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Myofascial Release
What is Myofascial Release?
Myofascial Release is a highly specialized stretching technique used by physical therapists to treat patients with a variety of soft tissue problems.
To understand what Myofascial Release is and why it works, you have to understand a little about fascia. Fascia is a thin tissue that covers all the organs of the body. This tissue covers every muscle and every fiber within each muscle. All muscle stretching, then, is actually stretching of the fascia and the muscle, the myofascial unit. When muscle fibers are injured, the fibers and the fascia which surrounds it become short and tight. This uneven stress can be transmitted through the fascia to other parts of the body, causing pain and a variety of other symptoms in areas you often wouldn't expect. Myofascial Release treats these symptoms by releasing the uneven tightness in injured fascia.
In other words, Myofascial Release is stretching of the fascia. The stretch is guided by feedback the therapist feels from the patient's body. This feedback tells the therapist how much force to use, the direction of the stretch and how long to stretch. Small areas of muscle are stretched at a time. Sometimes the therapist uses only two fingers to stretch a small part of a muscle. The feedback the therapist feels determines which muscles are stretched and in what order.
Each Myofascial Release technique contains the same components. The physical therapist finds the area of tightness. A light stretch is applied to the tight area. The physical therapist waits for the tissue to relax and then increases the stretch. The process is repeated until the area is fully relaxed. Then, the next area is stretched.
The therapist will be able to find sore spots just by feel. Often, patients are unable to pinpoint some sore spots or have grown used to them until the physical therapist finds them. The size and sensitivity of these sore spots, called Myofascial Trigger Points, will decrease with treatment.
Most patients are surprised by how gentle Myofascial Release is. Some patients fall asleep during treatment. Others later go home and take a nap. Most patients find Myofascial Release to be a very relaxing form of treatment.
Myofascial Release is not massage. Myofascial Release is used to equalize muscle tension throughout the body. Unequal muscle tension can compress nerves and muscles causing pain. Progress is measured by a decrease in the patient's pain and by an improvement in overall posture.
What to expect
When I treat patients with Myofascial Release, the first visit takes about 1 ‡ hours, and I start by asking a number of detailed questions:
- Why have you come to see me - what is the problem?
- If this is due to an accident, how were you injured?
- How long have you had this pain / problem / diagnosis?
- Who have you seen for this? What treatment(s) have you had from each?
- What medications do you take for any reason? How much? How often?
- Do you take vitamins or herbal preparations? What do you take? How much? How often?
- Have you had any broken bones or fractures? Which bones? When?
- Have you had any surgery? For what? When?
- What makes you feel better?
- What makes you feel worse?
- What activities can you no longer do?
- Have you been prevented from working because of this problem? For how long?
- On a scale of 1 to 10, with 10 being the worst your pain from this problem has ever been, what is your pain level right now?
- What else would you like me to know about you and / or this problem?
Once we finish talking, I'll do a physical evaluation. I'll look at your posture, the amount of movement you have in your joints and whether that movement causes increased pain or discomfort.
Next I'll place my hands on the back of your neck to feel your tissue tension. This tells me what muscles and soft tissues need to be treated and which ones should be treated first. Myofascial Release is a very gentle stretching technique, guided entirely by feedback. If you have a tender point or a trigger point, I'll find it just by feel.
Your part of the treatment is very simple. You must drink an additional gallon of fluid -- that's right, a gallon! -- above and beyond your normal intake both on the day of treatment and for one to two days afterwards to prevent excessive soreness. If you feel like you're coming down with the flu or if you feel nauseated, you haven't had enough to drink.
While you're being treated with Myofascial Release, your improvement won't progress in a straight line. Rather, your progress will zigzag; for some, it's more like riding a roller coaster. Although you may feel like you're taking two steps forward and one step back, you will be making progress. Donít get discouraged -- you will improve! This zigzag progress happens because your brain takes time to accept changes in the posture and muscle tension that it recognizes as "normal" for you. As your muscle tension and posture are changed by treatment, your brain will gradually accept these changes as your "new normal."
