Myofascial Release: Toward Mainstream Therapy
Penn State Sports Medicine Newsletter by Jim Brown, Ph.D., Executive Editor Ivanhoe Broadcast News, Inc. July 2000 (Ivanhoe Newswire)Physical therapists now have an effective but not widely recognized weapon in their arsenal to treat soft tissue injuries and conditions. It is called myofascial release (MR) and is considered "in transition" between alternative and mainstream therapy.
"Myofascial release," explains Roger Kilcrease, M.S., P.T., who practices at the Atlanta Back Clinic, "is the use of pressure applied by the hands and arms to get a lengthening of muscle (myo) and interwoven connective (fascia) tissue. It is used in combination with traditional physical therapy methods."
The technique has its foundation in the work of practitioners such as Ida Rolf ("Rolfing"), Joseph Heller ("Hellerwork") and J. F. Barnes. The term "myofascial release" began to appear in professional literature in the late 1980s and early 1990s.
Fascia is made up of both strong, somewhat elastic collagen fibers and extremely elastic fibers that are made mostly of water. It extends, surrounds and is part of every tissue in the body. With an estimated tensile strength of 2,000 pounds per square inch, it is not surprising that when it tightens, we feel the pain.
"I use it in cases where there is a chronic shortening of tissues because of postural problems, repetitive injuries or scarring of tissue after an injury," explains Kilcrease. "When athletes get injured, their muscles and connective tissues tend to protect the area by shortening and, in effect, splinting the area. Then the joint isn't allowed to operate in its normal range."
Not Appropriate for Everything
Myofascial release is not appropriate for all sports injuries. Any part of the body that might be negatively affected by even more "looseness" would not benefit from MR. In fact, the procedure might even induce instability. The best use of MR is where a joint or muscle group needs to be flexible as well as strong.
"Myofascial release is an accepted form of therapy," confirms Joanne Allen, M.D., a physiatrist in Georgia's Peachtree Orthopaedic Clinic. "It is one of several modalities that are appropriate for certain injuries, although it may not be familiar to the general public. While MR has been proven to be effective in the short term, it's value as a long-term solution to orthopedic problems is not as well established."
More Than Massage
Those who are not familiar with MR might think that it is another form of massage. However, the purposes of massage are to increase the flow of blood, relax the muscles and improve flexibility. MR is directed more toward a permanent lengthening of the tissue and restoring system-wide balance in the body. Although myofascial release has been described as a gentle form of tissue stretching, some patients might not agree that the technique is gentle. Rather, the therapist uses the hands to apply considerable pressure -- enough, in some cases, to cause soreness for several hours up to a day after treatment.
How do you know if you are a candidate for myofascial release? You don't know without professional advice, but those who can achieve lengthening of muscles and connective tissue simply by stretching are not likely to need MR.
As with any other form of therapy, the longer a person has had symptoms or the more profound the condition, the longer it may take to resolve the problem. That means weeks for some people, months for others. Age, diet, the nature of the injury and fluid intake are also contributing factors.
Increasing Attention
Adds Kilcrease, "The importance of fascia as a major structure of our bodies is receiving increasing attention by the medical community. Now, this tissue that envelops just about everything and allows for form and movement of internal organs is being looked at more closely." If it is not already part of standard physical therapy programs of study, most physical therapy schools offer elective courses in myofascial release. Practicing physical therapists can also attend MR courses as part of their continuing education programs.
"The attention myofascial release is getting in medical schools, physical therapy schools and in the press is moving the procedure toward mainstream therapy," concludes Kilcrease.