Those of you
that have visited the website and blog, or seen any of my posts on Facebook or
Twitter, but who haven't been to see me in a while and experienced Myofascial
Release (MFR) may well be wondering what on earth it is all about, and why I
keep harping on about it!
It doesn't have a nice, obvious title like
Sports Massage or Physiotherapy.
It isn't so
well-known in the public because of a recognised status in society like
Osteopathy or Chiropractic.
However, it is rapidly increasing in its
devotees, and is being more and more widely used by Sports Massage therapists
and Physiotherapists, and recommended by Osteopaths, Chiropractors, and
musculo-skeletal specialist doctors as a technique that can be beneficial in
many kinds of complaints where Muscles and connective tissue is involved.
I was
reading the FHT magazine ‘International Therapist’ an incredible article about
advanced massage techniques, written by Rachel Fairweather, and she managed to
sum in just a short paragraph what I am about to put in even greater detail
below.
She
described MFR as a 'method of freeing restrictions in the myofascial system
where the practitioner uses the "listening touch" to tune into the
tissues and follow the fascia to where restrictions are held. MFR techniques
help to relieve pain, resolve structural dysfunction, restore function and
mobility and release emotional trauma.'
She also
points out that fascial work is useful in cases of acute and chronic pain;
fibromyalgia; ME; pelvic and menstrual problems; IBS; headaches; and sports
injuries. She also reminded me to point out that all fascial techniques are
done without oil.
In my MFR
treatments I also use craniosacral techniques, which work on the deepest layers
of the fascia (the dural layer) that surrounds the brain and spinal cord, and
acupressure techniques (also listed in her summary of techniques).
I couldn't
have summarised it all better myself (in fact I didn't!) - and I am thankful to
her for this incredible article. If you would like to read the whole article, please
drop me a line and I will send you a copy - it is well worth a read.
The
Sciencey Bit ….!
Myofascial Release is beneficial in many types of pain and trauma. As a
therapist in this modality for over 3 years I have assisted clients to heal
themselves from many types of muscular overwork and shortening; chronic
inflammatory processes including micro-traumas or unresolved injuries; and
direct injuries with resultant scar tissue.
My clients have presented with a range of symptoms including migraine
and headaches; temporomandibular joint (jaw) problems; back pain (cervical,
thoracic, lumbar, and sacral); postural imbalances; patients who are
post-trauma; those with decreased range of motion or mobility; those with
excessive scarring (post-surgical, and trauma); and many forms of chronic and
acute pain. MFR has helped patients with musculo-skeletal problems in every
limb, and joint. It provides the necessary stimulus for the innate ability of
the body to heal itself, and it works on the physical, neurological, and
psychological aspects of the body. Many clients have experienced an emotional
release alongside their physical release, particularly if their muscular
problems have stemmed from emotional stresses - this makes it a very holistic
method of treatment.
However,
please do not think that I advocate MFR above any other form of therapy, it is
an addition, not a replacement for other techniques, and is best used in
combination in a well though out and implemented treatment plan. But moving on
to the nitty gritty, for those who want the lowdown on the science!
MFR is all
about creating space. Elongation (or stretching) of the tissues is important,
but creating the space for this to take place is critically important. Creating
space brings in oxygen, which allows the decrease in tissue tension. Without
the space for the stretched muscle (for example) to move into, it won't stay
there once the treatment is over, because it will have to revert to the space
available to it.
Some Definitions:
Myo is: a prefix
used in biology to denote muscle, originating from the Greek derived
Fascia is: the
fibrous connective membrane of the body that may be separated from other
specifically organized structures, such as the tendons, the aponeuroses, and
the ligaments, and that covers, supports, and separates muscles. It varies in
thickness and density and in the amounts of fat, collagenous fiber, elastic
fiber, and tissue fluid it contains. Kinds of fasciae are deep
fascia, subcutaneous
fascia, and subserous
fascia.Mosby's Medical
Dictionary, 8th edition. © 2009, Elsevier.
Connective
Tissue is: a fibrous type of body tissue with varied
functions; it supports and connects internal organs, forms bones and the walls
of blood vessels, attaches muscles to bones, and replaces tissues of other
types following injury. Connective tissue consists mainly of long fibers
embedded in noncellular matter, the ground substance. The density of these
fibers and the presence or absence of certain chemicals make some connective
tissues soft and rubbery and others hard and rigid. Compared with most other
kinds of tissue, connective tissue has few cells. The fibers contain a protein
called collagen.
Connective tissue can develop in any part of the body, and the body uses this
ability to help repair or replace damaged areas. Scar tissue is the most common
form of this substitute. See also collagen
diseases. Miller-Keane
Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh
Edition. © 2003 by Saunders, an imprint of Elsevier, Inc.
structural
tissue composed of fibrous materials and a substrate that contains a variety of
cells. Bone, cartilage, hair, nails, and fibrous tissue between cells and
around muscles are all considered types of connective tissue. Jonas:
Mosby's Dictionary of Complementary and Alternative Medicine. (c) 2005,
Elsevier.
Connective
tissues (fascia, muscle, blood, bone, etc.) are made up of 3 layers, the
superficial, deep and dural layers; 3 components, elastin for flexibility and
resiliency, collagen for shape, support and strength, and ground substance (or
cellular matrix) which determines the functional capabilities of every cell in
the body. They surround, support, protect, separate, and play a role in
metabolic and cellular communication. Just think about an orange. The peel (the
superfical layer) supports, and surrounds; the inner 'skin' (the deep layer)
surrounds, supports, and separates each segment, and within each segment every
juicy little particle (the dural layer) is surrounded, supported, separated,
and protected.
Many
practitioners of original Myofascial Release techniques have unwittingly been
performing an often agressive, symptom-focussed form of soft tissue
mobilisation in which not all components of the fascial system are reached
(often the dural layer is not activated). These are excellent forms of remedial
massage when used appropriately, and can be combined with other modalities as a
wonderful beginning for what was to come - true Myofascial Release (MFR). When
compared against other soft tissue mobilisation techniques MFR differs mainly
when it comes down to the length of the stretch applied.
- Trigger Point techniques (used in Sports Massage etc.) hold a
stretch for up to 45 seconds.
- Shiatsu will hold the stretch for 45 seconds
- Strain/Counterstrain (orthobionomy) techniques and Rolfing hold for
90 seconds.
- Massage has no hold, or very short holds.
- MFR, goes beyond the traditional - see Figure 1 above. MFR holds
for 3 minutes, and more ...
A release is complete when there is the sense that when let go the
stretched tissue won't bounce back, that it will remain where it is at the end
of the technique.
Figure 1. The timeline of hold
Essentially MFR is
a low load, long duration stretch into the tissue. It increases the
biomechanical efficiency of the joints, co-ordination and movement quality. It
increases metabolic efficiency, and increases strength, power and
endurance.These effects counter the mechanism of tissue damage (ie the spilling
and loss of proteoglycans with a resultan loss of water; degydration with the
inability to move lactic acid; the solidification to a crystallised substance
of the matrix; signals to the brain that there is a problem and that repair
needs to commence; and signals to other parts of the body which creates
symptoms often far from the site of injury).
Cellular tissue damage has 2 responses: to repair what is damaged, and
to brace the area for that healing. The goals of tissue treatment therefore
need to be to decrease the neuromuscular response; to open the fascia; and to
stop fibroblast activity. Fibroblasts are specialised cells that create chains
of proteins to build fibrous tissues in areas where it should, and often
shouldn't be (scar tissue; new connective tissues like elastin, collagen and
cellular matrix - including the matric constituents like proteoglycans). There
is no system to control the fibroblast activity, they can either lay down more
scar tissue, or they can absorb themselves. It is important to 'talk' to the
body and stop an over-reaction. MFR, by applying its low load, long duration
stress to the fascia changes the electrical potential in the cells, which
signals the fibroblasts to change their function from laying down more scar
tissue, to absorbing themselves more.
Scar tissue is a normal part of healing, but it is weaker and less
elastic than normal tissue, and has a much more fibrous matrix.The
proteoglycans found in the matrix are like sponges, and they need to be 'fed'
(with oxygen), and they require water. Dehydration of the cells is a big part
of inflammation, and without water there will be an abundance of elastin and
collagen, but a very dense and fibrotic matrix. Immobile scar tissue is not
normal, however it will deform with less force if it is stretched in more than
one plane at the same time. To minimise the effects of scar tissue it is
important to modify cell permeability and allow cells to 'communicate'
chemically. This can mean that the deposition of fibres can take place in more
appropriate patterns. MFR, by stretching tissues in more than one plane, with
its low load, long duration stretches increases cell permeability, changes the
electrical potential to affect cell communication, preventing overwork by the
fibroblasts, creates space for nutrient and water flow, and stretches the
myofascial tissues to cause release and rehydration - this leads to a reduction
in pain, helps to increase range of motion and mobility, and makes you feel
great. What more can you ask for from a treatment?!
(Summary of some of
the Human MFR coursebook, by Ruth Mitchell-Golladay, an absolute artist at the
'listening touch', and my mentor. Thank you so much for teaching me this
amazing technique.
Any errors in the
above are definitely not hers - they are all mine!)
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