This article is based on the 5-hour on-demand video course, Myofascial Release Clinical Applications: Upper Body, presented by Theresa A. Schmidt, DPT, MS, OCS, LMT, CEAS.
It’s a modality of many names: soft tissue mobilization, fascial manipulation, connective tissue massage, deep tissue work, and more.
For those suffering from limited range of motion or pain, however, myofascial release (MFR) can mean increased mobility, increased function, and reduced pain.
What’s below the surface
As the name suggests, myofascial release focuses on the gentle manipulation of the fascia, or the bands of connective tissue that surround the muscles and other internal organs. These bands consist of proteins — collagen and elastin — and ground substance, a gel-like material that allows for free movement of collagen fibers.
Together, these tightly packed bundles of proteins and ground substance create the fascial structures, which provide support and facilitate the free movement of fluids through the interstitial spaces of the body.
Taut rubber bands
Like most parts of the body, the fascia is adaptable. Mechanical stresses shape the fascial structures, alternately stretching and tightening them to adjust to the position of the body — not unlike a bundle of rubber bands.
Poor posture, injuries, illness, or repetitive motion can cause the fascia to shorten, restricting mobility. By applying controlled force to the soft tissue structures in a specific direction, myofascial release gently stretches the elastic components of the fascia, loosening the ground substance and restoring free movement between fascial planes.
On-Demand Course: Myofascial Release Clinical Applications: Upper Body
Initial assessment
Myofascial release begins with a simple visual assessment. Observe the patient before treatment begins: Is there any obvious tension? Stilted or restricted movements? These may point to areas of fascial tightness.
Once the patient is positioned comfortably, palpate the areas, remembering that restrictions and adhesions may exist in deeper fascial layers.
Start at the superficial layer and work downward, adjusting pressure accordingly. While palpating, note:
- Tissue tone
- Skin temperature and moisture levels
- Extensibility
- Resistance to pressure
- Any pain response or twitching
Motion analysis
While performing the initial assessment, make sure to pay attention to the motions that happen easily and those that don’t. Measure skin glide, skin roll, and transverse muscle play; note any taut bands in the layers.
Ask: Do the muscles easily lift, move, and compress, or is there resistance, pain, or binding? Does one muscle adhere to its neighboring muscle, or can the layers of tissue be separated? Can each muscle contract independently? Is there freedom to glide between muscle layers?
On-Demand Course: Myofascial Release Clinical Applications: Lower Body
Contraindications and precautions
While myofascial release tends to be a gentle intervention, some patients may have preexisting conditions that may make it challenging. Acute inflammations, infections, unhealed tissue, recent sutures, and hematomas are all reasons to avoid MFR until the patient is medically stable and cleared by their healthcare provider.
Ultimately, responsibility lies with the practitioner to determine the proper treatment for each patient.
If you’d like to learn more about how to perform myofascial release, we invite you to check out the full 5-hour on-demand video course, Myofascial Release Clinical Applications: Upper Body, on which this article was based.
View the course.
IMPORTANT! For Florida Massage Therapists, this course helps satisfy your 12-hour hands-on requirements. For this cycle only, those hands-on hours may be completed online via on-demand video. If you’re looking for additional courses to meet this requirement, you can browse applicable Florida courses here.
