Myo means muscle. Fascia refers to connective tissue. Release is similar to stretch. Myofascial Release could be called connective tissue stretching. Release, however, is more descriptive.
Fascia is the fibrous tissue that holds us together. You can see it in chicken or steak when you prepare a meal. It connects and packages the cells and systems of the body including: muscles, nerves, blood vessels, internal organs and even bones. Everything is connected to everything, as we like to say.
The fascial tissue has both mind-boggling complexity and profoundly simple properties. It is made up of three components: tough collagen fibers, stretchy elastin fibers and a matrix which is mostly water with a few fiber producing cells existing within this configuration.
Fascia is a 3-dimensional web. As a structure, fascia or connective tissue disperses the forces of muscle activity and gravity throughout the body so those forces are not concentrated in one location. Just holding a small weight at arms length requires hundreds of pounds of muscle tensile force and joint compression.
All functional systems in the body are interconnected. Fascia blends into tendons and ligaments and anchors internal organs to the skeletal frame. No system in the body can function better than the fascia that holds it together. It is very common for a fascial restriction to be present without producing outright pain in one area of the body and affect another area that is symptomatic. Sorting this out requires some trial and error between patient and therapist.
When the fascia system has been insulted by injury or illness the fascial tissue changes as a result. Usually change from the norm results in restricted or tightened fascial tissue. This includes scars from surgeries or common injuries or inflammatory disease processes.
Collagen fibers become kinked or pleated as they tighten. Kinked collagen fibers reduce the fascia’s relative rehydration compared to normal fascial tissue. Muscle groups no longer glide over one another freely with movement. What is seen is less extensibility and limited range of motion. With this comes impedance on nerves and blood vessels and a patient can experience numbness, tingling or odd sensations even though there may not be serious pathology present. Reduction in the efficiency of internal organs in the body may be more subtle.
In the meantime, Mother Nature finds a way to propel us forward. If one leg is injured we can limp and get to where we are going. If our spine or ribs are injured we can adapt our postural habits that feel more natural initially… but eventually at a price!
When injuries force us to compensate or deviate from the normal bio mechanics, the fascia must adapt to keep holding us together and continue to disperse mechanical forces. As this happens, some structures (muscles and fascia) get overused and joints break down, manifesting as chronic pain–pain that may come-on for no apparent reason and does not go away with traditional treatments. More pain results in more deviations. This is the trade-off for compensating out of the norm of happy, balanced body mechanics and emotional functioning. The sequence becomes a vicious cycle and for some of us, the wheels start coming off the rails.
The release of fascial restrictions has been described as the missing link in physical medicine by John F. Barnes, PT, who developed the Myofascial Release Approach and teaches international seminars of these methods.
In general, MFR techniques are stretches or positions that are held for durations of several minutes with low to moderate force. The stretch is maintained at the perception of resistance from the restriction until it “melts out” and then can be followed further into the restriction as the fascia releases or the patient spontaneously unwinds into new positions or the process reaches a conclusion.
The Barnes Myofascial Release Approach considers three categories of treatment.
MFR structural work includes the versatile cross-hand release technique variations with pressure from hands, finger tips or elbows as well as traction or compression applied to limbs or spine. The result is easier movement and greater range of motion. The release of tissue-restrictions reduces interference with nerve and circulatory function resulting in greater strength because there is less pain inhibition. Further strengthening becomes a more attractive option.
Techniques called Rebounding rock the recumbent body side to side or end to end, “sloshing” the water within the cells and tissue. This is a clever way of visualizing and releasing some hard to address fascial restrictions and encourages hydration at the tissue level, not necessarily achieved by simply drinking more water. Rebounding helps other structural work become more responsive. Rebounding feels good and patients love it. (So do cats and dogs.)
Unwinding is a treatment where the patient does most of the work, moving spontaneously with minimal conscious effort. It can be subtle movement of a single limb or spine segment or a whole body yawn that changes position frequently. The therapist’s role is to facilitate the movement. Unwinding is also good structural therapy and a therapeutic way to release emotional stress out of the body. Infants and children do this without inhibition.
If we as physicians, therapists and body workers do not address the body system that does the connecting, then we have overlooked the obvious, a mistake that is easy to make but not difficult to address.