Myofascial release is now very popular and is not a new idea although it has gained great popularity in recent years. Rodger began considering the fascial system as a source of pain, mechanical dysfunction and ill health almost 20 years ago and has trained with world leaders such as John F Barnes and Stephen Goldstein. Rodger trains all his team in many topics on an ongoing basis but the myofascial approach is widely accepted amongst his team as they see the benefits to such an holistic treatment.
So just what is Myofascial release? Myo means muscle and fascia is a form of connective tissue in the body. It is sometimes describes as a 3 dimensional web / matrix which runs throughout the entire body – literally. Not only in the outer skeleton and muscles but into the brain, nervous system, internal organs and even extending into the bone. There is indeed superficial fascia which can be dense and tough and is the silvery white sheet of tissue you see in a piece of meat. You tear the meat off it in a rack on ribs / Chinese ribs, it separates the bellies of muscles in your Sunday roast. There is also a less known deep form of fascia which is gossamer thin and microscopic. This highly hydrated / rich in water and creates structure yet fluidity to movement. If you imagine your body as a matrix – like the image above, or a spiders web. If there is a knot or abnormal tension in one place then it will affect the rest of the web. So tension in one are from injury or previous organ disease / inflammation etc, for example, might place tension elsewhere in the body and later result in problems arising elsewhere in the body. For example – Rodger has seen many patients who come in complaining of pain in their right shoulder following gall bladder surgery or in the left shoulder following cardiac surgery. Imagine holding your shirt by the waistband then lifting your arm up – you would feel the tension / stress around the shoulder as the fibres in the shirt cannot glide and slide and are tethered / fixed.
So all to commonly physiotherapists and other medical practitioners are guilty of working only locally to the painful structure. Indeed there may be an inflamed tendon in the shoulder but why did it become inflamed? Maybe it was following specific injury? Fine – then local treatment may be all that is required. However, if it is secondary to restrictions elsewhere in the fascial web then local treatment will usually be fruitless or afford only a temporary resolution.
Through skilled palpation and ability to feel these very subtle restrictions the therapist can work on the restrictions in the web rather than focussing on the local issue.
So myofascial release is a very holistic form of therapy. Frequently minors niggles and ailments over than the primary reason for attending the physiotherapist will be resolved during treatment. For example- Rodger has found it extremely common that patients suffer low back pain concurrently with IBS, or throat tonsil or thyroid problems along with neck and shoulder pain. Very often the IBS etc will improve or resolve along with the back pain / neck pain when treated with this myofascial approach.
The treatment is extremely gentle and is often only a few gramps of pressure on points of the body. It can sometimes feel like we are not doing anything because the pressure is so light although patients often feel the changes within their body during treatment and see the benefit afterwards.
There are many styles of myofascial release. By far the most common and popular currently is what I would refer to as “direct” myofascial release. This is where you use more pressure and can be quite deep pressure at times. I think many people have called deep connective massage myofascial release. You will see foam rollers being used a lot if you search the internet on this subject. In my opinion this form of myofascial release is far less effective and less holistic. The “indirect” approach is where rather than trying to force the fascia to release by tension increases slowly, you actually unwind the tension. Like most things in life I find, if we take the tension out of a situation then matters resolve a lot quicker and with less collateral damage! However, there is a place for both systems – the skill as with all therapy is in knowing which tool is the best one for the job!