Monday, 13 May 2013

What is 'Myofascial Release (MFR)' ?

What is Myofascial Release?

Myofascial Release is a highly specialized stretching technique used by physical therapists to treat patients with a variety of soft tissue problems.
To understand what Myofascial Release is and why it works, you have to understand a little about fascia. Fascia is a thin tissue that covers all the organs of the body. This tissue covers every muscle and every fiber within each muscle. All muscle stretching, then, is actually stretching of the fascia and the muscle, the myofascial unit. When muscle fibers are injured, the fibers and the fascia which surrounds it become short and tight. This uneven stress can be transmitted through the fascia to other parts of the body, causing pain and a variety of other symptoms in areas you often wouldn't expect. Myofascial Release treats these symptoms by releasing the uneven tightness in injured fascia.
In other words, Myofascial Release is stretching of the fascia. The stretch is guided by feedback the therapist feels from the patient's body. This feedback tells the therapist how much force to use, the direction of the stretch and how long to stretch. Small areas of muscle are stretched at a time. Sometimes the therapist uses only two fingers to stretch a small part of a muscle. The feedback the therapist feels determines which muscles are stretched and in what order.
Each Myofascial Release technique contains the same components. The physical therapist finds the area of tightness. A light stretch is applied to the tight area. The physical therapist waits for the tissue to relax and then increases the stretch. The process is repeated until the area is fully relaxed. Then, the next area is stretched.
The therapist will be able to find sore spots just by feel. Often, patients are unable to pinpoint some sore spots or have grown used to them until the physical therapist finds them. The size and sensitivity of these sore spots, called Myofascial Trigger Points, will decrease with treatment.
Most patients are surprised by how gentle Myofascial Release is. Some patients fall asleep during treatment. Others later go home and take a nap. Most patients find Myofascial Release to be a very relaxing form of treatment.
Myofascial Release is not massage. Myofascial Release is used to equalize muscle tension throughout the body. Unequal muscle tension can compress nerves and muscles causing pain. Progress is measured by a decrease in the patient's pain and by an improvement in overall posture.

Who can benefit from Myofascial Release?
Myofascial Release should be considered when a patient has not responded to more traditional forms of medical and physical therapy treatment. I have successfully treated patients with the following diagnoses using Myofascial Release as part of my physical therapy treatment plan.

BACK STRAIN, chronic back pain, low back pain, thoracic back pain
Persistent, recurrent back pain can cause or be the result of asymmetrical soft tissue tension that does not respond to active stretching by the patient. Active myofascial trigger points can be the stimuli for continued muscle spasm. The pain–spasm cycle further distorts the patient’s posture and causes additional soft tissue injury. Using Focused Myofascial Stretching, the physical therapist can neutralize the trigger points and equalize the soft tissue tension, decreasing the postural asymmetries.

CHRONIC CERVICAL STRAIN, chronic cervical pain
Persistent cervical pain can cause or be the result of asymmetrical soft tissue tension that does not respond to active stretching by the patient. Active myofascial trigger points can cause radiating pain into the face, jaw, skull, shoulders, upper back and down the arms. Chronic cervical strain and forward head posture can cause vertigo and balance dysfunction. All of these problems must be addressed in a comprehensive physical therapy treatment program.

When a patient does not completely recover from an initial injury, inefficient accommodation to the residual restriction of movement causes additional asymmetrical soft tissue stresses. Chronically irritated and inflamed tissues develop adhesions that further limit efficient movement. As this feedback loop continues, the patient’s pain complaint becomes diffuse and global. Pain causes fatigue, depression and impaired sleep.

Myofascial Release can address all of these problems as part of a comprehensive physical therapy treatment program. As a direct, "hands-on" treatment, Myofascial Release reverses the physical withdrawal behavior of many patients who are in chronic pain. As the asymmetrical soft tissue stresses decrease, the feedback loop is interrupted. Sleep patterns improve and overall pain decreases. Gradually, the layers of injury are peeled away like an onion until only the sequelae from the original injury are present and can be treated.

FIBROMYALGIA, Myofascial Pain Dysfunction, Fibrositis
Myofascial Release is one of the most effective treatments for patients with moderate to severe symptoms of fibromyalgia. Soft tissue adhesions and active Myofascial Trigger Points must be reduced before the patient can participate in an active exercise program successfully. Postural asymmetry is energy expensive and contributes to the extreme fatigue reported by patients who have fibromyalgia. The patient may initially feel worse when beginning treatment with Myofascial Release. As postural symmetry improves, the patient will feel less fatigued and have less morning stiffness.

TRIGGER POINTS, tender points
Myofascial Trigger Points can produce symptoms that mimic many other medical diagnoses. For example, hypersensitive Myofascial Trigger Points in the neck and shoulder muscles can cause headaches, tooth pain, jaw pain, difficulty swallowing, pain behind the eyes, pain in the eyes, vertigo, intrascapular pain, arm pain and hand pain. Myofascial Trigger Points can cause atypical angina, diarrhea, groin pain, sciatic distribution pain, chest and abdominal pain. For a complete description of the effects of Myofascial Trigger Points, please consult Myofascial Pain and Dysfunction: The Trigger Point Manual, volume I and II by J.G. Travell and D.G. Simons, William & Wilkins Publishe


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1 comment:

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