Put simply, the technique broadly known as myofascial release involves the application of slow, sustained pressure to areas of pain and dysfunction, with the goal of stretching and releasing the fascial restrictions beneath.
Pursuing myofascial release training can add another effective technique to your massage therapy toolbox.
Most therapists already understand the term myofascial release, or at least have their own perception of it. Definitions of this technique vary among therapists, and it is not uncommon that I may use many different forms of myofascial release with a client within the same session.
Definitions of the term myofascial release can describe hundreds of soft tissue and manual therapy techniques — everything from soft tissue to deep tissue techniques. After all, most manual therapy addresses the muscle, the Latin for which is myo, and most affect the fascia, because this connective tissue is all-encompassing, throughout the body.
Approaches to Myofascial Release
Myofascial release can be subdivided into two general areas: direct approach or indirect approach.
Throughout my professional career, I have studied or have a working knowledge of most manual therapy or soft tissue techniques, including those listed above. I consider all of these techniques or methods tools that may be useful in a given situation, but I gravitate toward the more direct approaches.
In the past, I had a simple mindset that my time was limited, so I should use as much pressure as the client could tolerate to achieve the outcome I desired. The problem was, the client was sore the next day, not to mention my own body after delivering all that pressure.
I decided to search for a non-invasive technique that would not cause the client soreness, yet be able to get deep and not cause myself any injuries. The closest I have found, reminiscent of CranioSacral Therapy, is what is taught in Myofascial Release Seminars by John F. Barnes, PT.
In the image above: Applying gentle pressure for a sustained time period can be exhausting for massage therapists. Be creative and try to find ways to use gravity so your body weight is providing all of the necessary pressure.
Myofascial Release in Action
Research has shown that fascia is incredibly strong and resilient. The softening or lengthening a therapist may feel during a treatment may often result in fascial tightness creeping back to the level that existed prior to the treatment, along with a small improvement in length and tension. This means a few more appointments may be necessary, and this treatment will be more time-consuming for the therapist.
With the therapist’s intuitive touch and constant, sustained pressure to treat restricted regions, not only can conditions be effectively treated, but the underlying issue can also be detected and addressed.
When addressing superficial layers, you may be able to effect the remodeling of these tissues, which appear to be caught in chronic pain patterns. When you work deeply, in tendon attachments, where Golgi tendon organs are abundant, you may also be influencing muscle patterns.
Consciously working at both superficial and deep levels is warranted when dealing with chronic pain. I like to push to the point where it is uncomfortable but not painful. I find where that is and just wait.
In my course Mastering Myofascial Release, I teach students to use a small amount of pressure to feel for the direction of most restriction and then, instead of sliding through it, waiting a minimum of 90 seconds to five minutes.
After you get through that first barrier, you get to the second barrier, which may have been passed over in traditional therapy. You have to wait there again a minimum of 90 seconds to five minutes, pressing into the restriction with gentle, sustained pressure without sliding.
When you feel the release, it feels like taffy stretching. At that point, you don’t slide, but instead just take the slack out of the system and move to the next barrier. Without you using any more pressure, the body will slowly start to let you in.
The fascial system is like the concentric layers of an onion — there’s barrier after barrier, and you have to be patient, take your time and go through each barrier.
To accelerate release, instead of just applying pressure to an area, it is also helpful to encourage a stretch or elongation of the fascial tissue. Look at Fig. 1, in which the client is in abduction to elongate the front of the shoulder, while receiving two fascial treatments: stretch and pressure.
In the image above: The client is in abduction to elongate the front of the shoulder, while receiving two fascial treatments: stretch and pressure.
Applying pressure for a sustained time period can be exhausting, so I encourage the therapist to be creative and find a position in which their body weight is providing all of the pressure necessary instead of generating this pressure with their muscle strength.
During their myofascial release training, many participants in my course Mastering Myofascial Release have fun trying to think outside the box and utilize their body weight instead of straining their muscles and joints. Working smarter, not harder, is always best.
In the image above: The most efficient tools at your disposal are your fingertips, forearms, or heel of your hand. Other tools might save the fingers, but the risk of not being able to judge the optimal amount of pressure is too great.
Tools for Myofascial Release
The most efficient myofascial release tools at your disposal are your fingertips, forearms, heel of your hand, knuckles or elbows. A device designed for instrument-assisted soft tissue manipulation (IASTM) might save your fingers, but with the use of such tools the risk of not being able to judge the optimal amount of pressure is too great.
When using your fingers, the joints should be locked together to minimize strain so you will be applying efficient pressure with the fingers as one individual unit. Curling the fingers or bending the elbows or wrists will eventually fatigue even the strongest individual.
Again, discovering a position that allows the therapist to use their body weight instead of muscles to provide pressure is the ultimate goal. Use your body, go deep and get those results.
About the Author
Garry Adkins, LMT, has been a Certified Massage Therapist Instructor since 1994 and is a National Certification Board for Therapeutic Massage & Bodywork Approved Provider of continuing education. He is licensed to practice in the state of Michigan and specializes in the treatment of elite athletes who need injury rehabilitation.