2. Myofascial Release Myo refers to muscle. Fascia refers to the body’s supporting connective tissue. The goal is “viscolengthening” and “plastic deformation” of the fascia.
3. What is Fascia? Fascia is a seamless web of tissue that interconnects all of the body’s organs. It is responsible for normal, smooth movement. Fascia surrounds muscles, tendons, nerves and separates skin and adipose from muscle. Fascia is important connective tissue that maintains the integrity of the human body. Fascia has two layers: superficial and deep.
4. What is Fascia? Located between the skin and adipose tissue, the superficial fascia contributes to skin mobility and is composed of loose, highly elastic tissue with a low concentration of collagen.
5. What is Fascia? Located between the adipose tissue and muscle tissue, the denser deep fascia has more collagen and distributes loads produced by muscles. This collagen is more “multidirectional” than that found in ligaments, and allows it to respond the multidirectional stress. Examples of deep fascia include the lumbardorsal fascia and the iliotibial band.
6. What is Myofascial Release? Myofascial release is a form of manual therapy to stretch the fascia. The purpose is to relax these tissues or elongate them to restore tissue mobility. Injury, immobilization, disease and aging can result in fascial adhesions or restrictions, resulting in inefficient movement patterns, altered alignment, faulty mechanics and pain syndromes.
7. Benefits of Myofascial Release Because of its viscoelastic (plastic-like) properties, fascia will elongate with slow, moderately intense force referred to as “creep.” Myofascial release can help increase lymph and venous flow to promote the removal of exudates after an injury.
8. Benefits of Myofascial Release Myofascial release is useful in conjunction with other treatment including therapeutic exercise and joint mobilization. Myofascial release can help increase lymph and venous flow to promote the removal of exudates after an injury.
9. Common Techniques For superficial fascia evaluation and release, place the palm of your hand (or you can use your forearm) on the patient’s skin and stretch the skin just enough to take up the slack. Use the amount of force necessary to indent a ripe tomato. Translate in an inferior, superior, medial and lateral direction and note asymmetries. For deeper release, apply more pressure.
10. Common Techniques For skin rolling, use the pads of your fingers and thumb to gently lift and roll the skin.
11. Common Techniques For the crosshandtechnique, place the heel of one hand over the center of the tissue restriction site. Then cross your other arm against the first, placing the heel of that hand just below the first. Begin with gentle touch and light pressure. Then progress to more pressure by taking up the slack in the tissue. Gradually increase the pressure until you feel tension and then hold firmly. As the tissue relaxes, take up the slack and continue the stretch. Repeat until no further stretch is possible, then slowly release and re-evaluate. If treating a small area, use the fingers rather than the hands to apply pressure.
12. Common Techniques J-Strokes are used to release superficial fascialrestrictions. Use one hand to put tension on the skin to stretch the restriction. This hand does not move, it serves to stabilize the tissue. Use the index and middle fingers of your other hand to apply a J-stroke pattern down towards you to “strip” the restriction.
13. Common Techniques For deep tissue stroking,use your index finger’s PIP joint and your thumb together (same hand), your MCP joints, or both thumb pads as a treatment tool to apply firm, longitudinal stroking maneuvers for deep tissue release. This technique is particularly effective for the ITB, hamstrings and gastroc.
14. Common Techniques Additional deep tissue stroking involves using the clinician’s heel of the hand or forearm as a tool. Technique effectiveness can be enhanced by stabilizing the distal aspect of the tissue to be elongated with one hand, as you mobilize the tissue proximally using the other, or by placing the tissue on stretch.
15. Contraindications Consider any contraindications including but not limited to: acute injuries, skin lesions, fracture, hypersensitivity to touch, those with arteriosclerosis, embolism or pain of unknown origin.
16. References Denegar et al, Therapeutic Modalities for Musculoskeletal Injuries, 3rd edition Knight and Draper, Therapeutic Modalities: The Art and Science Starkey, Therapeutic Modalities, 3rd edition
