Myofascial Release: Regional Proximity

Applications for the Upper Brachial Plexus Lungs

Extremity, Face & Scars

Shoulder dysfunction may also affect neurological structures and visceral

structures in close proximity. The reverse is also true in that visceral or
neurological pathology may also affect proximal musculature.

Axilla & Rotator Cuff Infraspinatus & Teres Minor

Infraspinatus
Teres Minor
The approach
to the these two
muscles will be
as a group.
Place direct
pressure into
the posterior Pressure is applied using one or two fingers. Locate the most hypertonic
area of the combined musculature for the greatest effect. Draw the arm
axilla. laterally to bring the musculature laterally. Pressure is applied with a
medial and slightly posterior force. DO NOT apply pressure to the ribs.

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 Axilla & Rotator Cuff Subscapularis

Subscapularis

The approach to
subscapularis will be
with direct pressure
to the tendon origin.
This is achieved by
making contact at the
roof of the axilla and
applying pressure Pressure is applied using one or two fingers. Locate the most hypertonic
towards the A-C joint. area of the musculature for the greatest effect. Draw the arm laterally
to bring the musculature laterally. Pressure is applied to the cepahlad
aspect of the axilla. The direction of force is towards the A-C joint.

Biceps & Brachialis Biceps & Brachialis

Biceps
Short Head

Brachialis
Biceps
Long Head

The structure of the biceps femoris provides a unique Using both thumbs begin at the distal end of the biceps
myofascial access by separating the dual muscle bellies. and progress proximally. Pressure is applied posteriorly,
The deep pressure will also address the brachialis. laterally and slightly proximal. DO NOT slide over the skin.

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 Triceps Triceps
Due to the multiple
origins of the triceps
muscle, treatment will
be directed towards
the common insertion
at the olecranon
process.
Apply deep direct
pressure 1 – 2 cm
proximal to the
olecranon process
and drag proximally
without sliding on the Using one or two thumbs apply deep direct pressure 1 – 2 centimeters
skin. proximal to the olecranon process. Drag the fascia proximal without
sliding over the skin. Await release.

Medial Epicondylitis (golfer’s elbow) Medial Epicondyle

Forearm muscles
attach to medial
epicondyle

Flexor Medial
Muscles Epicondyle
Isolate a hypertonic locus with your thumb approximately 1 – 2
centimeters distal to the medial epicondyle. Apply deep pressure
and drag the fascia proximal

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Lateral Epicondylitis (tennis elbow) Lateral Epicondyle

Forearm muscles
attach to lateral
epicondyle

Extensor
Lateral Muscles
Epicondyle
Isolate a hypertonic locus with your thumb approximately 1 – 2
centimeters distal to the medial epicondyle. Apply deep pressure
and drag the fascia proximal

Interosseus Membrane Interosseus Membrane

Anterior Posterior Function

The interosseus
membrane
functions to
stabilize the ulna
and radius and
also as a conduit
to transmit
forces from the
carpus to the Place both thumbs proximal to the carpus. Apply deep
humerus. pressure. Pressure is applied posteriorly, laterally and
slightly proximal. Repeat 2 or 3 times moving proximally.
DO NOT slide over the skin.

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 Thenar & Hypothenar Eminences Thenar Eminence
Palmar Aponeurosis Tendon Sheaths

The hand contains multiple sources that may recruit painful Use a single finger tip to isolate the most hypertonic locus just distal to
stimuli. Tendon sheaths, several layers of muscle and fascia the carpus. Fold the patient’s palm as you apply pressure proximal
further complicate treatment based solely on pain. towards the carpus.

Hypothenar Eminence
Face & Skull

The face and

skull may be
approached by
using pressure
and slightly
dragging the
tissue directly or
indirectly. You
may also add a
circular force
Use a single finger tip to isolate the most hypertonic locus just distal to
the carpus. Fold the patient’s palm as you apply pressure proximal
towards the carpus.

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 Scars & Adhesions
• These include superficial (visible) and those
that are deep (palpable only).
• Sequelae that often can result are minor
cutaneous nerve entrapments for which
standard diagnostic tests (EMG’s, SSEP’s,
etc.) may be inconclusive but are palpable,
Scars & Adhesions and therefore, treatable !

Scars & Adhesions

Scar up close Note directionality of fibers

Scars and adhesions, visible and under the skin, can be released with
myofascial technique. Evaluate the scars by palpation to determine
vectors of tension and restriction.