What is Myofascial Release
Myofascial Release Therapy (MFR) is a type of soft tissue therapy that focuses on addressing the myofascial tissue or fascia, releasing shortening of this tissue, trigger points, tension and inflammation and reducing or correcting therefore the symptoms linked to an imbalance on these tissue.
The fascia is a complex spider web like network of connective tissue. As defined in the International Fascial Research Congress “…fascia forms a whole-body continuous three-dimensional matrix of structural support…” and it’s found everywhere in the body.
So the fascia is a connective tissue, but what is connective tissue?
There are only 4 types of cells in our body (I know crazy!):
- Ephitelial
- Neural
- Muscular
- Connective tissue (connects what needs to be connected and therefore separates what should be separated)
All fascia is connective tissue but not all connective tissue is facia!
Connective tissue is the most abundant type of tissue in the body existing in different forms, from liquid to solid. Here’s a list of examples found in our body:
- Blood
- Fat (adipose tissue)
- Tendons
- Ligaments
- Aponeuroses
- Cartilage
- Bone
So again! all fascia is connective tissue but not all connective tissue is facia!
Fascia encompasses the fibrous soft tissue components of these connective tissues and as we’ve mentioned above it’s found everywhere in the body, we can find it in the form of:
- Ligaments
- Tendons
- Wrapping around the brain (meninges)
- Nerves (epineurium)
- Bones (periousteum)
- Muscle fibres (endomysium)
- Bundles of muscles (myofasciae)
All of these create the fascial web, a continuous 3D net so intricate that if isolated would be a complete representation of the person.
Important to note that as a continuous interconnected system, dysfunction in one part of that fascial system can cause pain, reduced mobility or dysfunction somewhere else in the body.
This quality alone makes the fascia a fascinating system to work with and trying to decipher it a skill that keeps us therapists occupied.
Image belongs to Thomas W. Myers, extracted from his book Anatomy Trains
Movement happens in chains or slings
The fascial tissue contains cells called Myofibroblasts that allow it to contract in a similar way our muscles do.
This is relevant because we used to think fascia was an inert tissue, with no major role and definitely no contractile properties.
Interestingly enough, myofibroblasts are stimulated by a protein called TGF-beta-1, which triggers contraction in the fascia. The production of this protein increases with the stimulation of the SNS (sympathetic nervous system) under stress.
There is therefore scientific evidence to link stress with stiffness of the fascial tissue, something we see in clinic on a regular basis.
Our experience in clinic suggests that a treatment approach focused on re-balancing the nervous system is key to obtain the best possible results and frequently not much else is needed in order to relieve the symptoms of pain and restriction.
The body as a tensegrity structure
The old and wrong concept?
Rigid bones, perfectly stuck on top of each other supporting the whole thing in place. Many forms of therapy and their skill sets are still stuck in that old concept of the body.
The new concept?
I like to imagine floating bones held in space by the tensional compressional forces of fascial chains or guy wires. This is the new human body.
This concept also applies to the cells, that can be seen as mini tensegrity structures.
Within this cells, we find a protein called integrin, that connects both internal and external environment of the cell sensing and transmitting mechanical information from outside to inside. This means that applied mechanical stress causes almost immediate changes at molecular levels.
This means that it is now scientifically proven that manual therapy that addresses the fascia directly changes the body right down to the cellular level!
The fascia is also a sensory organ
The fascial tissue has more nerve endings than the skin itself and 10 times more sensory receptors than red muscle.
Some sensory nerve endings respond to deep touch and other to light touch, at our clinic we use a combination of different techniques with that in mind with the intention of obtaining the best possible results in the least possible amount of time.
Clearly the fascia is intimately connected with the nervous system and it is fair to assume that therefore the formation and releasing of fascial restrictions and inflammation might also be controlled by the nervous system rather than purely mechanical.
Some of these sensory receptors play a part in proprioception, or our feeling of body positioning in space, feeding into a part of the brain called somatosensory cortex.
Even a greater number of these sensory receptors play a part on interoception, reporting to a part of the brain called the insular cortex, involved in emotional processing. Which means that there is a scientifically proven connection between the fascia tissue and our emotions, meaning our fascia can affect our emotions and vice-versa.
The role of myofibroblasts
The fascial tissue contains cells called Myofibroblasts that allow it to contract in a similar way our muscles do. This is relevant because we used to think fascia was an inert tissue, with no major role and definitely no contractile properties.
Interestingly enough, myofibroblasts are stimulated by a protein called TGF-beta-1, which triggers contraction in the fascia. The production of this protein increases with the stimulation of the SNS (sympathetic nervous system) under stress.
There is therefore scientific evidence to link stress with stiffness of the fascial tissue, something we see in clinic on a regular basis.
Our experience in clinic suggests that a treatment approach focused on re-balancing the nervous system is key to obtain the best possible results and frequently not much else is needed in order to relieve the symptoms of pain and restriction.
how we go about addressing the fascia
Of course as it couldn’t be otherwise there are different schools of thought and practice within the fascial community all aiming to affect 4 main structures:
- Myofascia
- Cranial fascia (craniosacral therapy)
- Visceral fascia
- Fascia surrounding nerves and blood vessels
Having a skill set that can address all these 4 areas is desirable of course.
In our clinic we use a combination of different treatment methods like myofascial release and trigger point work.
In relation to myofascial techniques, we also use a combination of different disciplines and schools of thought, two of the main ones are:
- Structural integration work
- Myofascial release (skin rolling, holding, cross hand stretches, leg/arm pulls…)
Recap
I hope that this small post about the magical fascia was informative and that it helped you understand a little bit what the fascia is as well as its implications in relation to musculoskeletal pain and dysfunction.
There is much yet to learn about the complex ways our musculoskeletal system works and a long road ahead in order to get the implications and reasonably new characteristics of the fascia to change our stiff stablished systems and help improve our quality of life.
Us myotherapists that get to regularly admire the results of addressing this tissue will continue to make noise and spreading it to the mainstream community.
It’s ever growing and I’m sure that we’ll eventually get it to where it belongs, amongst one of the most effective ways of dealing not only with musculoskeletal pain but also with stress and stress related presentations.
References:
- Fairweather, S. Mari (2015) Massage fusion, Handspring Publishing. @Jingmassage
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 9 years, successfully treating a wide range of conditions.