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Myofascial Release Therapy for Back Pain, Posture and More

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Myofascial release - Dr. Axe

Whether you’re an athlete looking to improve your training and performance, or someone trying to reduce pain and achieve better alignment, myofascial release therapy can likely help.

This type of manipulative therapy targets hard knots and trigger points in the muscle tissue that can elicit tenderness, pain, stiffness and even twitching.

While it’s still considered an “alternative treatment,” one that has been studied significantly less than similar approaches, there’s evidence that it may be beneficial for those dealing with pain or inflexibility even after trying surgery, medication and stretching.

What Is Myofascial Release?

Myofascial release (or MFR) is a type of hands-on treatment that is used to reduce tightness and pain in the body’s connective tissue system. It’s intended to improve range of motion, flexibility, stability, strength, performance and recovery.

The purpose of MFR is to detect fascial restrictions — areas of connective tissue that are tight, painful or inflamed — and then to apply sustained pressure to that area in order to release the fascia.

Since it originated in the 1960s, literature regarding the effectiveness of MFR has been limited, shown mixed results and not been of the best quality. Recently, however, a 2015 systematic review concluded that “MFR is emerging as a strategy with a solid evidence base and tremendous potential.”

What is fascia?

Although experts currently don’t agree on one official definition of fascia, it’s considered to be a band or sheet of connective tissue, made up mostly the type of collagen protein that attaches and stabilizes muscles and other internal organs. It’s described as having has an appearance similar to a spider’s web or a woven sweater.

This system covers every muscle, bone, nerve, artery, vein and internal organ, spanning the entire body from head to toe. It surrounds and attaches to all structures, supporting overall functionality of the body.

Normally, fascia is relaxed and has the ability to stretch and move. But when it becomes inflamed or damaged, it starts to become tight and restricted in movement as it loses its pliability. Not only can this cause inflexibility and pain, but it causes tension to develop in other parts of the body too, since the body’s fascia is an inter-connected system.

Myofascial release therapists often describe dysfunctional areas of fascia as trigger points, knots, adhesions, ropes or scar tissue. When someone has many of these, it’s referred to as myofascial pain syndrome (MPS).

Releasing these trigger points or knots, as well as the surrounding area, is the focus of MFR treatments. Not only does this dissipate pain at the specific trigger point, but it can help stop pain from “rippling out” to other parts of the body.

How does MFR compare to other manipulative techniques?

Is foam rolling the same as myofascial release? The use of foam rollers is popular for practicing self-myofascial release (SMR). MFR doesn’t necessarily require the use of a foam roller (since it can be done with a therapist’s hands), however foam rolling has the same purpose: It uses application of pressure to help break up scar tissue and soft-tissue adhesions that lead to pain and stiffness.

The main difference is that foam rolling is performed by the individual on themselves, rather than by a practitioner.

Foam rolling is also encouraged as part of a warm-up or cool-down before and after a workout because it increases blood flow to muscles and helps to “lengthen” connective tissue, improving range of motion.

What is a myofascial release massage, and how does it differ from other massages?

MFR technique is somewhat different than some other types of manual adjustments, including other massage therapy techniques and rolfing, because it’s performed for a shorter time and directly on the skin without oils, creams or machinery. MFR, massage and rolfing include some of the same techniques, but with MFR there’s more focus on specific trigger points, rather than the whole body.

MFR maintains pressure for three to five minutes at a time on a targeted area. It also requires steady pressure to soften and stretch fascia. Overall it tends to be firmer and more targeted (and sometimes less relaxing) than typical massages.

How It Works

Myofascial release therapy involves applying gentle and sustained pressure applied to connective tissue using the therapist’s hands. Another way it is described is “low load, long duration stretching.”

According to the MFR Treatment Centers & Seminars website, “This essential ‘time element’ has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate.”

MFR therapists use a variety of myofascial release techniques and tools, treating each patient uniquely based on their specific symptoms.

Here’s what you can expect from an appointment with a MFR therapist, which usually lasts between 30–60 minutes per session in total, including discussion before and after:

  • First, your therapist will work on locating the areas of fascia that appear to be restricted.
  • Tests will be performed to measure the level of loss of motion or pain you’re experiencing.
  • Your therapist will perform hands-on treatment that is slow and gradual. Usually this takes place in a private therapy room, much like with physical therapy.
  • Ideally you will continue to be treated weekly or several times per week, for several weeks or even months. The duration depends on your specific condition and symptoms.
  • You may also be instructed to perform myofascial exercises at home between sessions.

In many cases, MFR will be combined with other treatment approaches and remedies for pain management. Some examples include: use of hot or ice packs, stretching, acupuncture, chiropractic adjustments, physical therapy, occupational therapy, and use of non-prescription pain relievers.

Who Can Benefit

People who can benefit most from myofascial release therapy include those with:

  • Pain felt mostly in one area, such as the neck, back, shoulders, hips, or one side of the body
  • Physical trauma, such as a fall, car accident or whiplash
  • Chronic injuries
  • History of inflammatory responses that lead to physical limitations
  • History of surgical procedures that leads to scarring
  • Emotional trauma that causes muscle tension
  • Habitual poor posture
  • Repetitive stress and overuse injuries among athletes
  • Temporo-mandibular joint disorder pain (TMJ)
  • Carpal tunnel syndrome
  • Fibromyalgia
  • Migraines

You may be a good candidate if you struggle with pain and limitations but results on standard tests like x-rays, CAT scans, electromyography, etc. haven’t been able to pinpoint a specific physical problem. Myofascial restrictions  are not always easy to spot on these tests, but they can still exist and impact your quality of life.

How can you find a qualified myofascial release therapist? 

Treatments are offered by practitioners including osteopathic physicians, chiropractors, physical or occupational therapists, massage therapists, or sports medicine/injury specialists. Look for a provider that has completed specific myofascial release training courses and has earned a certification.

One of the founders of myofascial release massage is John F. Barnes, PT, LMT, NCTMB, who is considered to be one of the most influential people in the field of manipulative therapies.

Barnes has been treating patients since the 1960s and today is the owner, director and chief physical therapist at two MFR “sanctuaries” located in Pennsylvania and Arizona. He also manages an educational company called Myofascial Release Seminars which has trained thousands of therapists. To find a therapist trained in his technique, visit his website here.

Benefits

1. Helps Restore Proper Body Mechanics

MFR treatments focus not only on pain reduction, but also on restoring postural and movement awareness in order to reduce future injuries.

Good posture is important for preventing tightness of tissues that leads to restriction and pressure. Over time, poor posture can cause parts of the body to be pulled out of alignment, leading to muscular compensations and overuse injuries. This commonly affects parts of the body including the shoulders and hips, in addition to the glutes and back.

2. Helps Reduce Pain

Myofascial pain is thought to have several primary sources: pain within tight skeletal muscle or connective tissue that is being contracted, and pain that generates outward to a nearby structure that is being cut off from blood supply or put under pressure.

MFR treatment is believed to help loosen “bound down” fascia so that movement is restored, while also preventing other connected parts of the body from suffering. There’s evidence that not only can this type of treatment reduce muscle pain in specific parts of the body, such as the shoulders or back, but it can also decrease symptoms stemming from tension throughout the body, such as headaches and neck pain.

3. Enhances Strength and Performance

Myofascial release massage helps the body handle stress and impact better, including the types purposefully applied to the body via exercise and strength-training.

Sometimes MFR is used prior to training to help athletes prepare, or used in combination with other treatments to promote recovery and make other forms of stretching/strengthening more effective.

Research indicates that some of the perks associated with MFR for athletes include: improving range of motion, blood flow and joint function; protecting against injury; reducing soreness; and shortening recovery time (post-exercise fatigue) after a workout.

4. Improves Flexibility

Fascial restrictions negatively affect both flexibility and stability, so resolving tight areas of fascia can be an effective way to improve mobility, the ability to perform daily activities and overall quality of life.

5. Emphasizes Self-Help and Patient Independence

While it’s not exactly the same thing as visiting a therapist, you can practice mysofascial release on yourself at home.

How do you do myofascial self-release? The most popular way to do self-myofascial release is with a foam roller. Massage balls and sticks are also available, which help to apply pressure to specific areas of muscles.

Some experts recommend limiting use to about two minutes or less per muscle group, specifically focusing on muscles that feel tight. Foam rolling for too long or with too much pressure can actually reduce the effectiveness (especially if you’re doing it as part of a warm-up before exercise) and start fatiguing your muscle, so keep it brief.

Begin my moving at a consistent tempo of approximately one inch per second while remaining on areas of tension for up to 90 seconds. You should feel your muscle warm up, loosen and relax.

Risks and Side Effects

When performed by a trained therapist, this type of manipulative therapy is considered to be very safe. However, it shouldn’t be performed on anyone with open wounds, burns, fractured or broken bones, or deep vein thrombosis. Because some studies suggest it doesn’t work for everyone with chronic musculoskeletal pain, it also shouldn’t replace other treatments or doctor’s visits.

Does myofascial release hurt? Some people report feeling some discomfort during or after myofascial massage, however it shouldn’t be very painful. You may temporarily feel sore or have difficulty moving, but this should improve within 1–2 days.

If you have concerns about getting started, it’s a good idea to speak with your doctor, chiropractor or orthopedist first. He or she can recommend which type of manipulative therapy is best for your condition, and give you instructions for practicing self-MFR at home.

Final Thoughts

  • What is myofascial release? It’s a type of hands-on/manual therapy technique that focuses on reducing tightness and pain stemming from dysfunctional myofascial tissue. It targets trigger points or knots, which are inflamed or damaged parts of fascia, a system of connective tissue that wrap, connect and support your muscles.
  • Myofascial massage benefits may include improving range of motion, flexibility, stability, strength, performance and recovery, while reducing pain.
  • Trained therapists or doctors usually perform MFR. You can also perform self-myofascial release using a foam roller, balls or sticks.
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