THIS ARTICLE REFLECTS THE PRIVATE VIEWS OF THE AUTHOR AND SHOULD NOT BE CONSIDERED A MEDICAL REFERENCE..
In my previous Fascia articles, I introduced the cobweb of connective tissue that shapes us, what goes wrong with it and how we look after it. This article looks at Myofascial Release, a set of bodywork techniques used by skilled therapists aiming to repair fascia by releasing fascial restrictions.
While evidence to support the theory behind these techniques is not well established, some people have experienced considerable relief of symptoms. Some therapists are sceptical about this practice, saying while the techniques may be useful, the rationale is shaky
I myself am undergoing a series of treatments, and have experienced an almost complete relief of pain and feelings of restriction in hip and lower back. Previously I had been diagnosed as having arthritis of both hips, and facet joint arthritis in the L5/S1 joint! A year ago I could not walk for 10 minutes, but last weekend I was on the beach hunting oysters for 3 hours!
The fact that people may experience relief of symptoms with a technique does not validate the theory behind it, of course. Alternative possible explanations for the value of these techniques include: Trigger Points within muscle are being relieved by this stretching; An incorrect stretch response in a muscle is being re-educated to more normal working.
There is also the placebo effect where the greater commitment I put into the treatment (in this case the more marked the pain I feel) then the more likely I will experience a relief of symptoms. While this may be so, it is interesting that the relief seems to be persisting for weeks at a time.
Paul Ingraham, a canadian massage therapist and journalist committed to the evidence base for practice, is a great sceptic of the claims by fascia enthusiasts. He has an interesting article listed at the bottom of this posting “Does Fascia Matter?” where he points out fascia is a strong substance, and no manual techniques are going to have a mechanical effect on it.
However, if a technique seems to help relieve painful restrictions and to allow more ease of movement, without known bad side effects, then it would be madness to wait for a complete explanation of the theory before practicing it! However, until a rational and verifiable explanation for the treatment is found, myofascial release treatments can in no way be considered in any way medical, and any therapist claiming results from the treatment more than a remedy should have good hard evidence before trumpeting them!
- The therapist sinks pressure into the tissue, to the level where they feel tightening;
- The therapist then presses along the sheet of tissue, to create a “bow wave” of resistance;
- The therapist exerts pressure slowly to encourage the client to relax and stretch. Sometimes the client will move in particular directions, to ease/increase the pressure on the tissue
What does myofascial release feel like?
Usually the feeling to the client is a burning stretching sensation, like a “Chinese burn”. While it is not pleasant, the client should quickly feel a releasing of restrictions in the tissue, and so people are usually very happy to undergo a temporary sensation of discomfort to assist release.
However, as with any therapy, for effective treatment, the client must be “in charge” of the session, in that the therapist must do nothing that will cause pain to the client. This would be counter-productive, because the client needs to relax into the treatment, and it affects the client/therapist relationship if the sensations produced are above a tolerable threshold.
When practicing this technique, I like to move slowly, so the client can “understand” the process, and it seems almost a “re-education” of the tissues. It helps empower the client, as they understand they can stop the process at any point.
Some therapists object to the whole concept of myofascial release, on the grounds that the healing is done by the client, and that the therapist risks “playing god” by thinking they are “curing” the client. I am convinced that the therapist must retain an attitude of humility, and an understanding they are a skilled technician assisting the client in their own recovery. Rather in the way a tree in the woods is assisting a bear to scratch it’s own back!
Rolfing and Myofascial Release
The world of Structural Integration, or “Rolfing” focusses on using myofascial release techniques to help move the client into a place of greater freedom, and uses a “series” of 10 or 12 sessions to focus on particular areas of the body. Thomas Myers, with his Anatomy Trains book (see below) is probably the best known exponent currently outlining the areas that are explored.
It is not established by any means why there should be a particular sequence of investigation, but I understand that this can help make sure all areas of the body are covered in time.
Other Myofascial Release processes
Martin was trained in Myofascial Release by Alex Fugallo, a well established osteopath in London. Alex teaches on courses provided by Martin’s professional association, the Institute for Sports & Remedial Massage.
Alex teaches a 3-series of treatments, focussing first on the Hips and legs, the trunk and then neck, shoulders and arms.
Alex seems keen not to “over-cook” the client, which is a comment levelled at rolfers, and uses a protocol to assess what areas to concentrate on.
James Earls and Thomas Myers (2010) Fascial Release for Structural Balance, Lotus Publishing: Chichester
Thomas Myers (2001) Anatomy Trains – Myofascial Meridians for Manual and Movement Therapists, Churchill Livingston: Edinburgh
John Smith (2005) Structural Bodywork, Elsevier Churchill Livingston: Edinburgh
Paul Ingraham (2013) Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties – from website