MYOFASCIAL

RELEASE
 DEFINITION
The word "myofascial" is derived from the Greek
word "myo", which means "muscle," and the word
fascial.
 Myofascial release is the application of the gentle
manual application of sustained pressure to release
fascial restriction.

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 MYOFASCIAL RESTRICTION
Fascia covers every muscle and every fiber within
each muscle.
When muscle fibers are injured, they heal by forming
adhesions, the fibers and the fascia which surrounds it
become short and tight.

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 HOW MYOFASCIAL RELEASE WORK?
The gentle and sustained myofascial release is believed
to supply mechanical and thermal energy which allow
facilitation of sliding movement of collagen and elastin
fibers.
The gentle and sustained pressure and stretch of
myofascial release is believed to free these adhesions
and soften and lengthen the fascia.
By freeing up fascia that may cause compression on
blood vessels or nerves, myofascial release is also said
to improve circulation and nervous system
transmission.
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 TECHNIQUES

1. Direct Myofascial
Release
2. Indirect Myofascial
Release
3. Self Myofascial
Release

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 TECHNIQUE OF APPLICATION

The physical therapist finds the area of tightness.

A sustained pressure over time 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 treated.

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 DIRECT MYOFASCIAL RELEASE
 The direct myofascial release (or deep
tissue work) method works on the
restricted fascia.
Practitioners use knuckles, elbows, or
other tools to slowly stretch the restricted
fascia by applying a few kilograms-force.
Direct myofascial release seeks for
changes in the myofascial structures by
stretching, elongation of fascia, or
mobilising adhesive tissues.
The practitioner moves slowly through
the layers of the fascia until the deep
tissues are reached.

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 DIRECT MYOFASCIAL
RELEASE(CONT…)
Direct myofascial release technique:
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.

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 Direct myofascial release on plantar fascia

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 Direct myofascial release on the thigh

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 H
E
A
D
&
F
A
C
I E
N
T
R
A
-
O
R
A
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L 01/04/2024
 Direct release myofascial technique - the trunk

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 Direct release myofascial technique - the cervical
region

CERVICAL REGION

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 Direct release myofascial technique - thigh

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 INDIRECT MYOFASCIAL RELEASE
The indirect method involves a gentle stretch, with
only a few grams of pressure, which allows the fascia
to 'unwind' itself.
The gentle traction applied to the restricted fascia will
result in heat and increased blood flow in the area.
This allows the body's inherent ability for self
correction to return, thus eliminating pain and
restoring the optimum performance of the body.

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 INDIRECT MYOFASCIAL
RELEASE(CONT…)
The indirect myofascial release technique(eg. Cross
hand technique):
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.

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Cross hand longitudinal stretching of the lumbar and
thoracic erector spinae musles

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 Cross hand longitudinal stretching of the middle
trapezius musles

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Cross hand sretching of the quadriceps femoris muscle

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 SELF MYOFASCIAL RELEASE
 Self myofascial release(SMR) is when the individual uses a
soft object to provide myofascial release under their own
power.
 Usually an individual uses a soft roll, or ball on which to
rest one’s body weight,then,by using gravity to induce
pressure along the length of the specific muscle or muscle
groups, rolls their body on the object, slowly allowing for
the fascia to be massaged.

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 ILIOTIBIAL
UPPER BACK BAND

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 CALF COMPLEX ADDUCTORS

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 HAMSTRING
COMPLEX HIP FLEXORS

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 THE PRINCIPLES OF MYOFASCIAL
RELEASE:
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.

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 EFFECT OF MYOFASCIAL RELEASE
oRelieve pain
oRestore function
oIncrease range of motion
oImprove motor performance
oRestore body equilibrium

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 INDICATION
1.The patient's pain complaint has not been alleviated by
traditional physical therapy treatment.
2. The patient has a complex, global, or specific pain
complaint that does not follow dermatomes,
myotomes, or visceral referral patterns.
3. The patient has an underlying chronic condition that
causes tightness and restrictions in the soft tissues.
4. The patient has painful complex postural
asymmetries.

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 INDICATION(CONT...)
5. The patient has impaired mouth closure, swallowing
& phonation resulting in tightness & restriction of
hyoids & muscles of mastication.
6. The patient experiences non-labyrinthine induced
vertigo & dizzziness secondary to active myofascial
trigger points.
7.The patient is a competitive athlete or performer who
needs subtle stretching to increase speed or accuracy &
to prevent injury at extreme range of motion.

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 CONDITIONS THAT CAN BE TREATED
WITH MFR
Dizziness and vertigo .
Fibromyalgia.
Headache.
Myofascial pain dysfunction.
Trigger points, tender points.

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Physiological effect
 Increases circulation to the area of restriction delivers
oxygenated blood & nutrients to the tissue & removes harmful
metabolic waste products.

 Increases venous & lymphatic drainage decreases local

swelling & edema caused by tissue inflammation.

 The elasticity & flexibility of connective tissue elongate

connective tissue

04/01/2024 MFR 29
Cont..
 Increased temperature causes an increase in elasticity &
stretch of muscle.

 The stretch reflex stimulates tone in hypotonic muscle in area

of looseness. Muscle stretching excites the muscle spindle
causing reflex contraction of muscle.

04/01/2024 MFR 30
 CONTRAINDICATION
1.The patient does not understand or respect boundaries.
2. The patient does not tolerate close physical contact or
touch.
3. The patient has an unstable medical condition, e.g.,
unstable angina.
4. The patient has a dermatitis.
5. The patient has a contagious or infectious disease that
is transmitted by the upper respiratory tract or by direct
contact with the skin.

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 CONTRAINDICATION(CONT...)
6. The patient does not understand the concept of the
"Good Hurt."
7. The patient does not trust the therapist.
8. The patient is under the influence of drugs or alcohol.
9. The patient is unable to give informed consent to
treatment due to his mental status.
10. The therapist does not feel comfortable with the
patient (i.e., after the initial interview and evaluation,
the therapist's "gut response" says not to treat this
patient with Myofascial Release or not to treat this
patient at all).
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 PRECAUTION
1.Myofascial Release consistently lowers blood pressure.
All patients must rest in a horizontal position for 10-15
minutes following treatment. The patient should get up
slowly and not get off treatment table until any
dizziness has resolved.
2.Myofascial Release may lower blood sugar levels,
particularly when deep Trigger Point Releases are
performed. Individuals who are diabetic should check
their blood glucose level prior to treatment. Individuals
who are prone to hypoglycemia should have a snack
prior to treatment.
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 PRECAUTION(CONT...)
3. Individuals with healing fractures or wounds may
receive Myofascial Release to uninvolved areas.
4.Individuals with compromised circulation may be treated
with Myofascial Release to the uninvolved areas and to
the area of compromise while being closely monitored.
5.The patient is taking medication that increases blood-
clotting times and causes the patient to bruise easily.
6.When treating a child or a mentally incompetent adult,
the caregiver or other responsible adult should always be
present. The therapist should carefully explain the
treatment to the chaperon.
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 THERAPEUTIC ENVIRONMENT
• Quiet room
• Appropriate lighting
• Proper height of equipment
• Minimal patient clothing
• No extraneous objects
• Position of patient
• Body mechanics of the therapist

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 REFERENCE
The myofascial release manual 3rd edition by Carol J.
Manheim
Myofascial Pain & dysfunction the trigger point
manual volume 1 by Janet Travell
Images taken from Google images & Wikispace

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