To complement the MASSAGE Magazine article, “A Gift from China: Tuina,” by Kirsten A. Wiley, in the June 2011 issue. Article summary: Tuina can be talked about in two ways: from a Western medical perspective or from a traditional Chinese medicine perspective. Just like massage techniques in the West, Tuina can increase blood circulation and lymph drainage, and can provide the benefits of informed touch.

by John F. Barnes, P.T.

Among its many functions, the myofascial system is the major shock absorber of our body systems, the many forms of stretching, massage and muscle energy techniques temporarily improve the elastic and muscular component of the myofascial complex. They do not release the collagenous aspect, which is vital for lasting results. Combining myofascial release with your expertise will quickly enhance your efforts to lessen injury and improve performance.

This begins to explain the sports and performance injuries that reoccur despite extensive therapy and stretching and flexibility programs. An athlete with fascial restrictions will not efficiently absorb the shocks of continued activity. The body then absorbs too much pressure in too small of an area, and during performances the body keeps breaking down.

This same effect takes place over time from the microtrauma of having discrepancies of leg length due to torsioned pelvis. Each step sends imbalanced force throughout the body. The body must compensate through muscular spasm and fascial restrictions, ultimately producing symptoms.

Impacts, falls, high-velocity injuries and the various traumas of performance and life can create a shortening and thickening of the myofascial system. Trauma stimulates the body to generate additional connective tissue fibers as a form of compensation during the healing process.

Normally, the fibers later would be removed and replaced with healthy tissue by the natural processes of the body. Often, however, the rate of assembly exceeds the rate of removal and the fibers build up. As a result of this build-up on the cellular level, the ground substance of the extra cellular matrix solidifies.

Myofascial restrictions cause pain, limited motion and shock absorption. This also creates a dehydration of the ground substance, decreasing electrical conductivity and our ability to absorb shock. Trauma or malfunction of the fascia can set up the environment for poor cellular efficiency, necrosis, disease, pain and dysfunction throughout the body.

Connective tissue is composed of collagen, elastin and the polysaccharide gel complex, or ground substance. These form a three-dimensional, interdependent system of strength, support, elasticity and cushion. Proteoglycans are peptide chains that form the gel of the ground substance. This gel is extremely hydrophilic, allowing it to absorb the compressive forces of movement.

As long as the forces are not too great, the gel of the ground substance is designed to absorb shock and disperse it throughout the body. If fascia is restricted at the time of trauma, the forces cannot be dispersed properly and areas of the body are then subjected to an intolerable impact. The result is injury that does not resolve. The forces do not have to be enormous; a person who just does not have enough give can be severely injured.

Myofascial release techniques are performed to reduce these symptoms. In addition to increased range of motion, the enormous pressure of the fascial restrictions are eliminated from pain-sensitive structures, alleviating symptoms and resorting the normal quality and quantity of motion and the body’s ability to absorb shock.

John F. Barnes, P.T., L.M.T., N.C.T.M.B., is an acknowledged expert in the area of myofascial release and president of Myofascial Release Treatment Centers and International Myofascial Release Seminars. He is the author of Myofascial Release: the Search for Excellence (Rehabilitation Services Inc, 1990) and Healing Ancient Wounds: The Renegade’s Wisdom (MFR Treatment Centers & Seminars, 2000). Barnes is on MASSAGE Magazine’s editorial advisory board. For more information, visit