Myofascial Release

Question 1

Fascia

Answer 1

Loose, irregular connective tissue found throughout the body

Holds structures together and connects the body as a whole

Composed of: Mucopolysaccharide, Collegen, Elastin

Displays Thixotropy

Becomes more pliable with movement, stretching, and increase in temperature

Question 2

3 layers of Fascia

Answer 2

Superficial
Potential Space
Deep

Question 3

Superficial Fascia

Answer 3

Loose connective tissue
Lies under the dermis of the skin
Composed of loose fatty connective tissue

Function: Mobility, insulation, energy

Question 4

Deep Fascia

Answer 4

Intricate series of dense connective sheets and bands that surrounds and holds the muscles and other structures in place throughout the body

Compartmentalizes the body
Fuses to the periosteum of bone
Helps transmit forces of an attached muscle

Ex) Pericardium, Pleura, ITB, IM Septum, retinacule

Question 5

Subserous Fascia

Answer 5

Between deep and serous membrane

Function: covers organs, lubrication

Question 6

Myofascial release addresses which two layers of fascia?

Answer 6

Subcutaneous and Deep

Question 7

Fascial Orientation

Answer 7

Multi-directional but most aligned vertical

4 major dense areas: pelvic diaphragm, respiratory diaphragm, thoracic inlet, cranial base

Question 8

Function of Fascia

Answer 8

Support blood vessels and nerves
Allows adjacent tissues to move on each other while providing stability and contour
Lubrication between structures
Makes periosteum stronger
Fascial sheaths surround muscles and connect muscle groups
Can assist in maintaining a muscle force
Can be an origin for acute and chronic problems

Question 9

Fascial Contraction

Answer 9

Excessive strain, poor ergonomic environments, trauma, and abnormal postural alignment cause strain on the myofascial system = contracture

Causes pain and limits movement

Question 10

Fascial Response to Injury

Answer 10

Fascia reorganizes along the lines of tension imposed on the body and will contract or shrink
Loses it’s elasticity
Lubrication does not occur
May cause some biomechanical and immunological changes to occur

Question 11

Myofascial Release Definition

Answer 11

A highly interactive stretching technique that requires feedback from the patient’s body to determine the direction, force and duration of the stretch
Facilitates maximum relaxation of tense tissues

A specialized system of prolonged manual stretching of the fascial tissues of the body, to the point where there is a release of tension
Subtle stretching technique
Evidence that fascia may have an ability to contract in a way similar to smooth muscle

Question 12

MFR Goal

Answer 12

Facilitate the most efficient posture and movement patterns that the patient can maintain

Question 13

MFR Progress measured by…

Answer 13

improved postural symmetry
Reduction in active myofascial trigger points
increase in fluidity of movement

Question 14

Assumptions for MFR

Answer 14

1) All living tissue has inherent motion that has a rate and an amplitude of movement.
2) Restrictions or dysfunction in one area or type of tissue can result in a reaction or symptoms in another area
3) “seeing” with your hands
4) When what the patient tells you is happening is different from what you are feeling, your feeling is more accurate

Question 15

Indications for MFR

Answer 15

Back and cervical pain
Chronic pain
Headaches/migraines
TMJ
Carpal tunnel syndrome
Fibromyalgia
Spasm/spasticity
Restricted range of motion
Patients that can’t tolerate heavy pressure

Question 16

Contraindications for MFR

Answer 16

Malignancy
Aneurysm
Acute rheumatoid arthritis
Systemic or localized infections
Osteomyelitis
Hematoma
Anticoagulant therapy

Question 17

Precautions for MFR

Answer 17

Open wounds
Healing fractures
Hypersensitivity of the skin
Osteoporosis or advanced degenerative changes

Question 18

Intervention Guide Lines

Answer 18

Guide treatment by objective findings rather than subjective complaints
Never force a barrier during treatment but don’t back off of a barrier once reached
Use the least force possible to effect the desired change
Tightness will give way or melt under the application of load
MFR should never be used exclusively

Question 19

Technique Guide Lines

Answer 19

1) Do not use medium
2) Do not slide skin
3) Gentle contact and enter tissues slowly until restriction is felt
4) Hold stretch until they release
5) Flow with the tissue
6) Exit tissues carefully
7) Hydrate!

Question 20

Myofascial Release Techniques

Answer 20

Direct
Indirect
Bridging

Question 21

Direct Technique

Answer 21

Using knuckles, elbows, or other tools to slowly stretch the restricted fascia by applying a force
Moving slowly through the layers until the deep
Engage fascia by taking up the slack, move or drag the fascia across the surface while staying in touch with the underlying layers

Question 22

Indirect Technique

Answer 22

Gentle stretch with only a few grams of pressure – fascia “unwinds”
Increase heat and blood flow to return to area
Body’s inherent ability to correct itself returns
Eliminating pain and restoring performance
Key: Sustained pressure over time

Question 23

Bridging Technique

Answer 23

Combines principles of soft tissue mobilization, muscle energy, indirect techniques and craniosacral techniques

Question 24

Specific Myofascial Techniques

Answer 24

Skin Rolling
Arm/Leg pulls
Cross-hand stretch
Transverse Plane releases

Question 25

Skin Rolling

Answer 25

Addresses superficial fascia

Question 26

Cross-hand stretch

Answer 26

Affect the skin and release of local lines of restriction – sustained pull
Forearms could be used to release deeper fascia

Question 27

Transverse Plane Release

Answer 27

Work on restrictions in the pelvic floor, respiratory diaphragm, thoracic area, sub-cranial