Myofascial Release Brisbane (Morningside) Clinic

Myofascial Release (MFR) involves releasing fascial trigger points within muscles and fascia to reduce tension, improve mobility and relieve pain. There are many ways to release fascial tension and pain along with Myofascial Release Techniques. Terry at TotalMSK in Brisbane has specialised in fascial release treatment techniques for over 19 years. Besides being highly qualified, he has gained a huge amount of specialist fascial knowledge and treatment experience.

Myofascial release (MFR) is a very versatile form of treatment, due to there being many techniques which work in different ways. The versatile nature of the techniques and the fact that fascia is present throughout the body mean that myofascial release is suitable for a wide range of conditions. In particular, conditions involving changes to musculoskeletal and soft tissues, including work and sports injuries, some types of headaches and jaw pain, chronic pain, certain neurological, lymphatic, or vascular conditions, and much more.

Myofascial Release (MFR) - History

The word Myofascial has origins in ancient Greek and Latin. It is formed from the words "Myo" (muscle) and "Fascia" (fascial). Fascia is a form of connective tissue that covers muscles, bones, nerves, blood vessels, and organs. It is present throughout the body, has a high strength-to-weight ratio, and plays a vital role in mobility. Fascia connects, supports, and separates structures within the body. It also transmits forces and provides shape to the body. The “state" of fascia, healthy or unhealthy, directly impacts its function.

Andrew Still, a medical doctor and founder of Osteopathic Medicine, is credited with many fascia release techniques. However, other well-known contributors to fascia massage methods include Ida Rolf (Rolfing). The term Myofascial Release came about much later, in the 1960s. Osteopath Robert Ward and Physiotherapist John Barnes are credited with coining the name. Hence, why the term myofascial massage is often seen. Muscles, fascia, and the fascial system all contribute to the theory behind the treatment methods.

What is Fascia?

Normal, healthy fascia is well hydrated, smooth, and slippery. Healthy fascia allows tissues to move easily together and within the confines of the fascia. However, unhealthy fascia is less hydrated and sticky, which can restrict mobility and result in pain.

When fascia is sticky in one area, it directly impacts the local tissues around it. However, fascia transmits force, meaning that one sticky area can affect other areas. Hence, changes in fascia have both a local and global body impact. Such changes can create further sticky areas beyond the initial area. Changes in tissue can then affect the function of muscles, joints, mobility and other structures. Fascial tension can often result in local or distant pain. Equally, muscles and tissues can also refer pain to other areas of the body.

The image on the left shows a piece of chicken breast. The shiny, white material is fascia, which separates the muscles. The photo shows the fascia between the tenderloin and the breast. The link explains more about how fascia relates to myofascial pain syndrome.

Myofascial Pain

Myofascial Pain may feel like a deep muscular aching or localised tenderness that persists or worsens. Besides muscle pain, fascia may restrict mobility, lead to tension, and muscle cramps. Equally, fascia can impact nerves and fluid supply, including blood and lymph. Repeated sports injuries or tension that does not ease with stretching may indicate issues with a myofascial origin.

Equally, there are occasions when an injury does not seem to respond to a other types of treatment. Some treatments may only involve massage, prescriptive exercise, manipulation, or a mix of these therapies and no direct myofascial release. Sometimes, people can continue such treatment for prolonged periods and gain little benefit. The longer an issue persists without effective treatment, the higher the risk of developing chronic pain issues. Such conditions can then greatly impact one's quality of life and can be more complex to treat.

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Myofascial Massage vs Myofascial Release?

It is common to see people promoting myofascial massage services. Although massage and myofascial release may have some parallels, they are also very different. Connective tissue massage and myofascial release therapy are other commonly seen terms. Any manual therapy will impact fascia to some extent due to its presence throughout the body. Hence, this may explain the use of the term myofascial massage. Base-level massage training includes some basic methods that can work on fascia. Examples include stripping and friction techniques. More advanced training courses cover specific fascia release methods. Such courses also include more in-depth training in anatomy, physiology, diagnostics, and more.

Remedial Massage and Myotherapy

In Australia, Remedial Massage and Myotherapy courses include some fascial release techniques. However, there are other relevant differences between the Remedial Massage and Myotherapy level training. However, Myofascial release can come under such treatment modalities for private health insurance rebate purposes. However, insurance cover will depend on the policy and the therapist’s meeting and maintaining professional registration standards. Some massage and remedial massage qualifications do not meet the required standards.

Massage, Myofascial Release, Remedial Massage and Myotherapy and variants of these terms are not protected titles. Therefore, anybody can use such titles and work, even with little or no training. Such a situation may well explain why patient experiences may differ between therapists. Professional registration status helps protect the public and is a requirement of health insurers.

Myofascial Release (MFR) differences

Myofascial release is often precise and involves therapists applying techniques in different planes. Methods may include mixing sustained compressive, tractional, and rotational forces to soft tissues. Also, fascial release tends to treat deeper tissues than massage. Massage therapy is also less specific, mixing vigorous and gentle stroking-type tissue strokes. Techniques also differ in how myofascial release therapists identify and treat pain and soft tissue issues. Some methods look to identify and directly treat myofascial trigger points, such as Trigger Point Release. In contrast, other methods indirectly treat trigger points (TrPs). Although some styles have origins in direct myofascial release, it is possible to use many such methods indirectly, too. Many types of myofascial release are available at the Brisbane MSK Therapy and Chronic Pain Clinic (Morningside).

There is a myth that myofascial release breaks down scar tissue and fascia. A similar notion is that massage therapy releases toxins from within the body. Sadly, there is little evidence for either of these commonly held beliefs. Many types of myofascial release involve no actions remotely likely to break down scar tissue or fascia. Yet, such methods are still effective in easing myofascial pain and improving mobility. Scar tissue differs in many ways from the tissue it replaces. Even general medicine cannot change scar tissue into normal tissue yet. In many cases, surgery is the go-to option for removing excessive scar tissue.

Myofascial Trigger Points (TrPs)

A core part of any myofascial therapy treatment involves treating areas called Myofascial Trigger Points (TrPs). The link provides much more detail on how TrPs may form, their characteristics, the research, and how they relate to pain. Fascia release is more about releasing the fascial tissues in a "stuck" state. Such areas are called Myofascial Trigger points (MTrPs), or TrPs for short. In essence, treatment seeks to free the "stuck" areas rather than break them down. In brief, trigger points appear as tiny nodules within tight bands of skeletal muscle. These nodules and the tension of tissues within and around them make the areas very sensitive and painful. Some forms of fascia release look to locate and treat each TrP, and other methods work more broadly. Trigger points in one muscle section (primary) can lead to others forming (secondary) in different body areas. Such a situation can lead to pain referral and altered mobility in multiple regions. Again, the ability of fascia to transmit force plays a role in such a scenario. Equally, how we move can change at the time of injury, during recovery, and post-recovery. Such changes have relevance to resulting symptoms and treatment.

Much like sports massage, there is a myth that myofascial release is hugely painful. Some people even think a lot of pain is a sign of a good treatment. However, such a situation is more likely a result of the therapist's skill, knowledge, and experience. Myofascial release often involves some discomfort due to the sensitivity of painful muscle tissues. However, effective fascia release treatment feels more like a "good pain". Some methods may prove painful in one situation and not others, or even contraindicated. Such factors can seriously affect patient experiences. Hence, the technique might not be the issue, but more likely, the therapist's training and experience.

The research shows that releasing fascia and myofascial trigger points improves mobility and reduces myofascial pain. Hence, such techniques can assist in the management of fascial pain. Some fascia releasing methods have more research evidence than others. However, there are often less clear reasons for the varying levels of research into myofascial release techniques.

Most allied health professionals within the MSK field learn varying levels of soft tissue therapy skills. Many of these higher education courses involve a research element during studies. However, such research is often specific to further each profession rather than assisting others. Equally, allied health professionals may learn some or no fascia release methods during their studies. After all, a finite limit exists on the number of subjects taught during a higher education course. Such factors also restrict the likely choice of research projects and, thus, the research base. Some professionals will undertake further training in fascia release after qualifying. However, the level of further training sought can vary hugely between professionals, even within the same profession. Personal interests can greatly impact individual learning, knowledge, and experience.

Many fascia release techniques can attain the same desired outcome via different means. Hence, the wide array of techniques. In any given situation, a method may prove painful or contraindicated. Fascia techniques are highly versatile in how and where treatment can occur. Some methods work with or without lotion or direct skin contact. Not needing direct skin contact means that treating the patient through clothing is possible. One of the best aspects of many techniques is the ability to apply such methods passively or actively. Purely passively treating tissues tends not to utilise tissues as they are used during normal activity. Hence, things may seem fine during treatment, but not later during actual activity. All forms of fascia release uniquely aim to identify and treat trigger points directly or indirectly. Although many forms of manual therapy exist, they work in different ways, and all have their place.

When performed by a trained and experienced therapist, myofascial release treatmentcan provide fast and long-lasting results. Treatment can provide pain relief, reduce tension, increase mobility, and reduce or alleviate some neurological and vascular symptoms. Effective treatment requires a much more in-depth knowledge of the fascial system, beyond what is taught on most massage courses. Equally, there are many specific myofascial release techniques, some with specific names, such as micro-fascial release and counterstrain.

• Neck pain (see the article on Neck Pain Relief, causes and treatment)
• Migraines or tension - (see the article on Headache Relief, causes and treatment)
• Back Pain (see the article on Back Pain Treatment, causes and relief)
• Musculoskeletal aches associated with pregnancy (see back pain)
• Repetitive Strain Injury (RSI) - (see the article on Repetitive Strain Injury Treatment, causes and relief)
  • Lateral Epicondylitis - Tennis Elbow - (see the article on Tennis Elbow Pain Relief, Causes and treatment)
  • Medial Epicondylitis - Golfer's Elbow - (see the article on Golfers Elbow Pain Relief, Causes and treatment)
• Bursitis Pain - (see the article on Bursitis Pain Relief, causes and treatment)
  • Shoulder Pain and Subacromial Bursitis - (see the article on Shoulder Pain Relief, causes and treatment)
  • Hip Pain and Trochanteric Bursitis - (see the article on Hip Pain Relief, causes and treatment)
• Sciatica (see back pain related article)
• Trapped nerves
• Knee Pain - Shin Pain
  • Knee Pain - Iliotibial Band Syndrome (ITBS) - (see the article on ITB Knee Pain Treatment, causes and relief)
  • Knee Pain - Patellofemoral Pain Syndrome - (see the article on Patellofemoral Pain Syndrome Relief, causes and treatment)
  • Shin Splint - (see the article on Shin Splints Relief, causes and treatment)
• Work-related injuries
• Foot Pain - Ankle Pain
  • Foot Pain - Plantar Fasciitis - (see the article on Plantar Fasciitis Relief, causes and treatment)
  • Foot Pain - Ankle Injuries - (see the article on Ankle Injuries Relief, causes and treatment)
  • Achilles Tendinopathy - (see the article on Achilles Tendinopathy Relief, causes and treatment)
• Jaw pain, such as Temporomandibular Joint (TMJ)
• Chronic Pain - (see the article on Chronic Pain Relief, causes and treatment)

Methods, technique, application, and the therapist's knowledge and experience can all make a difference in what one feels. Many techniques involve applying pressure to soft tissues. A familiar feeling with most techniques is a sensation of tension or pressure building. Such a sensation occurs in and around the soft tissues under treatment, shortly followed by a softening. The fascia release often feels like a "melting sensation" as the pressure and tension melt away. Although there is usually an element of discomfort, the phrase "good pain" is often used by the patient.

It is possible to perform Self-myofascial release (SMFR) despite the limits that affect what one can achieve. Therapists designed many SMFR tools to protect their hands from wear and tear. Hence, such a tool design is not ideally suited to a self-treatment context. Although many popular SMFR tools exist, their actual use can affect outcomes. Much like myofascial release, no one technique works for everything. Equally, as fascia transmits forces, self-treatment changes tissue tension. The motion of applying a technique can increase tissue tension and pain in the treatment area. Although there are ways to counter this to some extent, there are limits when self-treating.

Physical properties of fascia can vary according to function, with fascia being anisotropic. Meaning that fascia may respond differently to the same force from a different direction. Equally, fascia is viscoelastic and so responds differently to types of force and duration. Such factors have relevance when treating. During treatment with a therapist, the patient's body is relaxed and fully supported. As a therapist applies techniques, they can control force, duration, and direction into the target fascial tissues. It is hard to do such things in an SMFR context, which also creates additional forces. SMFR can prove an effective addition to a self-management routine when used correctly.

Unlike when self-treating, a qualified fascia release therapist has in-depth training. Training covers assessment, anatomy, physiology, and technique application. Equally, training provides knowledge of when a method is safe or unsafe (contraindicated). There are huge differences between being treated and trying to self-treat. Equally, if you don't know what you are treating, it is easy to make things worse. Hence, SMFR is a useful option for general self-management of fascial pain rather than trying to resolve an injury. More common tools include myofascial massage balls and foam rollers.