myofascial unwinding," moving various body parts through a range of postural positions is said to unleash, or unwind, repressed "memories" that the tissues have unconsciously come to "store." This leads to both physical and psychological healing.

What You Can Expect

Whereas muscles often respond to the firm strokes and thrusts of massage, fascia is thought to respond to a much milder touch. And unlike a typical chiropractic manipulation, which focuses on improving the motion and function of a particular joint, myofascial release works on a broader swath of muscles and connective tissue. The movements have been likened to kneading a piece of taffy--a gentle stretching that gradually softens, lengthens, and realigns the fascia.

The therapist will first ask about your complaints and closely inspect your posture as you sit, stand, walk, and lie still. The bones in your neck, chest, pelvis, back, or other areas will be felt and the skin stretched to feel for areas of tightness. Using the fingertips, knuckles, heel of the hand, or arm, the therapist then feels, or "palpates," deeper layers for any areas of bound-down fascia. When a restricted area is found, the tissues are stretched gently along the direction of the muscle fibers until a resistance to further stretch is felt.

The stretch may be held for one to two minutes, and sometimes for up to five minutes, before a softening, or "release," is felt. The release indicates that the muscle is relaxing, fascial adhesions are slowly breaking down, or the fascia has been realigned to its proper orientation. The process is then repeated until the tissues are fully elongated.

Physical therapist Carol Manheim, author of the Myofascial Release Manual, describes the process as "a nonverbal conversation between the therapist's hands and the patient's body. It should be very comfortable and relaxing." Because the fascia is an interconnected network, the therapist may work on many parts of your body, and not just those that hurt. To help you relax, you may be encouraged to breathe deeply or make sounds. If there is any discomfort, most people describe it as "good" or "healing."

Some people immediately feel better, even free of pain, and are able to move their joints more freely as soon as the session is over. Others feel some increased discomfort that night or the next day. Any soreness should subside within a day or two, however, and you should feel less pain and move more easily than you did before.

Sessions typically last 30 minutes to an hour and may be given one to three times a week depending on your condition. Costs per session range from about $50 to over $125 and may be covered in part by insurance as an adjunct to a chiropractic or physical therapy program prescribed by your doctor. A simple pulled muscle may respond completely after a session or two, whereas longstanding myofascial pain may require three months of regular treatment, coupled with a home program of exercise and stretches.

In fact, you should ask to be given exercises to do at home. Unlike stretching routines for specific sports, these exercises will be designed to lengthen the muscles and connective tissues in various directions. To relieve tightness in the pelvic region, for instance, you may lie with your hip resting on a small foam ball for several minutes. Exercises are tailored to your individual needs.

Health Benefits

Myofascial release therapy has not been extensively studied but is gaining increasing notice among mainstream doctors. A 1999 study in the New England Journal of Medicine, for example, found that osteopathic spinal manipulation, including myofascial release, was as effective as standard therapies for the relief of lingering low back pain but had an added benefit: Those who received hands-on therapy required far fewer costly painkillers, muscle relaxants, and anti-inflammatory drugs, which could have potentially dangerous side effects.

In addition to back pain, myofascial release is used to treat a wide array of painful ailments affecting the muscles and connective tissues. These include fibromyalgia, rheumatoid arthritis, muscle spasms, whiplash injuries, and carpal tunnel syndrome. People with diabetes, who are at increased risk for painful plantar fasciitis and frozen shoulder, may also benefit. Elite runners, and Olympic athletes have used the technique for stress injuries (it has also been used in racehorses and their riders), as have weekend warriors with tennis or golfer's elbow, shin splints, or a bad sprain that is having trouble healing.

The therapy is used for many other conditions as well in people of all ages. Those with jaw pain, discomfort from the scars of surgery, headaches, and chronic fatigue syndrome may all benefit. In women, the technique is sometimes used for relief of pelvic pain, menstrual problems, incontinence, and even infertility. It is also offered to children with, among other conditions, birth trauma, head injuries, cerebral palsy, and scoliosis.

How To Choose a Practitioner

Myofascial release is generally performed by either physiatrists (doctors who specialize in rehabilitative medicine) or by physical therapists or massage therapists who have been specially trained in its techniques. It is also sometimes performed by osteopaths (D.O.s) or M.D.s who specialize in pain management. (Your primary-care physician may be able to write a prescription for myofascial release in order to improve your chances of getting insurance to pay for treatments.) Others who may be trained in the technique include occupational therapists, dentists, nurses, chiropractors, alternative body workers, and exercise specialists. (Traditional Asian massage techniques may also release the fascia but generally do not use this terminology.) Because myofascial release is similar to Rolfing, you may want to consider visiting a Rolfer if a myofascial release therapist is not readily available.

Since myofascial release is a technique rather than a specific profession, there is no professional organization to certify those trained in the field. While some physical therapy, chiropractic, and osteopathic schools offer training to their students in the method, most courses are taught at the postgraduate level to practitioners who are improving their skills at hands-on diagnosis and therapy. As with any therapy, word-of-mouth from friends or doctors you trust is a good place to start when looking for a therapist. Be sure to select a person who makes you feel comfortable.

Cautions

 Remember that many practitioners who use myofascial release are not medical doctors. Therefore, if you have signs and symptoms of a potentially serious disease, see your personal physician first.

 If you recently had surgery or an injury or are pregnant, let the therapist know. Some movements or stretches may not be appropriate.

 Some people become nauseous or lightheaded or develop soreness during or after treatment. Therapists recommend that you drink plenty of water to help flush out any waste products that may be contributing to the discomfort. If soreness persists for more than a day or two, let your doctor know.

 If you are taking anticoagulants such as Coumadin and bruise very easily, let your therapist know. Even though the stretches are very gentle, as with any hands-on technique, they may cause bruising. The bruising is harmless, but you should be aware of it.


Date Published: 04/19/2005
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