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What is Myofascial Release?
To first understand what myofascial
release is one must first understand the structure and function of fascia, and role myofascial restrictions play in the pathology
of the body. Fascia is organized into a three dimensional
web of connective tissue with a vertical orientation that is continuous from head toe. For added support there are dense transverse
planes of fascia at the pelvic floor, respiratory diaphragm, thoracic inlet, cranial base, and at each joint1. The
function of fascia is to create space for nerves blood vessels etc and to provide support. Fascia is composed
of collagen for strength, elastin for flexibility and ground substance for lubrication and shock absorption. To
give sufficient strength, elasticity and glide in a particular region all three components need to be distributed properly.
For example strength is needed at the respiratory diaphragm to support our lungs and ribcage but elasticity and glide is also
needed for respiration to occur. There are two types of fascia, superficial and deep. Superficial fascia
lies just beneath the skin and attaches to the underlying tissues and organs. It provides storage
for water and fat, serves as insulation, and most importantly provides a pathway for nerves and blood vessels.
Deep fascia surrounds, without interruption, every muscle, bone, organ and cell in the body.
Fascia is a continuous sheath of connective tissue that runs throughout the entire body, therefore, a fascial restriction
in any one part of the body can cause symptoms in another part of the body. The fact that fascial restrictions
can’t be seen using traditional screening methods and the pain caused from myofascial restrictions does not follow a
dermatomal pattern can make fascial restrictions difficult to diagnose. We use the term myofascia to describe both the contractile
and non-contractile components of fascia. Muscle and fascia are functionally linked, muscle with the help
of its fascial bindings give life to our osseous framework3.
What is a myofascial restriction and how does it occur? Myofascial restrictions can occur through trauma, inflammation, scarring, poor or
prolonged posture1. It can take 3-6 months following injury for a myofascial
restriction to develop and this is how it happens. When fascia is inflamed it shrinks and the normally
wet gelatinous ground substance that gives fascia its glide becomes hardened and binds down the tissue. This decreases flexibility,
fluidity of movement and the ability to absorb compressive forces. When fascia becomes restricted it hardens and shortens
creating enormous pull and entrapment of tissues such as nerves, blood vessels, organs, lymphatics, or muscles.
A fascial restriction can have a tensile strength of 2000 pounds per square inch. This can create abnormal strain
patterns that can pull osseous structures out of proper alignment resulting in compression of joint surfaces, discs, and bursae
which creates asymmetry and inflammation2. Another point to consider is that fascia
is slow to heal because of poor blood supply and it is a focus of pain because of its rich nerve supply.
How does
myofascial release work? The therapist uses gentle
sustained pressure for 90 to 120 seconds into the direction of restriction and holds until a release is felt.
A gentle pressure applied slowly allows a viscous medium to flow greater than a quick pressure would, this is known
as viscous flow phenomenon. The viscosity of the ground substance has an effect on the collagen by controlling
the ease with which collagen rearranges itself. As the collagen rearranges, the collagenous barrier is
slowly released causing a change in the tissue length. Furthermore it is theorized that the ground substance
changes its viscosity during a release from a solid, restricted state back to its proper viscosity through the properties
of applying mechanical, thermal, and bioelectric energy to the colloidal properties of the ground substance. This
theory is based on a physics principle stating that a colloid changes from a solid to a gel when mechanical thermal and bioelectric
energy is applied1.
References: 1.
Satalino, Lisa PT. A symposium on the fascial pelvis. 2009 2.
Barnes, JF, Myofascial Release-The Search for Excellence. JF Barnes and Rehabilitation Services, 1990. 3. Manheim Carol MS PT. The
Myofascial Release Manual Third Ed. Slack, 2001.
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