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| {{short description|Massage technique}} | |||
| {{Manipulative methods}} | |||
| {{Alternative medicine sidebar |fringe}} | |||
| {{Unreliable sources|date=January 2014}} | |||
| {{for|the controversial medical concept|Myofascial trigger point}} | |||
| ⚫ | '''Myofascial release''' ( |
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| ⚫ | '''Myofascial release''' (MFR, ]) is an ] therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the ] in muscles.<ref name="digiovanna">{{Cite book |url=https://books.google.com/books?id=tot78_5FxZwC&pg=PP1 |title=An Osteopathic Approach to Diagnosis and Treatment |vauthors=Spinaris T, DiGiovanna EL |publisher=Lippincott Williams & Wilkins |year=2005 |isbn=978-0-7817-4293-1 |edition=3rd |pages=80–82}}</ref> | ||
| ⚫ | ] is a thin, tough, elastic type of ] that wraps most structures within the human body, including ]. Fascia supports and protects these structures. ] |
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| ⚫ | ] is a thin, tough, elastic type of ] that wraps most structures within the human body, including ]. Fascia supports and protects these structures. ] practice holds that this soft tissue can become restricted due to ], overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension and corresponding ].<ref name="digiovanna" /> | ||
| ==Background and terminology== | |||
| == Description and conceptual basis == | |||
| The approach was first described by osteopath ] and his early students.<ref name=OsteoGlossary>{{cite web|title=Glossary of Osteopathic Terminology|url=http://www.aacom.org/resources/bookstore/Documents/GOT2011ed.pdf|publisher=American Association of Colleges of Osteopathic Medicine|page=28|date=April 2009|accessdate=25 August 2012}}</ref> The term "myofascial" was first used in medical literature by ] in the 1940s in reference to musculoskeletal pain syndromes and ]s.{{citation needed|date=September 2013}} In 1976, Travell began using the term "myofascial trigger point" and in 1983 published the reference ''Myofascial Pain & Dysfunction: The Trigger Point Manual''.<ref name="TravellSimons1992">{{cite book |last1= Travell |first1= Janet G. |last2= Simons |first2= David G. |title= Myofascial Pain and Dysfunction: The Trigger Point Manual |year= 1992 |publisher= Lippincott Williams & Wilkins |isbn= 9780683083675}}</ref> The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with ], the originator of ]. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release.<ref name="Stillerman">{{cite book |last= Stillerman |first= Elaine |year= 2009 |title= Modalities for Massage and Bodywork |publisher= ] |pages= 151–2 |isbn= 032305255X}}</ref> | |||
| Writing for ], ] described myofascial release as an umbrella term for several types of physical manipulation, which might more simply be described as a kind of ] based on vaguely-defined scientific notions.<ref name="sbm">{{Cite web |author-link=Harriet Hall |date=24 November 2014 |title=Can Airrosti Really Resolve Most Chronic Pain in Just Three Visits? |url=https://sciencebasedmedicine.org/can-airrosti-really-resolve-most-chronic-pain-in-just-three-visits/ |publisher=] |vauthors=Hall H}}</ref> | |||
| <ref name="Knaster">{{cite book |last= Knaster |first= Mirka |year= 1996 |title= Discovering the Body's Wisdom: A Comprehensive Guide to More Than Fifty Mind-Body Practices |publisher= ] |page= 208 |isbn= 9780307575500}}</ref> | |||
| Some practitioners use the term "myofascial therapy" or "myofascial trigger point therapy" referring to the treatment of trigger points. The phrase has also been loosely used for different ] techniques, including soft tissue manipulation work such as connective tissue massage, soft tissue mobilization, ], and strain-] techniques. | |||
| Myofascial techniques can be described as passive (patient stays completely relaxed) or active (patient provides resistance as necessary), with direct and indirect techniques used in each. | |||
| == Effectiveness == | == Effectiveness == | ||
| The ] states that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility" and cautions against using it as a substitute for conventional cancer treatment.<ref name="acs">{{Cite book |title=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies |publisher=] |year=2009 |isbn=978-0-944235-71-3 |editor-last=Ades |editor-first=TB |edition=2nd |pages= |chapter=Myofascial release |chapter-url=https://archive.org/details/americancancerso0000unse/page/226}}</ref> The poor quality of research into the use of myofascial release for ] conditions precludes any conclusions being drawn about its usefulness for this purpose.<ref name="oc">{{Cite journal |last=McKenney |first=K |last2=Elder |first2=AS |last3=Elder |first3=C |last4=Hutchins |first4=A |year=2013 |title=Myofascial release as a treatment for orthopaedic conditions: a systematic review |journal=J Athl Train |type=Systematic review |volume=48 |issue=4 |pages=522–7 |doi=10.4085/1062-6050-48.3.17 |pmc=3718355 |pmid=23725488}}</ref> | |||
| ⚫ | In 2011, the UK ] (ASA) upheld a complaint regarding the effectiveness claims published in an advertising leaflet produced by the Myofascial Release UK health care service. The ASA Council ruled that materials presented by Myofascial Release UK in support of the claims made in their ad were inadequate to establish a "body of robust scientific evidence" to substantiate Myofascial Release UK's range of claims.<ref name=sbm/><ref>{{Cite web |date=2011-03-16 |title=ASA Adjudication on Myofascial Release UK |url=http://www.asa.org.uk/Rulings/Adjudications/2011/3/Myofascial-Release-UK/TF_ADJ_49922.aspx |access-date=2015-04-21 |publisher=]}}</ref> In addition, the ASA determined that the ad breached advertising rules by introducing a risk that readers might be discouraged from seeking other essential medical treatments.{{cn|date=August 2024}} | ||
| The ] state that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility" and caution against using it as a substitute for conventional treatment.<ref name=acs>{{cite book |publisher=] |work=American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies |edition=2nd |year=2009 |isbn=9780944235713 |editor=Ades TB |pages=226-228 |title=Myofascial release}}</ref> | |||
| ⚫ | In 2011, the UK ] |
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| ==Direct myofascial release== | |||
| The direct myofascial release method claims to engage the myofascial tissue "restrictive barrier" (tension). The tissue is loaded with a constant force until "release" occurs.<ref name=OsteoGlossary /> Direct release is sometimes called "deep tissue work", a misnomer as some of the important tissues are quite superficial. Practitioners use knuckles, elbows, or other tools to slowly stretch the fascia by applying a few ] or tens of ]. Direct myofascial release is an attempt to bring about changes in the myofascial structures by stretching or elongation of fascia, or mobilizing adhesive tissues. The practitioner moves slowly through the layers of the fascia until the deeper tissues are reached. | |||
| Robert Ward suggested that the intermolecular forces direct method came from the ] school in the 1920s by William Neidner, at which point it was called "fascial twist". German physiotherapist Elizabeth Dicke developed connective tissue massage (German: ''Bindegewebsmassage'') in the 1920s, which involved superficial stretching of the myofascia. ] developed ] in the 1940s, a holistic system of connective tissue manipulation and movement education, with the goal of balancing the body. She proposed that she could improve a patient's body posture and movement by bringing the myofascial system toward its optimal pattern. Since Rolf's death in 1979, over a dozen ] schools have split off from ] with minor variations on the theme from her original teachings.<ref name=Myers>{{cite journal |last=Myers |first= Thomas W. |title= Structural integration -- Developments in Ida Rolf's 'Recipe'-- I |journal= Journal of Bodywork and Movement Therapies |date= 2004 |volume= 8 |issue= 2 |pages= 131–42 |doi= 10.1016/S1360-8592(03)00088-3 }}</ref> Rolf's schools maintain that their lineage is distinct from the massage profession, but myofascial release and the larger massage profession have been significantly influenced by her ideas and methods.<ref name="Stillerman" /><ref name="Knaster" /><ref name="Claire">{{cite book |last= Claire |first= Thomas |year= 1995 |title= Bodywork: What Type of Massage to Get and How to Make the Most of It |publisher= ] |page= 308 |isbn= 9781591202325}}</ref> | |||
| Michael Stanborough borrows principles from Rolfing which can be applied for direct myofascial release technique:<ref name=Stanborough>{{cite book |last= Stanborough |first= Michael |title= Direct Release Myofascial Technique: An Illustrated Guide for Practitioners |year= 2004 |publisher= Churchill Livingstone |location= Edinburgh |isbn= 9780443073908 }}</ref> | |||
| * Land on the surface of the body with the appropriate 'tool' (knuckles, or forearm etc.). | |||
| * Sink into the soft tissue. | |||
| * Contact the first barrier/restricted layer. | |||
| * Put in a 'line of tension'. | |||
| * Engage the fascia by taking up the slack in the tissue. | |||
| * Finally, move or drag the fascia across the surface while staying in touch with the underlying layers. | |||
| * Exit gracefully. | |||
| ==Indirect myofascial release== | |||
| The indirect method involves a gentle stretch, with only a few grams of pressure, which is said to allow the fascia to "unwind" itself, guiding the dysfunctional tissue "along the path of least resistance until free movement is achieved."<ref name=OsteoGlossary /> | |||
| Reviews published in 2013 and 2015 evaluating evidence for MFR efficacy found that clinical trials that had been conducted varied in quality, technique, outcome measurements and had mixed outcomes; the 2015 review noted: "it is time for scientific evidences on MFR to support its clinical use."<ref name=oc/><ref name=":0">{{Cite journal |last=Ajimsha |first=M.S. |last2=Al-Mudahka |first2=Noora R. |last3=Al-Madzhar |first3=J.A. |date=January 2015 |title=Effectiveness of myofascial release: Systematic review of randomized controlled trials |journal=Journal of Bodywork and Movement Therapies |volume=19 |issue=1 |pages=102–112 |doi=10.1016/j.jbmt.2014.06.001 |pmid=25603749}}</ref> Another review concluded that the use of foam rollers or a roller massager before or after exercise for self-myofascial release has been observed to decrease soreness due to ] and that self-myofascial release appears to have no negative effect on performance. However, the optimal timing and duration of use requires further study.<ref>{{Cite journal |last=Schroeder |first=AN |last2=Best |first2=TM |date=2015 |title=Is self myofascial release an effective preexercise and recovery strategy? A literature review |journal=Current Sports Medicine Reports |volume=14 |issue=3 |pages=200–8 |doi=10.1249/JSR.0000000000000148 |pmid=25968853 |s2cid=5976175 |quote=There appears to be some basis for the use of the SMR technique via a foam roller or roller massager for preexercise, for maintenance, and to aid recovery following exercise. SMR has been observed to decrease soreness following DOMS, which may indirectly enhance performance by allowing the individual to exercise longer and harder. The direct effect of SMR on performance may be duration dependent and remains in question. At the very least, SMR appears to have no negative effect on performance, with a few studies showing increase in performance. Yet another benefit of SMR is its ability to increase ROM. There has been little published work on the mechanism of SMR; however, animal studies using MLL following EEX have shown that immediate MLL is more beneficial than delayed MLL but MLL duration has no significant effects on recovery. In conclusion, SMR via a foam roller or roller massager may be a valuable tool for exercising individuals, allowing the individuals to self-treat at a time (i.e., immediately following exercise) and a frequency (i.e., several times a day) convenient for him or her by eliminating the need for a massage therapist. Studies to date suggest that SMR may have beneficial effects on both recovery from EEX and precompetition. |doi-access=free}}</ref> | |||
| Carol Manheim summarized the assumptions underlying the practice of myofascial release:<ref name=Manheim_MFRmanual>{{cite book |last=Manheim |first=Carol J. |title=The Myofascial Release Manual |year= 2008 |publisher= Slack |location=Thorofare, NJ |isbn= 9781556428357 |edition= 4th}}</ref> | |||
| * Fascia covers all organs of the body, muscle and fascia cannot be separated. | |||
| * All muscle stretching is myofascial stretching. | |||
| * Myofascial stretching in one area of the body can be felt in and will affect the other body areas. | |||
| * Release of myofascial restrictions can affect other body organs through a release of tension in the whole fascia system. | |||
| * Myofascial release techniques work through an unknown mechanism. | |||
| == History == | |||
| The indirect myofascial release technique, according to Barnes,<ref name=Barnes_MFRsearch>{{cite book |last= Barnes |first= John F. |title= Myofascial Release: The Search for Excellence |year= 1990 |publisher= Rehabilitation Services |isbn= 9781929894000}}</ref> is as follows: | |||
| The approach was promulgated as an ] concept by ], inventor of osteopathy, and his early students.<ref name="OsteoGlossary">{{Cite web |date=April 2009 |title=Glossary of Osteopathic Terminology |url=http://www.aacom.org/news-and-events/publications/glossary-of-osteopathic-terminology |access-date=25 August 2012 |publisher=American Association of Colleges of Osteopathic Medicine |page=28}}</ref> The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with ], the originator of ]. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release.<ref name="Stillerman">{{Cite book |last=Stillerman |first=Elaine |title=Modalities for Massage and Bodywork |publisher=] |year=2009 |isbn=978-0-323-05255-9 |pages=151–2}}</ref><ref name="Knaster">{{Cite book |last=Knaster |first=Mirka |title=Discovering the Body's Wisdom: A Comprehensive Guide to More Than Fifty Mind-Body Practices |publisher=] |year=1996 |isbn=978-0-307-57550-0 |page=208}}</ref> Ward also suggests, in other sources, that the term "myofascial release" was coined in 1981, when it was used as the name of a course taught at Michigan State University. It was popularized and taught to therapists, massage therapists and occupational therapists by John F. Barnes through his seminars.<ref>{{Cite book |last=Barnes |first=John F. |url=https://www.worldcat.org/oclc/555687719 |title=Myofascial release : the search for excellence. |date=1990 |publisher=Rehabilitation Services |isbn=1-929894-00-7 |location= |oclc=555687719}}</ref> | |||
| * Lightly contact the fascia with relaxed hands. | |||
| * Slowly stretch the fascia until reaching a barrier/restriction. | |||
| * Maintain a light pressure to stretch the barrier for approximately 3–5 minutes. | |||
| * Prior to release, the therapist will feel a therapeutic pulse (e.g., heat). | |||
| * As the barrier releases, the hand will feel the motion and softening of the tissue. | |||
| * The key is sustained pressure over time. | |||
| == |
== See also == | ||
| * ] | |||
| ⚫ | {{reflist| |
||
| * ] | |||
| * ] | |||
| == |
== References == | ||
| ⚫ | {{reflist|30em}} | ||
| <!--- | <!--- | ||
| == External links == | |||
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Latest revision as of 05:06, 2 September 2024
Massage technique Myofascial trigger point.
Myofascial release (MFR, self-myofascial release) is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation and stimulating the stretch reflex in muscles.
Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. Osteopathic practice holds that this soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension and corresponding diminished blood flow.
Description and conceptual basis
Writing for Science-Based Medicine, Harriet Hall described myofascial release as an umbrella term for several types of physical manipulation, which might more simply be described as a kind of massage based on vaguely-defined scientific notions.
Effectiveness
The American Cancer Society states that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility" and cautions against using it as a substitute for conventional cancer treatment. The poor quality of research into the use of myofascial release for orthopaedic conditions precludes any conclusions being drawn about its usefulness for this purpose.
In 2011, the UK Advertising Standards Authority (ASA) upheld a complaint regarding the effectiveness claims published in an advertising leaflet produced by the Myofascial Release UK health care service. The ASA Council ruled that materials presented by Myofascial Release UK in support of the claims made in their ad were inadequate to establish a "body of robust scientific evidence" to substantiate Myofascial Release UK's range of claims. In addition, the ASA determined that the ad breached advertising rules by introducing a risk that readers might be discouraged from seeking other essential medical treatments.
Reviews published in 2013 and 2015 evaluating evidence for MFR efficacy found that clinical trials that had been conducted varied in quality, technique, outcome measurements and had mixed outcomes; the 2015 review noted: "it is time for scientific evidences on MFR to support its clinical use." Another review concluded that the use of foam rollers or a roller massager before or after exercise for self-myofascial release has been observed to decrease soreness due to DOMS and that self-myofascial release appears to have no negative effect on performance. However, the optimal timing and duration of use requires further study.
History
The approach was promulgated as an alternative medicine concept by Andrew Taylor Still, inventor of osteopathy, and his early students. The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with Ida Rolf, the originator of Rolfing. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release. Ward also suggests, in other sources, that the term "myofascial release" was coined in 1981, when it was used as the name of a course taught at Michigan State University. It was popularized and taught to therapists, massage therapists and occupational therapists by John F. Barnes through his seminars.
See also
References
- ^ Spinaris T, DiGiovanna EL (2005). An Osteopathic Approach to Diagnosis and Treatment (3rd ed.). Lippincott Williams & Wilkins. pp. 80–82. ISBN 978-0-7817-4293-1.
- ^ Hall H (24 November 2014). "Can Airrosti Really Resolve Most Chronic Pain in Just Three Visits?". Science-Based Medicine.
- Ades, TB, ed. (2009). "Myofascial release". American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.). American Cancer Society. pp. 226–228. ISBN 978-0-944235-71-3.
- ^ McKenney, K; Elder, AS; Elder, C; Hutchins, A (2013). "Myofascial release as a treatment for orthopaedic conditions: a systematic review". J Athl Train (Systematic review). 48 (4): 522–7. doi:10.4085/1062-6050-48.3.17. PMC 3718355. PMID 23725488.
- "ASA Adjudication on Myofascial Release UK". Advertising Standards Authority (United Kingdom). 2011-03-16. Retrieved 2015-04-21.
- Ajimsha, M.S.; Al-Mudahka, Noora R.; Al-Madzhar, J.A. (January 2015). "Effectiveness of myofascial release: Systematic review of randomized controlled trials". Journal of Bodywork and Movement Therapies. 19 (1): 102–112. doi:10.1016/j.jbmt.2014.06.001. PMID 25603749.
- Schroeder, AN; Best, TM (2015). "Is self myofascial release an effective preexercise and recovery strategy? A literature review". Current Sports Medicine Reports. 14 (3): 200–8. doi:10.1249/JSR.0000000000000148. PMID 25968853. S2CID 5976175.
There appears to be some basis for the use of the SMR technique via a foam roller or roller massager for preexercise, for maintenance, and to aid recovery following exercise. SMR has been observed to decrease soreness following DOMS, which may indirectly enhance performance by allowing the individual to exercise longer and harder. The direct effect of SMR on performance may be duration dependent and remains in question. At the very least, SMR appears to have no negative effect on performance, with a few studies showing increase in performance. Yet another benefit of SMR is its ability to increase ROM. There has been little published work on the mechanism of SMR; however, animal studies using MLL following EEX have shown that immediate MLL is more beneficial than delayed MLL but MLL duration has no significant effects on recovery. In conclusion, SMR via a foam roller or roller massager may be a valuable tool for exercising individuals, allowing the individuals to self-treat at a time (i.e., immediately following exercise) and a frequency (i.e., several times a day) convenient for him or her by eliminating the need for a massage therapist. Studies to date suggest that SMR may have beneficial effects on both recovery from EEX and precompetition.
- "Glossary of Osteopathic Terminology". American Association of Colleges of Osteopathic Medicine. April 2009. p. 28. Retrieved 25 August 2012.
- Stillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 151–2. ISBN 978-0-323-05255-9.
- Knaster, Mirka (1996). Discovering the Body's Wisdom: A Comprehensive Guide to More Than Fifty Mind-Body Practices. Bantam. p. 208. ISBN 978-0-307-57550-0.
- Barnes, John F. (1990). Myofascial release : the search for excellence. : Rehabilitation Services. ISBN 1-929894-00-7. OCLC 555687719.
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