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Myofascial Release Technique Certification

Approved for 8 Online Continuing Education Units/Credits (CEU's) for Pennsylvania Licensed Massage Therapists

Receive Your 8 CEU's Now

Approved for 8 Online CEU's for Pennsylvania Licensed Massage Therapists. Cost $100.00 / Certificates Awarded Upon Completion.



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Introduction
History
Summary

Myofascial release (MFR) is a collection of approaches and techniques that focuses on freeing restrictions of movement that originate in the soft tissues of the body. The benefits of this work are diverse. Direct bodily effects range from alleviation of pain, improvement of athletic performance, and greater flexibility and ease of movement to more subjective changes such as better posture. Rather than being considered a specific technique, MFR is better understood as a goal-oriented approach to working with tissue-based restrictions and their two-way interactions with movement and posture.

The umbrella of MFR methods focuses heavily on how specific activities or lack of activity as well as compensations for prior injuries result in chronic stress and avoidance of full range of movement. Ida P. Rolf was among the first to be recognized for her belief that much of the chronic pain and dysfunction in our bodies is caused by poor postural habits affecting the muscles that hold us erect in gravity with minimal contraction and lengthening, and especially the fascia surrounding these muscles. Pain and restricted movement of joints may result in shortening of muscular units and adhesions between layers of fascia, which can cause a vicious circle of more pain followed by more protective holding and soft tissue shortening. The application of controlled and focused force in a purposeful direction acts to stretch or elongate the muscular and fascial (myofascial) structures to promote the goal of restoring the fluid and lubricative quality of the fascial tissue, the mobility of tissue, and normal joint function. The restoration of joint function occurs when such function has been adversely affected by the dysfunction of the surrounding myofascial tissue. This should be differentiated from dysfunctions intrinsic to the joint itself, which are beyond the scope of this chapter (Box 9-1).

BOX 9-1   ​Learning Myofascial Release

Learning occurs best when one reflects on personal experience with awareness but without self-criticism. The former guides our path; the latter impedes our progress. When you shift to a more myofascial approach, the work and techniques may seem strange or uncoordinated, especially if you are accustomed to using a lot of lubrication, following a fixed massage sequence, or keeping to a fixed tempo of strokes. This feeling of strangeness is simply a necessary stage of learning and integrating new kinesthetic skills. The most significant difference between myofascial release and conventional relaxation oil massage is that with myofascial release, the emphasis is on slow and patient lengthening of tissue by grabbing and stretching rather than sliding over with compression. Since this will feel significantly different to your client, it is advised that you explain what your purpose is and why sensations and techniques may feel different from what the client is used to. As with all who practice and master such skills, you will someday look down to find your body and hands performing skills of myofascial release without conscious thought or effort. Although a single chapter cannot truly provide “how to” instruction, it is hoped that having a clearer understanding of fascia and some of the approaches to working with it will lead you to automatically expand your touch and intention to include myofascial work in whatever form of bodywork you perform.

Erik Dalton, an advanced Rolfer and bodywork author and instructor, has described our society as a culture of “flexion addicts.” He notes, “The last century has witnessed a dramatic acceleration in our culture’s flexion addiction. This pervasive and insidious condition is primarily due to the population’s generational transition from an active group of movers to a sedentary bunch of sitters.”1

In the absence of acute injury, pain and restriction are commonly the long-term effect of chronically flexed (i.e., shortened) positions. As noted by Cantu and Grodin,2 application of Wolff’s law to soft tissue (i.e., Davis’s law) implies that “all connective tissue seeks metabolic homeostasis commensurate to the stresses being applied to that 151particular tissue.” Tissues habitually held short become physically shortened, both in the contractile elements of the muscle cells and in the more static collagenous elements of fascia that support the muscles. Lack of movement and lines of stress from tension and opposition to gravity facilitate formation of adhesions and fibrosis. Antagonists of chronically activated muscles can be overworked or neurologically inhibited and become fibrotic or weak. Ultimately, pain and dysfunction occur—conditions that MFR aims to address by a combination of directly applied pressure, recruitment of neurologic reflexes, and relearning of movement potential. Because our (human) bodies are collections of interacting systems—connective tissue, neurologic, chemical-immune, and emotional—we have multiple paths that we can combine to effect positive changes. The author follows suit with Cantu and Grodin’s classification of myofascial approaches as being reflexive, mechanical, or movement-oriented,2 having used combinations of these in his own work. This combined approach is distinguished from one confining itself to consideration of the purely physical application of force to fascia. An additional subtle but important component of the work is facilitation of the body’s own tendency toward healing and a positive homeostasis when tissues are normalized and dysfunctional habits are retrained.

In the multiple professions in which manipulation of soft tissue arose in the twentieth century, myofascial release became a term of convenience for a wide range of differing but highly valued “goods” of healing and commerce.

Much confusion is saved by remembering that myofascial release is a generic term. It is an umbrella phrase used to describe various approaches with considerable variation in philosophies and techniques that share a common focus on freeing fascial restrictions. Depending on the personality, training, and skills of the practitioner; the type and degree of restriction or dysfunction; and, to a very large extent, the makeup of the client, different techniques may have varying degrees of success. Any technique that works to free fascia is a form of MFR, and what works well for one client may not be as effective in another.

The recorded history of the term myofascial release is as much a linguistic history as it is a comprehensive gathering of the history of practice. For as long as massage has been practiced in its many forms, and long before dissection demonstrated a separate tissue defined as fascia that surrounds and permeates all muscles and organs, any accomplished practitioner would have felt the distinct properties of fascia as being very different from those of muscle tissue. Simply from tactile distinction, practitioners, consciously or intuitively, would quickly have developed techniques for releasing fascial restrictions that were different from those used to ameliorate purely muscular dysfunctions.

Robert Ward, an osteopath, is credited with coining the term myofascial release in the 1960s.3 Since then, John Barnes, a physical therapist, has become a well-known writer and teacher of MFR as a separately identified study.46 MFR, however, has been considered by Ward and other authors to be a “bridging technique” that ties together a number of different approaches toward relieving pain and restrictions of movement.7 Another way of looking at this is that MFR is not so much a technique in itself as it is a goal orientation that successfully weaves a number of techniques together. We thus find the underlying framework for the development of MFR coming from a number of different treatment traditions involving direct pressure, neurologic facilitation of muscles, and reeducation of learned neuromuscular patterns of posture and movement.

Philip Greenman mentions that “fascia has received attention from such individuals as the osteopathic physician William Neidner, who used twisting forces on the extremities to restore fascial balance and symmetry.”7 Ward also suggested that the direct method, called fascial twist, came from the osteopathy school in the 1920s by Neidner.8 Also according to Ward, MFR originated from concepts used by Andrew Taylor Still, the founder of osteopathic medicine, in the late nineteenth century.8,9 Ward further comments that he was using “combinations of isometric, isotonic, functional indirect, and MFR concepts since the early 1950s, since they were taught by Wilbur Cole and Esther Smoot.”8 Long before this osteopathic thread of the 152early twentieth century, we can surmise that the human tendencies toward touch10 had led people to notice the effects of organized pressure on tissue as well as its abilities to sooth anxiety and reduce pain. The techniques used would have been kinesthetic, observational, and palpation skills passed on as a direct tradition from master to apprentice with little written down (Box 9-2).

This chapter provides a historical background of the varied threads of work contributing to modern techniques of MFR. It also provides the essential anatomy and physiology for understanding this work and its motivation. No single chapter can be definitive: far more has been left out than could possibly have been included. Nonetheless, this 170chapter provides an introduction to MFR that enables massage practitioners to begin to incorporate myofascial techniques into their existing set of skills.

As the public becomes more informed on the benefits of massage that specifically addresses fascial dysfunctions, whether called MFR or deep tissue massage by the practitioner, it seems worthy of some additional attention as a modality that the author feels depends, in large part, on the practitioner’s ability to develop MFR kinesthetic skills. Although there are many MFR variants that were covered in this chapter, the vast majority of practitioners who use myofascial skills apply them in a more generic massage setting. Most spas and private massage therapists performing therapeutic work now charge higher rates for deep tissue massage, but there is little continuity in what is expected by the public or is practiced by therapists. Although some clients may just expect a more intense massage and assume that the extra charge is because the therapist works harder, this is far from what should be the case.

Properly performed, deep tissue massage is not simply doing a “regular” massage while pressing harder or using tools such as elbows or knuckles. In addition to more precise focus on the depth at which restrictions are held (not how hard one presses), MFR involves a substantial change in intent. The client and practitioner are mutually positioned to allow a focus on specific myofascial elements and stretching tissue. This contrasts with simply sliding over the skin surface and broadly compressing the tissue beneath it, and differentiates direct technique/deep tissue work from more relaxation-based massage. The specificity and slower tempo of the work also imply that MFR would not be the sole modality of a whole-body massage. If covering the body is a goal, the practitioner would work deeply where indicated and in other areas use broader brush techniques from other modalities, such as Swedish or sports massage.

Barnes writes, “The separation of a fascia from its muscular component and their influence on each other is imaginary. In other words, we have been evaluating and treating an illusion. Reality demands that we consider both [muscle and fascia] by understanding their characteristics and using this information in our evaluation and treatment regimens.”5 Virtually every teacher of any form of body therapy (and most things in life) will emphasize the importance of intention—having a purpose and focus behind the physical pressure of strokes.

This subtle quality of intention is what separates manual massage from machines that can knead, vibrate, or press tissue. Since we all work with fascia whether we intend to or not, it behooves any therapist to include MFR as an intention behind the work, whatever form of bodywork is being performed. Rather than leaving the results of intervention to serendipity or, in the worst case, possibly causing a counterproductive effect, the practitioner thus guides the results by conscious fascial intention toward the desired end of a substantial benefit to the client’s body and life.

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Receive Your 8 CEU's Now

Approved for 8 Online CEU's for Pennsylvania Licensed Massage Therapists. Cost $100.00 / Certificates Awarded Upon Completion.



Please allow time for your purchase to process. We will contact you via email with instructions to access the online course as soon as your payment is complete. Please make sure your email address is correct. Thank you for your patience.