by Danielle Clark-Fox, DPT
Myofascial release (MFR) has begun to gain some popularity in the manual therapy world, prompting many clinics and therapists to advertise these skills to potential patients. But how do you make sure you, as a patient, are receiving these skills by someone who really knows what they are doing? And what exactly is myofascial release?
I should probably establish some credibility for myself in this arena first, right? I am a practicing physical therapist with my doctorate in physical therapy. I spent 3 months during one of my clinical internships training with a certified myofascial release therapist who was a certified clinical instructor. I have also pursued myofascial release continuing education courses over the last 3 years. I regularly receive treatment from a local myofascial therapist as well, helping to keep my body in the best form it can be.
John Barnes, PT is the man credited with creating myofascial release. He has been treating patients since 1960 when he graduated with his PT degree from the University of Pennsylvania. He is the owner, director and chief PT at the Myofascial Release Treatment Centers in Sedona, AZ and Paoli, PA. John Barnes began developing his Myofascial Release Approach and teaching seminars in the 1970s. He has trained over 50,000 therapists in his highly successful Myofascial Release Approach. John speaks regularly across the country, has published two books about his journey with myofascial release and is well published in several medical journals.
Myofascial Release is a safe and very effective hands-on technique involving applying gentle sustained pressure to myofascial connective tissue restrictions to eliminate pain, restore motion and improve function. This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate and permanently change the tissue integrity. Trauma, inflammatory response, poor posture, repetitive motion and/or surgical procedures create myofascial restrictions. Fascia has been tested with tensile strength of up to 1200 lb before breaking; imagine that tightening in your body and its effects on surrounding structures!
Fascia is densely woven connective tisue, covering and penetrating every muscle, bone, nerve, artery, vein, internal organs including the heart, lungs, brain and spinal cord. The most interesting aspect of the fascial system is that it is not just a system of separate coverings. It is actually one continuous structure that exists from head to toe without interruption. In this way it has been likened to a spider web or yarn sweater, especially when illustrating the effects of a restriction; when one area is being pulled it will affect the entire neighboring area.
A myofascial treatment session involves assessment of posture, pain and functional issues as well as palpation to determine where restrictions are located and what areas of your body they are affecting. Actual treatment should be performed skin on skin without the friction and decreased sense of the tissues created by clothing. Most therapists prefer you in your underwear or a sports bra and shorts for treatment to ensure access to your entire body for treatment. As a therapist in an outpatient clinic, I have been able to perform small techniques with patients in their street clothes; however for my own body work I look forward to the warm table with a fuzzy blanket over me ensuring my comfort and total access for my therapist.
MFR (for short) is extremely beneficial in treating many conditions including fibromyalgia, TMJ, migraines and cervicogenic headaches, pelvic floor dysfunction, scars and adhering scar tissue, carpal tunnel, back pain, neck pain, postural issues, chronic pain syndrome, whiplash, disc dysfunction and chronic fatigue syndrome.
A physical therapist or licensed massage therapist who is proficient in MFR should have completed several courses through John Barnes or another teaching of their choice. To be registered with John Barnes himself a practitioner will have completed coursework including a week long intensive at either the Sedona or Paoli clinic. Any practitioner you are interested in scheduling a session with should be able to answer the question of where they have completed their training very easily- through John Barnes or not. My personal advice- if someone says they practice MFR and don’t know about John Barnes they probably don’t really know what MFR is.
What I love about MFR is the mind/body/spirit connection, attention to detail of the body and a sense of working with your body and its functional lines versus forcing healing. John Barnes says “healing is a process, not an event” which correlates well to one of my favorite sayings “Listen to your body. Do not be a blind and deaf tennant.” So please, be open to possibilities and explore the world of MFR on your healing journey and/or quest to create the best connection with your body possible. Hopefully with some of these tips you will find a credible and well-trained practitioner who can best assist you on your journey.
Dr. Fox is a physical therapist at Boston Sports Medicine.