FREQUENTLY ASKED QUESTIONS (MYOFASCIAL RELEASE)

Myofascial Release is a gentle technique used to release adhesions near and far within the fascial system, which runs from the top of your head to the tips of your toes. A fascial adhesion can spread in bizarre ways and eventually effect a part of your body which has nothing to do with the original adhesion other than the fact that the fascia connects literally everything in your body.

Fascia is connective tissue consisting of elastin, collagen, specialized cells such as fibroblasts, and a gel like substance called ground substance (contains hyaluronan, glucosaminoglycans, proteoglycans, etc.) Elastin provides elasticity. Collagen fibers provide strength and flexibility, coiling around the elastin fibers. Collagen fibers resist tension, provides strength, and stops the elastin fibers from being stretched too far. The ground substance keeps it hydrated and allows everything to glide.

According to the National Institutes of Health, “The fascial system interpenetrates and surrounds all organs, muscles, bones and nerve fibers, endowing the body with a functional structure, and providing an environment that enables all body systems to operate in an integrated manner.” Fascia surrounds everything in your body. For example, not just the muscle, also the muscle fascicle, the muscle fiber, fibril, down to the smallest cell. It’s even inside the cell. Since it surrounds every last cell, and those cells and structures touch, it forms a 3-dimensional web throughout your body from head to toe.

Turns out fascia is an extremely important system in your body and affects EVERY other system.

Your muscles may move your bones, but it’s the fascia that keeps the muscles and bones where they belong. It doesn’t just support your muscles, bones and organs and keep them where they belong; arteries, veins, lymphatic channels, etc. run through and are supported by the fascia.

It allows the body to move by providing lubrication between the cells and structures. If your cells and structures stuck together, the bits and pieces, and possibly you, couldn’t move.

It protects your body from injury. Those collagen fibers have the strength of 2000 pounds per square inch. It doesn’t make you invulnerable, but without it, you couldn’t take a hit without your insides being pulverized.

Your fascia also has memory and is preemptive in protecting you from a threat. You may have suppressed a bad memory, but your body will remember it and manifest to protect against it recurring. “A fascial cell has not only memory, but also has the awareness of the mechanometabolic information it feels, and it has the anticipatory predisposition in preparing itself for alteration of its natural intra- and extracellular milieu.” This means that if you have, for example, had an injury or been emotionally hurt, your body may react the same way in anticipation even if the event is not reoccurring. Got yelled at by your teacher when you were a kid or by your boss? You may feel your heartbeat race and your body tense when you are, even subconsciously, reminded of it by a person, place, or even a smell.

The interstitial fluid, which is the fluid in the area between, well, every cell and everything in your body, is also lined by fascia since everything it is between is lined by fascia. Interstitial fluid provides hydration, nutrients, oxygen, white blood cells and antibodies to the bits and pieces of your body and removes the waste products and delivers them to where they need to go. It also provides communication by carrying transmitting molecules such as hormones and growth factor. The fascia allows all this to pass in and out of the cells.

Fascia helps regulate fluid flow, such as lymph and blood, throughout your body.

Fascia has sensory receptors that transmit pain, temperature, body position, and other sensory information to the brain and does it faster than your nerves can.

Fascia has a role in wound healing and scar formation.

The difference between Massage Therapy and Myofascial Release is that Massage Therapy targets the muscles in the area of pain, the surrounding areas, and trigger points. Other than known trigger points, we can’t know if there are other tissues involved or causing the pain. If there are, and it isn’t worked, your problem will return. Myofascial Release targets the fascia, which is connective tissue that runs from head to toe. Fascia is 3 dimensional and restrictions can spread in bizarre ways, connecting totally unrelated tissue and organs. When we release restrictions, your body begins self healing.

Massage Therapy is great for relieving pain, local or referred, but if the effect of Massage Therapy doesn't last, then I suggest you try MFR. Keep in mind that neither Massage or MFR will fix a chronic issue in 1 session without the problem recurring. The longer you have an issue, the more treatments and the closer together they should be for either to be effective. If you have an acute problem, Massage Therapy is the choice I’d make since the lines of fascial adhesions haven’t formed yet. If you found lasting relief with Myofascial Release, massage is good for the maintenance of that relief.

I’d suggest choosing Myofascial Release if the benefit of Massage Therapy hasn’t lasted and it’s not because you continue with the bad habits that caused it. I also suggest MFR before back surgery for herniated or bulging discs because releasing fascial adhesions affecting the spine may release the pressure on the spinal column (fascia can exert 2000 lbs of pressure per square inch). I also suggest it if your doctors give you differing diagnoses, you don't trust the diagnosis, if your doctor can't give you one, or gives you one that basically says they don't know what you have (fibromyalgia, myofascial pain syndrome, irritable bowel syndrome...). Heck, try it before any expensive or invasive surgery because it won't injure you, and if it helps, then you may not need the surgery. Fascia is the only system that permeates the entire body from head to toe; every organ, including the brain; every muscle group, muscle, muscle fiber and cell; every artery and vein; the lymphatic system; digestive system, respiratory system, endocrine system, your eyes... you get it. Imagine 2000lb per square inch of pressure on a nerve, pressing on your eye, constricting your intestines... It can literally affect everything in your body.

Fascia was totally disregarded by the science community until recently. It was discarded when they studied corpses because it was considered to merely be protective and supporting in function. I suppose it is, in a corpse. Same as they thought the bones in the skull were fused and didn't move because they studied corpses, but they have proven, in real life, that the sutures not only move, they have blood and nerves in the sutures between, and the movement serves a purpose.

Most research is funded by the government and pharmaceutical companies. Some are suggesting, but no one is demanding the government study it, and pharmaceutical companies prefer you take meds for your symptoms rather than get rid of them. However, there are studies and a lot of empirical evidence. If you are in pain and your doctor hasn’t helped, do you want to wait for someone to conduct enough large studies to explain it fully?

I’m not good at science. I understood the general idea, but can’t explain it and certainly can’t remember all the technical words. If you are interested, I suggest you check out https://www.myofascialrelease.com/resources/therapeutic-insight.aspx. At the top of this page is also a link to a good article on the NIH website. It points out facial problems that are often misdiagnosed, calls for further study, and supports that fascial treatment could help with many health problems.

Most widely known are chronic muscle and joint pain, headaches and migraines, herniated and bulging disks, scoliosis, fibromyalgia, myofascial pain syndrome, TMJ, carpal tunnel syndrome, tennis elbow, anxiety, and PTSD, but it goes so much further. Since fascia is a body wide system, it can affect any part of the body. Fascial adhesions on your optic nerve or eye could affect your vision. Adhesions on part of your brain could affect whatever that part of the brain does, including hormonal, body regulating, speech, behavior, cognitive ability, etc. Fascial adhesions on your intestines could have been diagnosed as irritable bowel syndrome. Fascia regulates interstitial fluid flow and absorption as well as blood and lymph flow, and an adhesion could be devastating. The possibilities are endless. I’m not suggesting Myofascial Release is a miracle worker, but if it’s a fascial restriction and your doctor hasn’t been able to diagnose you, his treatment didn’t work, or your doctors don’t agree, I’d suggest you try it.

Myofascial Release can only treat fascial related problems. Just because a problem COULD be the problem, doesn’t mean it is. Issues it CAN’T EVER treat are infections, varicose veins, damaged nerves, broken bones, blood clots, bleeding disorders, aneurism, cancer or any of the contraindications noted below.

Consulting a doctor may be required prior to treatment, depending on what you are being treated for. An appointment for a consultation without treatment is available.

No MFR at all:
Acute rheumatoid arthritis
Acute Circulatory Condition
Obstructive Edema
Blood Thinners
Malignancy
Aneurysm
Anticoagulant Therapy
Fever
Infection
Advanced Diabetes

Affected Areas Must Be Avoided
Blood Clots
Advanced Degenerative Changes
Hematona
Open Wounds
Osteoporosis
Skin Hypersensitivity
Sutures

No Cranial work
Intracranial Hemorrhage
Intracranial Aneurysm
Recent Skull Fracture
Herniation of the Medula Oblongata

Inflammation, trauma, stress, overuse, bad posture, and dehydration are the most cited.

While we can only touch the skin of the body and head (where legally allowed), the fascia is a 3 dimensional web and Myofascial Release can affect areas that are deep or distant and seemingly unrelated.

Fascia does not show up on MRIs, X-Rays, or other imaging tests. Blood and urine tests also will not be able to indicate if there is a problem. Maybe someday someone will discover a way to see it on imaging, but not yet.

You should make sure you hydrate well the day before and the day of your appointment. Stuck fascia is dehydrated. The better you are hydrated, the better your fascia can rehydrate and the better I can feel it. Get a good night’s sleep the night before. Do NOT put any lotion or makeup on. Make sure you wear or bring a swimsuit or loose shorts and, if you are a woman, a sports bra or loose tank top. If you are OK wearing your underwear for the treatment, you can do that too as long as you are adequately covered. No thongs, g-strings or speedos please.

You will have an initial consultation with your therapist prior to your first treatment starting. This can either be done as a stand alone appointment, or during your first treatment appointment. During the consultation we will discuss what brings you in and your medical history as well as any significant trauma you can remember. Although I don’t start with a preconceived idea of where in your body your issue originated, since fascia is a body wide system and the adhesions spread, knowing about you falling off your bike and breaking your leg when you were 10, or that you were born with the umbilical cord wrapped around your neck, can actually be helpful in tracing to the initial cause and help us know where to treat in addition to your area of pain.

You will be asked to change into a swim suit or loose shorts and, if you are a woman, a sports bra or loose tank top. Underwear is OK as long as you are adequately covered by it. If you have applied lotion or makeup that day, you will be asked to wash it off as our techniques require that we hold traction on bare skin for at least 5 minutes, and if you have lotion or makeup on, our fingers will slip. If you can’t wash the lotion off or wear clothes that prevent us from working on bare skin, we will be limited to cranial and cervical work and arm and leg pulls.

Each session will begin and end with a visual structural analysis and maybe measuring your range of motion, depending on what we are treating you for. You will lie on the table with your swim suit on, uncovered, as you are treated.

Once you are on the table, we will both pause as we center ourselves to shut down our left brains (thinking) and listen to your body with our right brains (feeling). This isn’t metaphysical in nature, I need you to be present so you can communicate if you feel anything in another area of your body while I am performing the release, such as warmth, tingling, twitching, pain, etc. I need to center because I can’t feel your fascia if I am thinking about the errand I have to run after our session is over. Don’t stress about staying present, just do the best you can, sometimes it takes a session or two. I will be looking for visual signs such as redness, twitching, and holding. This is why you are not covered, I can’t see those signs if they are under a sheet. If neither of us sees any signs, that’s OK too. Signs are helpful, but I can still work off your pain and your structural analysis.

Since I have to hold a release for at least 5 minutes, and my touch is fairly light, it may seem like I’m not doing much, but the collagen in the fascia is strong and sees sudden or deep pressure as a threat and it won’t release and hydrate. If you feel anything distal from where I’m working, please let me know.

Once the session is over, your therapist will perform another structural analysis and remeasure your range of motion if applicable. You and your therapist will discuss the session and your therapist may suggest self-treatment you can do at home and possible changes you can make to keep your problem from recurring as well as when you should return.

After you leave, please note any changes you may see or feel and report them to your therapist. Your session was just the beginning. It is common that the healing that was started by releasing adhesions will start a cascade of self-healing, and what you may feel is unpredictable. Myofascial Release will not injure you, but you may feel discomfort for a day or two. You may feel flu-like since your body could be releasing fluids and toxins from areas that were released. Some people feel emotional. As your fascia releases further and reorganizes, you could feel strange feelings such as twitching, your ear may drain, or you may find yourself reading something and realize you don’t have your glasses on. Let your body heal itself and avoid anything that can stop it, such as working out, getting deep tissue massage, or falling down the steps. Don’t expect anything, but don’t be concerned if it does happen.

I prefer you wear a swimsuit, but you can also wear loose shorts (the shorter the better) and a sports bra or tank top. Myofascial Release cannot be done over clothes. If you wear clothes I will be limited to cranial and cervical work and leg/arm pulls. Also, please do not wear makeup or apply lotion to your face or body prior to your session as I can’t hold the release for the minimum of 5 minutes required if you do.

The collagen in your fascia is very strong and resists force and is not quick to let go. It takes at least 3-5 minutes for it to soften and then rehydrate.

It may. It may not. The myofascial web goes from your head to your toes and interconnects every part of your body. Fascia doesn’t show up on imaging and can interconnect in bizarre ways. If it’s a new issue and the fascial adhesions haven’t spread, one session may do it. HOWEVER, it may not be a new issue, it may have started elsewhere and just didn’t make itself known before. Usually if the area being worked is connected to other parts of your body, it will make itself known either to you or your therapist during your treatment.

It is recommended that your session last at least 45 minutes and no more than 90 minutes without a break between. You can receive up to 3 hours in a day. Myofascial Release is a slow process since each release needs to be held at least 5 minutes, therefore I suggest your first session be 90 minutes to allow for a thorough intake, which is part of your time, and we can discuss how long I think it will take to work on your issue after the session.

How many sessions you will need will be determined by how extensive your issues are, how long you’ve had them, how your body responds, if you keep hydrated, what you do between sessions, etc. It is very individual and can't be predicted. The longer you’ve had an issue, the more you hurt, the sooner you should come back. *Treating an issue is usually 3 times a week. We call this a "Progressive Package" *A 1-Day Intensive session is 3 hours in one day with a break in the middle and gets you better results than 2 single sessions on different days. *A 1-Week Intensive Package is 3 hours a day with a break in the middle, for 5 days in one week. 15 hours in one week may seem like a lot, but if you have a cronic issue so bad you can hardly walk, or you have torticollis, it’s needed. *Maintenance is as needed and we have 45 and 90 Minute sessions available. This could be monthly or every 6 months.

Maintenance is preemptive. Massage is also a good option for maintenance of muscle fascia to keep fascial lines of adhesions from forming due to overuse of muscles. If your fascial adhesions tend to be from stress and anxiety, or you have an accident or surgery, MFR is a good choice to keep facial lines from forming or spreading.

You should consult your doctor as the time varies depending on the type of surgery, complications, and your healing progress. Some work, such as cranial work, can be done as soon as you feel well enough if it will not affect the surgical area. Generally, you can have MFR 3-4 weeks after surgery, avoiding the surgical area. Usually after 6 weeks we can work on the healed scar tissue.

After your MFR session, your body will begin a self-healing process and your fascia will begin to reorganize. It can be followed by massage therapy using static pressure on a knot or moderate strokes, but it is not suggested that you use deep pressure or strokes as the purpose of myofascial release is to release the fascia, and stressing the tissue after or between a series of sessions can undo your progress with the myofascial release. Stressing the tissue is also why it is suggested that you don’t work out afterward. Give your body a chance to heal.

I would not suggest it. The immediate results from MFR can be unpredictable as your body may release toxins and fluids, and further fascial adhesions can release as your body self-corrects.

I practice the method developed by John F Barnes®. Osteopath Robert Ward and Physical Therapist John F Barnes are considered the 2 primary founders of Myofascial Release. John Barnes speaks internationally, advocating for and educating doctors and scientists about Myofascial Release. He has been and continues to learn, experiment and develop new techniques as well as practicing them and teaching others throughout this country and internationally. His wasn’t the first course I took for Myofascial Release, but it was certainly the best and most effective I’ve tried.