Massage Therapy Modalities – Myofascial Release
Myofascial release is a massage modality. Practitioners seek to reduce pain and support wellness by working on the body’s myofascial structure. The fascia has been compared to a spider web: a network of connective tissue wrapped around the body’s organs and other structures. It is believed that when the fascia becomes stretched or develops adhesions, people can experience considerable pain — pain that may be difficult to pinpoint.
The attention myofascial release gives to the positioning of the fascia may be compared to the attention chiropractors give to the alignment of the spine. Myofascial release can involve a different belief system as well a very different technique – though a number of chiropractors also incorporate myofascial techniques. Often, myofascial release is practiced by massage therapists who are adept at multiple modalities and who select them based on client needs and preferences or, in some cases, on physician referral and prescription. Myofascial release can be practiced in a spa, sports medicine clinic, integrative care center, or other healthcare setting.
Trigger point therapy can be considered a form of myofascial release. However, trigger point therapy focuses on specific points in the myofascial structure that may be causing pain.
Myofascial release may be effective for sports injury and for chronic pain syndromes such as fibromyalgia or carpal tunnel syndrome. There can be a place for myofascial release in various practices, including speech and language pathology (https://www.facebook.com/carterswallowingcenter/). As with other modalities, there are some contraindications.
Myofascial therapy often focuses on gently moving the myofascial structure, looking for areas where there may be stiffness. A physical therapist at Georgetown Physical Therapy describes myofascial release as a non-painful form of medical massage (https://bcrc.org/benefits-myofascial-release-therapy-mastectomy-lumpectomy/). Skill is paramount. Therapists must be skilled at responding to feedback from the client’s own body as it is manipulated.
It is important to note, too, that there are different types of myofascial release. While it can be a very gentle modality with light pressure applied to relax areas of restriction, some techniques use more force.
Massage therapy as a whole is a rapidly growing field, and myofascial release has come into the mainstream, at least in some healthcare organizations. A recent review of health coverage policies that looked primarily at Northeastern states found that myofascial release was among the more common modalities to be specifically noted as reimbursable. However, there can be significant difference from one part of the country to the next in reimbursement.
Becoming a Myofascial Release Practitioner
Practitioners hold more general licensing. They can, if desired, seek adjunct certification in particular modalities. Massage therapy is a common one. However, some physical therapists employ myofascial release. John Barnes, who has played a big role in bringing myofascial release to the forefront over a period of decades, is a physical therapist as well as a massage therapist. Other healthcare practitioners may be qualified to perform myofascial massage.
Massage therapy credentialing is a relatively short path to a therapy career. Programs are frequently as short as 650 hours; some states set requirements higher. Before achieving state licensure, a student will take a licensing exam. The prospective therapist will need supportive courses such as anatomy and physiology, pathophysiology, and indications and contraindications of massage. He or she will learn basic massage techniques and gain a foundation in several modalities. Some programs include electives. However, it’s not necessary to master all the modalities one will eventually employ in his or her practice. Massage therapists take continuing education throughout their career, and many choose to learn new modalities or deepen their expertise in those where they have some foundation. A massage therapist may take a block of courses in myofascial therapy at the post-licensure stage. The American Massage Therapy Association advises checking with one’s licensing board before studying new modalities (https://www.facebook.com/carterswallowingcenter/).
Courses deepen anatomical knowledge and help practitioners improve palpation techniques, identify fascial restrictions, apply different techniques, and understand circumstances where they are indicated or counter-indicated. Providers often award certifications.
Therapists may take courses focused on different areas of the body (e.g. lower body, upper body) or on applications (e.g. neurodevelopmental dysfunction). Courses can often be completed as weekend seminars. Continuing education credit is typically available. Practitioners may look for approvals by organizations such as the National Certification Board for Therapeutic Massage and Bodywork.
Some massage therapists seek certification as Certified Myofascial Trigger Point Therapists through the Certification Board for Myofascial Trigger Point Therapists.
Myofascial Release Research
It can be difficult to make generalizations about myofascial release as it is practiced in so many ways. This is also a challenge for researchers. A recent article in the Journal of Athletic Research took a systematic look at research in the use of myofascial release in treating orthopedic conditions and noted that studies varied in quality but that the therapy may be effective for a variety of conditions (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718355/).
A randomized control study of fibromyalgia patients published in the Journal of Evidence-Based Complementary and Alternative Medicine found that myofascial release improved multiple symptoms for fibromyalgia patients, including pain, anxiety, and sleep quality (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018656).