Is Myofascial Release real?

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!”