Myofascial release and deep tissue massage are considered “alternative medicine” and you’ll find people online “debunking” it as quackery… so here’s some welcome new science for people like me who can’t live without it.
Recently, The Journal of the American Osteopathic Association (JAOA) published an article by Manal Zein-Hammoud, PhD and Paul R. Standley, PhD entitled “Modeled Osteopathic Manipulative Treatments: A Review of their in Vitro Effects on Fibroblast Tissue Preparations.” A lengthy title for a potentially groundbreaking bit of science to support the little understood technique of myofascial release.
Technique of what?
To understand myofascial release, we must first understand fascia. In keeping this “science lite,” imagine a very strong dew-covered spider web encircling a shrub. And between the gaps in the threads is a clear gel, rather than air. If you can picture this, then you’re on your way to understanding fascia. This three-dimensional complex matrix threads itself throughout our body, surrounding our muscles, organs, nerves, bones, blood vessels and even our cells. Everything is held together and in place by fascia. It is impressively flexible and infinitely adaptable.
And because fascia is a very strong, very connected spider web, when one spot on it gets tugged or pulled or injured, the effects ripple throughout the body. This is why we may have pain in our knee that may have nothing to do with a knee injury, but everything to do with an injury to our lower back. The natural, fluid state of the fascia has been traumatized, causing it to harden and tighten.
Ever pull a thread on a sweater only to find the whole thing bunching up on one side? That bunching is exactly what happens to fascia when our bodies experience stress, whether it’s dehydration, injury, inflammation, repetitive activity—you name it.
Our body reacts to pain of any kind by creating a protection response, that while, initially is a good thing, over time can lead to increased pain, buildup of toxins and reduced blood flow and oxygen to the area. When we experience a slight amount of tissue damage—this can be due to a physical injury, or a psychological one like depression, or even something like an ulcer—pain signals are sent to the spinal cord which then triggers the muscles around the injury to contract in order to provide support and protection for the surrounding tissues.
This response, left unchecked, creates a vicious cycle of pain as more blood flow is restricted to the contracted area. More signals are sent, and more muscles tighten to protect the growing epicenter of pain. What may have started as something small has now grown—that sweater gets more gnarled and bunchy.
Myofascial release (MFR) is designed to go in and smooth out those hard knots, returning the fascia to its normal fluid and adaptable self.
But how?
In MFR, a gentle, sustained pressure is applied to points of restriction (those bunched up spots), allowing the connective tissue to release. Picture a stick of cold butter. If you jab your finger into it sharply, you’re just going to hurt your finger, and not even make a dent in the butter. But if you place your finger on the butter, and apply gentle pressure, you’ll find you’re able to slowly sink into the stick of butter, melting your way into it. This is essentially what is happening when an MFR therapist works on the body, or when one performs Self Myofascial Release (SMFR) with tools such as rollers and balls.
But the mechanics behind this technique have been under-studied and difficult to understand, or even explain. Some people brush it off as placebo or ineffective or even “out there,” or too “woo-woo” to be accepted in the academic medical world. Studies trying to illustrate the efficacy of MFR are often poorly designed and executed with little evidence backing their claims.
And this is why the Zein-Hammoud and Standley study is so momentous! Their experiments are not only well designed and controlled, but the results are derived from at least ten years of pertinent research and experimentation based on Standley’s studies of fibroblasts. Their research is the perfect example of how proper research should be performed—the scientific method at its best.
And the findings are not to be ignored. According to a derivative summary of the paper by Michael M. Patterson, PhD, the international associate editor of the JAOA, Standley’s work shows that “fibroblasts respond differently to various strain patterns, secreting various anti-inflammatory chemicals and growth factors, with implications for wound healing and muscle repair, among other physiologic processes.” Standley also experimented with the length of duration and the magnitude of MFR, and how they affect injuries, thus offering future suggestions for therapists on how to treat their patients.
Surprisingly, Standley’s research on non-injured tissue suggests the possibility of MFR aiding in the strengthening of the area.
“Finding the molecular mechanisms of how these therapies work would define the underpinnings of clinical efficacy and could propel OMT (osteopathic manipulative therapy) into evidence-based, first-line therapy,” said the lead author, Paul R. Standley, PhD.
Those of us who have utilized or experienced MFR techniques know that they work. But now we have science finally backing us up—lending credibility to the claims. And now the next time someone brushes off MFR as ineffectual, we can point them toward Standley’s work and tell them, “See? MFR works—it’s science!”
I had TKR 8 weeks ago and my knee is stiff with limited ROM. I take PT twice a week and just reached 90. What kind of help can you recommend?
What do you do in PT? What kind of stretching and massage are you doing outside of PT? Twice a week seems very little to me. When I have body issues, I like to make progress every day!
Looking for information on SI Joint issues. What mfr treatment will best help.? How to find a therapist in our area ? I’ve checked and there don’t seem to be any listed – south east North Carolina.
Hi Joan, my experience is that you can solve quite a few problems with self-care — by exploring your body with massage balls and rollers you can discover where you have tight tissues. Concentrating on those areas is always helpful and may relieve pain in places you wouldn’t expect. For example, the abdominals / psoas are often very tight and cause problems in lots of other places in the body including lower back, hips and ankles. I don’t know how to find a therapist in your area.
I had acdf c5/6 and c6/7 12 weeks ago and am still experiencing pain between my shoulder blades. It feels more muscular than neuro… very tight/knots. I’m going to ask my dr about physical therapy. Do you think MFR could help?
Hi Kelli, if you’ve got tight connective tissues, that’s what MFR is all about, loosening them up!
Lost range of motion in neck, can some technique help in releasing the tightened muscles?
for sure! look at our Neck Track product – it gets the job done.
I fell and broke two bones in my left hand at the end of January. I was in a 2-finger splint for 6 weeks. I’ve used up all my PT sessions but my fingers still don’t bend across the large knuckles. I have a splint with elastics and loops to pull my fingers down but I’ve been told the extensor muscles in my arm are tight which is why my hand doesn’t bend. Would MFR help and is there something I can do at home?
absolutely! MFR is very helpful for loosening tight muscles – I would start by reading this – you’ll find lots of good techniques there that will help you get started: https://deeprecovery.com/how-to-treat-tendonitis/ (tendinitis comes from tightness)
Hi I’ve got tennis elbow in both arms from swimming worse in right with pain at front and back of shoulder. Temporal modular pain also under jaw and extending below ear…difficult to open mouth wide due to restricted movement! Tightness in quads/ hamstrings/ outer side of hip which extends into glutes and under lower buttocks…physically feel like an old person.. please help I’m desperate to get fit and back to full health..I was swimming 3000-4000m w week…now nothing ,Pilates hurts arms , hips. Bernie
Hi Bernie, with that much tightness, you’ll want to look at the Causessection at the bottom of https://deeprecovery.com/how-to-treat-tendonitis/
Hi! I have a “frozen shoulder” in my right hand. It’s soooo painful that I can’t do any manipulation with my hand? Do you have some recommendation with myofascial in my case. I don’t want to do a surgury. Thanks
Hi, sorry to hear about the pain and lack of function! We are running a Kickstarter project now to launch a new set of massage balls which is very helpful for shoulder work – please have a look: https://deeprecovery.com/kickstarter
Hi,
I’ve had stiffness in the area below my neck around the shoulder for quite some time now. I have tried message and physio therapy but it doesn’t seem to have any drastic result. I have been told I have shoulder knots, which I can feel too if I push my finger around the area. There seems to be accumulation of muscle that stretches about 5 inches. Don’t know if it’s psycholgical, but I feel like these knots take away energy from my body and are highly irritatable. Some days I feel I have a poor posture, can’t stand tall and the knots are holding me down. I feel loss of breath as a sympom as well. Throughout the day I hear clicks around the area as I move the muscle a bit. How do I release these knots ? I would really appreciate any guidance or help as this is severly affecting my lifestyle and work. I do have a desk job. But my problem seems severe. I just want to get rid if these knots once and for all.
You’re in luck AD because this is workable – watch the upper and lower back video at https://deeprecovery.com/videos/
i have O/A in both knees. I also have significant wear/tear of cartilage in bilat knees. I have scar tissue in my R acl from trauma injury. ( sports injury)
I spent decades running, playing tennis and riding jumpers; all sports that put a great deal of stress through the knees.
I am in phys therapy- again- to try to rehab enough to postpone knee replacement surgery.
I remain very active, despite pain in both knees. I still ride horses, walk 5-10 miles daily & am very fit at 60 yrs of age- slender- great “core walker”.
I find I can’t get max benefit from phys ther exercices due to reduced extension/flexion of knee anatomy. Thus its painful to complete twice daily home assignment from PT.
Would MFR help me? If so, what can I do at home to help get myself able to maximally benefit from my PT exercises?
My main areas of restriction seem to be the entire area behind & beside the knee- can’t get extension. Also the ACL areas are tight from scar tissue ( mri results).
I am not ready to “throw in the towel”, been mega active all of my life. Not making progress in PT is so discouraging. thoughts?
hi Kay, have you used a foam roller at all? If you have not, I would probably start there, working the quads, hamstrings and calves. If you have tried a foam roller, how about a harder one using it more aggressively with the techniques I teach in my videos (12 second rule)? How about massage? The short answer is yes I believe MFR may help you substantially!
I have complications of long term Graves’ disease, including fascia involvement in my shins. This seems like a difficult location for ball therapy, do you have any suggestions?
Hi Molli, as it turns out the shins are very easy to work! Have a look at our video page, you’ll see we cover the shins…
I am in serious neck pain one thing my Dr suggested is myofascial therapy I have crappie insurance what can I do at home Lynda ziebel lmindy1964@gmail.com thank you
Hi Lynda,
With neck issues it’s very helpful to work the traps and paraspinals at the top of your back. Well, actually it’s good to work your whole back because everything is connected! Massage tools such as massage balls work great for self-myofascial release and allow you to do so from the comfort of your own home. If you don’t have a professional set, you can use tennis or lacrosse balls but many find they prefer specialized massage balls and you may find this guide helpful: http://deeprecovery.com/choosing-massage-balls/. Larger, softball-size massage balls are optimal as a smaller set may be too small for the traps. For specific exercises on the neck, you can see our instructional video at https://www.youtube.com/watch?v=MOxtEpLGCJQ which target the neck and jaw. You will see our Neck Track, a massage tool specifically designed for the neck, and you can try lifting your head and then turning it and setting it back down. You can also use the bottom of the Neck Track with its wider spacing to work more fully the side of your neck.
You could easily spend 45 minutes on your back alone and if you have the time, that’s worth doing when you first start. This is really helpful and you won’t be overdoing it because you’re just covering a lot of territory rather than working one spot over and over again. In a few days or a week or however long it takes you to feel looser, then you can start shortening your routine. Try to work both the neck and the back every day at first. Working isolated parts of the body can be counterproductive.