How does Myofascial release help musculoskeletal pain?

WHAT IS MYOFASCIAL RELEASE

Let’s start by explaining what myofascial release is, which might not be as easy a task as it seems.

Myofascial release (MFR) has become increasingly popular over the last 10 years, both between athletes and non-sporty people.

MFR is a soft tissue release technique that addresses the fascia in order to treat musculoskeletal pain, limited range of motion, for injury rehabilitation and the treatment of posture related problems. This leads us straight to the question “what is the fascia?”

WHAT IS THE FASCIA

The fascia is the connective tissue in our body that surrounds and holds every muscle, nerve fibre, organ, blood vessel and bone in place.

Far from having exclusively these structural properties the fascia is way more complex than what we initially thought and it’s known to have more nerve endings than the skin, which means that it’s sensitive and reacts to the environment around it. If you are interested in learning more about this fascinating organ you can read more about it here

Now that we know that myofascial release focuses on the fascia and we know what the fascia is it’s easier to picture the possible effects of MFR in our body.

UNDERSTANDING THE ORIGIN

Myofascial release as a term wasn’t captured until the 1960s, although it was Ida Rolf back in the 1940’s who is known to be a pioneer in the use and later on teaching of MFR. Her method was called Rolfing or structural integration and it addressed the whole myofascial system over a block of sessions in order to improve biomechanics and therefore correct pain and dysfunction.

Another important figure when it comes to explaining MFR is Dr Janet Travell, who around a similar date discovered and applied Myofascial Trigger Point work to help her patients out of pain. You can read more about Trigger Point work here and Janet Travell here.

Since Ida Rolf and the Rolfing method, Myofascial release has since developed into different modalities, it has been adapted and modified by different groups of practitioners over the years to fit their own philosophies giving birth to different training schools of thought and techniques.

We can define MFR today as a manual therapy method that can address both the structural tissues of the body and the sensory/motor systems of the body and therefore the central nervous system.

TREATMENT METHODS

There are now a days two main ways of working the fascia, direct myofascial release work and indirect MFR work. Usually depending on what school the therapist’s trained through. At INSIDE we use a combination approach of all different modalities.

Direct myofascial release work – This is, we could say, the most structural approach method and the most similar to Rolfing method. In this method the therapist will directly take the fascia to where they want it to go. It can simulate a slow and deep massage stroke.

Indirect myofascial release work – In this method the therapist employs techniques that indirectly release the fascia. An example of this could be, holding or sandwiching a part of the body. This work is more subtle and it might be felt by the client that “nothing’s happening”. Nevertheless this treatment method is indeed very powerful and it produces very effective results, although it is highly dependant on the therapist’s skill and ability (more so than the direct work).

Trigger point myofascial work can also be included here as a different MFR method. In this method still pressure is applied over a “knot” or Trigger Point over a few seconds in order to release it.

There are also a number of other techniques used in MFR depending on the objective of the session and what the therapist is trying to treat or accomplish (skin rolling and scar tissue techniques between others).

In our Clinic we set this objectives during the consultation with each individual client.

As mentioned above, at INSIDE we use a combination of both direct and indirect myofascial release therapy to treat musculoskeletal pain, postural related issues, limited range of motion, clinical conditions (find a list of the conditions we treat here) and as part of injury rehabilitation

How does Myofascial Release work

What happens in the tissue during a Myofascial release session?

Not an easy question to answer!

During direct myofascial release work the therapist will tune into the musculoskeletal system by gently sinking into the tissue and waiting for movement to happen, indicating that the tissue is releasing, and continuing the stroke in this manner in the chosen direction. It’s the pressure what seems to trigger the release in the tissue.

During indirect myofascial release work the therapist will tune into the musculoskeletal system indirectly by for example sandwiching a particular area of the body and waiting for a release in the tissue that lives in between their hands. In this method the intention, focus and ability of the therapist to tune into the system and follow the fascia as it releases is very important.

During Myofascial Trigger Point work the therapist will localise a “knot” or Trigger Point and apply steady pressure over a short period of time (usually 8-12 seconds but can sometimes be longer specially if the focus is the fascia and not only the muscle). The pressure again triggers the release in the tissue and muscle fibres that have been stuck in contraction, triggering pain and other symptoms, are able to return to their relaxed state.

In all these methods myofascial release work has the ability to deeply affect the central nervous system increasing the activity of the parasympathetic nervous system which is responsible for restoration and the immune system and decreasing the activity of the sympathetic nervous system which is usually hyperactive causing hypersensitization and increasing the pain response.

In any method of myofascial release work, the release can happen anywhere in the body and sometimes far away from the place where the therapist’s hands are.

WHY CAN YOU FEEL THE TISSUE RELEASING FAR AWAY FRON THE THERAPIST’S HANDS?

This is because the fascia or myofascial tissue is a continuous single piece of fabric that doesn’t divide, meaning that restrictions anywhere along this tissue affect the whole structure and body as a whole and might be felt far away from where the restriction is.

Let me explain better with a simple analogy. Stand up, grab and pull your t-shirt or jumper from your belly button area downwards towards your feet. That would represent a restriction in that area. Now don’t let go and take a look at the wrinkles that restriction is causing in your t-shirt all the way up to the shoulder area? Can you also feel the pulling on your shoulder or back of the neck? That restriction has caused a domino effect in the fascial system and is now affecting other parts of the body that are far away from the place where the restriction is (in this case the belly button area), which might trigger symptoms in these other areas and cause the domino effect to continue.

Now let go of the t-shirt and you might feel a release on your shoulder or neck. This is what happens when a myofascial restriction is released as well and it’s the reason why the release might be felt somewhere else to where the therapist’s hands are working on.

When the myofascial tissue releases can sometimes can be felt as tingling, twitching, emotions arising, change of breathing pattern, tickles, pins and needles, movement, etc. Although these don’t need to happen in order for the treatment to be effective, when they do happen they are all indicatives of effective work being done. These sensations can sometimes be uncomfortable to feel either emotionally or physically. The client is advised to deep breathe into the area, which will allow for the release to take place more effectively.

I’m hoping that I was able to convey how myofascial release therapy can help the musculoskeletal system as well as how fascinating and complex this organ is.

About the author

Rocio Santiago

MA in Nursing, Dip. Soft Tissue Therapy

Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.

The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.

Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.

Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.