by John F. Barnes, P.T.
I have been a featured speaker on myofascial release for the American Back Society’s symposiums for more than 25 years. The American Back Society is comprised of orthopedic surgeons, neurosurgeons, therapists, chiropractors and osteopaths interested in “leading edge” techniques.
I was honored to lecture on my approach of myofascial release at the American Back Society symposium with the theme, “The most important advances in health care in the last century!”
One year at the American Back Symposium, Nikolai Bogduk, M.D., reported on the importance of a re-evaluation of the anatomy and function of the spinal musculature and fascia, and of the osseous structures to which they attach and influence. Below you can read his important recommendations based on his findings:
“Experimental evidence indicates that excessive strain of muscles results in failure near the myotendinous junction. Sprains of the back muscles should, therefore, exhibit tenderness near the insertions of the affected muscles. However, because of the segmental, fascial anatomy of each myofascial element, a given offending movement may affect only particular fascicles. Thus, rather than involving the muscle as a whole, sprains may occur at selected, specific sites resulting in focal tenderness. Such sites may be misinterpreted or misrepresented as trigger points.”1
One can visualize how fascial restrictions in random strain patterns can shorten, creating abnormal tensions upon individual or groups of fascicles and the neural, vascular and osseous structures to which they attach and powerfully influence. These abnormal compressive forces can exert pressure upon the neural structures, creating entrapment syndromes. Fascial compression of the vascular structures can produce ischemic conditions. Shortening of the muscular component of the fascicle can limit its functional optimal length, reducing its strength, contractile potential and deceleration capacities. These fascial restrictions can also create abnormal strain patterns that can pull the osseous structures too close together or out of proper alignment. This can result in compression of the facet joints, or disc, producing pain and/or dysfunction.
I have found that release of the fascial system balances and provides more space between the joint structures of the skeletal system. Trial and error led me to see some joint manipulation techniques are too high in velocity or too short in duration. They tend to elicit the body’s protective responses and don’t affect the environment of the osseous structures, the myofascial system. The fascial strain patterns that remain tight tend to pull the osseous structures back into positions of dysfunction once the client reloads in gravity. This scenario explains why therapeutic modalities, exercise and flexibility programs, manipulation and muscle energy techniques (neuromuscular techniques), massage and mobilization procedures do not always produce lasting results. I have used and taught manipulative procedures for more than 40 years, and have found all of the above techniques to be helpful in certain situations. However, we can now understand why we have only achieved temporary results with these methods by realizing that they affect only the osseous structures or the muscular or elastic components of the myofascial complex.
I have developed an expanded method of myofascial release called myofascial/osseous release, taught in my Fascial Pelvis and Cervical Thoracic seminars, in order to achieve long-lasting results. Myofascial release is one end of the spectrum, where the therapist uses the fascial system as a handle or lever to relieve the pressure on pain-sensitive structures and mobilize the osseous structures. At the other end of the spectrum, myofascial/osseous release focuses on utilizing the osseous structures as handles or levers, to free the skeletal structures and their surrounding myofascia, safely and highly effectively.
The very important difference from other mobilization, muscle energy and manipulation and massage procedures is myofascial/osseous release techniques are performed very slowly, following the fascial restrictions three-dimensionally. Remember, the fascial system does not release quickly. Over time, the tissues feel much more like rope unraveling, releasing one strand at a time. This creates change in tension. The sensitive, trained hands of the therapist can follow this change in a three-dimensional manner, as if they were working at untwisting and stretching taffy.
Myofascial release and myofascial/osseous release techniques are safe, easy to learn, and highly effective for reducing pain and restoring motion and optimal function on a permanent basis. These techniques help treat the entire myofascial, osseous complex. Because of this, the most comprehensive approach to restoring the quantity and quality of motion for optimum function should include these procedures combined with mobilization, muscle energy techniques and soft tissue mobilization, massage and manipulation procedures. The addition of appropriate massage modalities, exercises, flexibility, and neuromuscular facilitation techniques can then maximize and maintain results.
John F. Barnes, P.T., L.M.T., N.C.T.M.B., is an international lecturer, author and acknowledged expert in the area of myofascial release. He has instructed more than 50,000 therapists worldwide in his Myofascial Release Approach, and he is the author of Myofascial Release: the Search for Excellence (Rehabilitation Services, Inc., 1990) and Healing Ancient Wounds: the Renegade’s Wisdom (Myofascial Release Treatment Centers & Seminars, 2000). He is on the counsel of advisors of the American Back Society, as well as on MASSAGE Magazine’s Editorial Advisory Board and is a member of the American Physical Therapy Association. For more information, visit www.myofascialrelease.com.
For more information about myofascial release, view two separate excerpts from the Fireside Chat with John F. Barnes, P.T. DVD on YouTube:
American Back Society Newsletter, Volume 7 Number 3, Summer 1991. 2.
John F. Barnes, Myofascial Release: the Search for Excellence, Paoli, PA.