What is Myofascial Release and How Can Physiotherapy Help?
There is Not One Single Technique for Myofascial Release
Did you know that not all muscle fibers attach only to bone? We commonly learn that each muscle has a specific origin and insertion, for example, the bicep brachii originates on the coracoid process & supraglenoid tubercle, then one portion inserts to the radial tubercle of the ulna. What about the portion that inserts on the bicipital aponeurosis – what structure is that? When muscle fibres attached to connective tissue, this means that a pull from that muscle not only acts to move the bone itself, but it will add a force on the adjacent fascia and connective tissue.
Now, what is fascia? Imagine yourself in a full continuous body suit, if you pull the fabric on your right shoulder, the fabric will stretch and subsequently have a pull around your left hip as well. Now imagine this body suit has different segments to it, where the arm is sewn onto the torso, torso onto the hip segment, and so on. Our bodies have several segments of fascia that all interconnect to become one complete unit. If you have tension in one segment, the fascia does not slide or move as freely as it should, and this may lead to pain or dysfunction in another area of the body.
The Importance of Myofascial Release
To further illustrate the involvement of fascia, take for example, pain at the knee. Many people complain about pain in the patellar tendon with plyometric movement – this is often labelled as “Jumper’s knee.” There are many reasons that may lead to the cause of jumper’s knee, such as not enough progression in load to training, malalignment of the knee or foot, etcetera. But looking from a fascial point of view, there may be tension in the fascia surrounding the quadriceps muscles that cause a pull that is not consistent with normal functioning. Therefore the gliding of muscle tension and surrounding tissues will be towards a different vector force, causing extra strain on the patellar tendon, and subsequently causing pain.
Physiotherapy point of view:
How do we know there is fascial involvement? One can argue that fascia is always involved in any form of movement. However, it is often overlooked as a cause when diagnosing pain. Quite often, the site of pain is not the root of the problem. Pain felt is frequently the “victim” of a dysfunction, malalignment or tightness elsewhere in the body. Therefore in a Physiotherapy assessment, we must look at a more global picture rather than simply zero in on the site of pain. I have seen patients who have had tension in their tibialis anterior down near their shin that causes pain closer to their lumbar spine. How can a structure so far away lead to pain in the low back? Just like the song “The hip bone is connected to the, thigh bone,” all the other structures, fascia, nerves, capillaries and more, are all interconnected. As a Physiotherapist, my focus initially is to look at what is going on specifically at the site of pain. But if initial treatment methods are not helping to resolve the issue, I look further up or down the line and try to pick out more clues. This is where looking at fascial lines and body chains become more important. It is like detective work and having a good understanding of how fascial lines are connected will give a better understanding of what to look for.
There are many types of fascial releases (myofascial release) including foam roller, roller stick, Graston, fascial manipulation, trigger point therapy, intramuscular stimulation, or simply soft tissue massage therapy. Each have their own benefits and so there is not one single technique for myofascial release. Whether a Physiotherapist or Personal Trainer, we all have different tools in our toolbox to help our clients and myofascial release is great tool to have.
Hannah Tan, Physiotherapy (MPT), Kinesiologist (BHK)