There is a growing trend among health care professionals and patients of physical therapy clinics that recognizes the effectiveness of manual therapy in treating variety of neuro-musculoskeletal conditions. Joint manipulation and soft tissue mobilization, hands- on or instrument assisted, form the backbone of majority of treatment plans in our clinic. One of the most utilized therapeutic modalities integrated into physical therapy treatment is myofascial release.
To understand the term “myofascial release”, it is crucial to explain, what the myofascia is. Prefix “myo” means muscle in Greek language, “fascia”, on the other hand, comes from Latin and it means a flat band or bandage . Fascia is the dense connective tissue composed of elastin and collagen fibers that surrounds and covers every muscle, nerve, blood vessel and organ in our body. Similar to yarn in a sweater, pull and damage in one area will strain distant areas and cause tension throughout fascial network. Healthy myofascial tissue has the ability to stretch and move without restriction. Due to poor posture, sedentary life style, emotional stress, inflammation, repetitive motions, surgical procedures, or traumas such as a fall or car accident, fascia scars and hardens. It loses its pliability, adheres to muscle, which leads to restricted range of motion of the neighboring joints and abnormal biomechanical functioning.
Myofascial release is an effective hands-on or instrument assisted technique that involves applying sustained pressure directly on the myofascial tissue. Initially, a therapist seeks autonomic or reflexive effects and gently stimulates sensory receptors in the skin and at the level of the subcutaneous fascia. This way a therapist desensitizes affected area and gains entry level to deeper structures with less potential for tissue microtrauma and exacerbation of pain. The next step of the intervention is mechanical change such as a stretch of the contracted muscle or superficial tissue rolling to mobilize adhesions. After freeing up the superficial restrictions, stronger pressure is applied to go through the “layers” until the deeper tissues are accessed. At times, forceful technique is required to free up longstanding restrictions. When optimal length and mobility of the soft tissue are established, therapy focuses on changing abnormal joint alignment and normalizing patient’s movement patterns.
The purpose of myofascial release is to break down scar tissue, loosen tightened fascia, reduce hypertonicity of the contracted muscle and decompress lesions such as nerve impingement. It is also intended to increase blood circulation, lymphatic drainage and facilitate tissue repair capacity. Although fascia and its corresponding muscle are the prime targets of the myofascial release, other structures, such as Achilles tendon or forearm common extensor tendon, are frequently treated with this technique.
Myofascial release therapy has been effectively utilized for relief from common problems such as neck and low back pain, headaches, plantar fasciitis, lateral epicondilitis (tennis elbow) to name just a few. It shortens and optimizes recovery from traumatic injury or surgery and improves performance in high level athletes. By targeting specific areas of restrictions, myofascial release therapy reduces pain, restores normal mobility and allows the patients to return to their normal functional capacity.
Maggie Garbiec, PTA