Myofascial release and musculoskeletal pain - why does it work so well?

myofascial release

Myofascial release is a specialised form of manual therapy that focuses on releasing restrictions in the fascia. In our Brighton & Hove based clinic we specialise in this treatment modality. 

 

Fascia refers to the body’s musculoskeletal connective tissue.

 

Over the last four centuries, fascia has been described in many ways. The mainstream spreading of the term fascia and myofascial release as well as its therapeutic implications have been linked to our anatomical understanding of it (which is dependant on advance in science) with the term gaining slow steady interest in society over the past century as more research has come out.

 

We can see that the term fascia has developed over the years and is likely to continue to change with evolving science and research technologies.

 

With the evolution of science and research technologies our knowledge about the fascia is constantly growing as we’ve seen above, and with it our understanding of the relevance of addressing the Myofascial tissue (fascia) in the treatment of musculoskeletal pain as well as in the area of conditioning and sports performance.

 

But what do we know about the fascia that explains why addressing this tissue is so effective in both the treatment of musculoskeletal pain and achieving peak performance?

Fascia in society

role of fascia in society

The term Myofascial release has been around for over a century, its consolidation as a treatment method for musculoskeletal pain though has been slow.

 

It’s taken science some time to develop to the point where we can study in depth the complex and fascinating living system that fascia is. Still to this day there is ongoing research on the myofascial system and more to be understood.

 

What we’ve come to learn so far though, has revolutionised not only the way we understand pain and how the musculoskeletal system operates but also our general understanding of the human body.

 

This new knowledge puts in evidence an outdated current medical system. The great amount of regulation surrounding the medical system as well as individuals’ personal investment and attachment to the old ideas means that our system is currently left behind science, pending to catch up.

 

Right now, myofascial release in offered by the NHS in selected Multiple sclerosis and cancer therapy centres as a treatment method aiming to relieve pain associated with these clinical presentations.

 

The applications of Myofascial release though are far beyond providing pain relief and it’s a proven effective treatment method (if not the most effective one) in dealing with all sort of musculoskeletal clinical presentations (i.e. carpal tunnel syndrome, thoracic outlet s., migraines, sciatica, lower back pain, etc.).

 

With Myofascial release being mainly practiced under the umbrella term “soft tissue therapy” or “massage” which are unregulated professions there’s no clear way for Myofascial release to be included in our rigidly regulated medical system as a treatment option for these presentations, at least not just yet.

 

Currently without a hands-on medical profession the NHS doesn’t have a system in place able to provide effective treatment for these musculoskeletal presentations.

 

This leaves patients experiencing these left in limbo, or taken through a lengthy and ineffective chain of specialists referrals that still don’t provide effective treatment.

 

It’s mainstream knowledge that historically we used our hands therapeutically to relief ailments of the body. These role fell on the hands fo the shaman. These healing practices were though linked with spirituality and religion. This is were it all got mixed up.

 

Society evolved and the current medical system was born and developed, we started looking at the body as cause and effect; healing was no longer linked to religious/spiritual practices. We developed a mechanical or Newtonian perception of the human body, where anything that couldn’t be seen or measured had no place within the medical system. We thought we couldn’t go wrong, if we see it, it’s real right? what we missed though is that the body doesn’t function under those simplistic mechanical principles. In that search for the truth, somewhere and progressively between the shamans and now, we lost ourselves and we lost hands on healing.

 

Science has now evolved to the point where we can understand the body as a quantum system (versus a Newtonian system) and our now outdated medical system (still deeply engirded in the old Newtonian model) is being challenged and it’s rigid to adapt.

 

With current research on the musculoskeletal system and the growing understanding of pain and the myofascial system, a new specialised version of hands-on treatment that it’s now based on science is slowly raising and gaining reputation within society as a reliably effective and needed profession, specialised in the musculoskeletal system.

 

There is still no clear place for us specialised hands-on therapists though, as in most people’s minds we float somewhere between a “masseuse”, with none or very little scientific understanding of the human body, and a medical professional.

 

This is due to the lack of regulation within our profession, as mentioned above, which could be seen as a blessing or a course, probably a bit of both.

On one hand our profession is free to develop, adapt and organically grow to new scientific findings (unlike the highly regulated medical professions specialised in the musculoskeletal system) and on the other hand that luck of regulation leaves us without a clear spot within the medical system and it also means that therapists with extremely different knowledge fall under the same umbrella term, “massage therapist” (which I don’t like using anymore for that particular reason) making it hard for people to differentiate the highly trained science based therapist specialised in the treatment of clinical conditions from those with lesser training or focused on the beauty sector.

 

Throughout history the term “massage” has always existed, but its reputation and applications through modern history have been far from the medical system.

 

The term has little reputation as anything serious, it has been sexualised through history and its reputation has been affected in other instances by self claimed gurus with self proclaimed ridiculous healing powers and no real understanding of the human body.

 

With the advances in science, there is hope for soft tissue therapy;  it’s now in the hands of serious professionals to take hands on therapy back to where it belongs, which is at the top of effective treatment methods to address the  musculoskeletal system.

Why does Myofascial release work?

why does myofascial release work

Myofascial release is spreading mainstream as a popular treatment option due to it’s effective outcomes but,

 

What do we know today from a science point of view that explains why Myofascial Release that explains why it works so well?

 

It all comes down to the Myofascial tissue and the functionality of this system. But what could possibly be so special about this connective tissue, right? Well let’s take a look at some of its key properties:

 

  1. Continuity: The fascia forms a continuous three-dimensional web throughout the entire body, connecting all structures in one single piece of fabric. This means that restrictions in one area affect the balance and functionality of the whole, which in terms means that addressing those restrictions improves balance within the system.
  2. Sensory Function: The fascial tissue has more nerve endings than the skin itself and way more than muscles. The fascia is extremely sensitive to both pressure changes (to which it responds automatically) and chemical changes in our body.
  3. Contractibility: It has the ability to contract similar to muscles through cells called myofibroblasts.
  4. Piezoelectricity: The fascia generates electrical charges in response to mechanical stress that can influence cellular behaviour and tissue healing.
  5. Light Transmission: Fascia has been found to conduct light signals (biophotons), potentially playing a role in cellular communication and regulation that way as well.
  6. Adaptability: Fascia is an extremely dynamic system, it can change its structure in response to mechanical and chemical stimuli.
  7. Interoception: The fascia plays a crucial role in how our body feels, with nerve endings directly reporting to the insular cortex of the brain involved in emotional processing.
  8. Structural Support: It provides support and maintains postural balance while allowing smooth movement between muscles and other bodily structures.
  9. Force Transmission: The fascia helps transmit force and tension throughout the body as part of its tensegrity structure. All point and especially these last two points make it an important tissue to target in sports conditioning.

 

These properties make the myofascial tissue an extremely sensitive and powerful system within our body, with a role that goes beyond being exclusively structural.

 

When healthy, myofascial tissue can glide smoothly. However when restricted it can lead to pain, limited mobility, lesser functionality and other illnesses.

Myofascial Release treatment at our clinic

myofascial release in our clinic

At INSIDE, a myofascial release treatment session begins with a consultation, including postural assessment, assessment of client goals, pain patterns, range of motion, medical history and lifestyle factors.

 

During the hands-on treatment, you can expect:

 

A combination of techniques including Myofascial release, Trigger point work, sports massage, and eastern-based techniques like acupressure. We purposely use a combination of different techniques in order to achieve the most effective results possible.

 

Our treatments are deeply relaxing and healing, as they address the nervous system, as well as outcome based and effective (we always set up a goal and work towards it, seeking measurable results)

 

After the session:

 

The myofascial tissue typically takes 2-3 days to settle after a treatment session and it can feel irritated before it settles down.

 

Some people experience immediate pain relief and increased range of motion, other people experience these 2-3 days after the treatment and some others might need a few sessions to feel the benefits.

 

It’s common for people to experience an improvement in overall feeling of wellbeing and mood.

 

Following a treatment session, on the same day, we recommended to avoid alcohol, drink plenty of water, maintain a healthy clean diet and avoid exercise.

This will provide the best environment for the body to do its repairing following the treatment obtaining the most out of it.

 

For chronic conditions that have developed over years, multiple weekly sessions may be needed for optimal results.

 

We recommend committing to a treatment plan and trusting the process to achieve the best possible outcomes.

 

At INSIDE we expect to see results in every case within 6 weekly sessions. This doesn’t mean that everyone will need that many sessions, it means that in the most complex cases we expect results within 6 weeks.

 

Positive results are of course not always possible and even though this does not happen frequently it must be had into account. 

 

Most people experience full relief of symptoms within 3-4  weekly sessions. 

 

The frequency of the treatments matters, we get the best results treating weekly.

 

We recommend coming for that extra session after symptoms have subsided to solidify and prolong the results.

 

We recommend you come with an open mind and heart in order to get the best results, regardless of whether or not you’ve had Myofascial release therapy before. Remember that as people every therapist is unique and their work can be very different from one another. 

REFERENCE:

Adstrum, Sue & Nicholson, Helen. (2019). A history of fascia. Clinical Anatomy. 32. 10.1002/ca.23371.

 

Robert Noah Calvert (2002). The history of massage : an illustrated survey from around the world. Rochester, Vt.: Healing Arts Press.

Fairweather, R. and Mari, M.S. (2015). Massage fusion : the Jing method for the treatment of chronic pain. Edinburgh: Handspring Publishing.

 

Myers, T.W. (2014). Anatomy Trains.

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.

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