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Myofascial Release International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Review Article Myofascial Release Salvi Shah1*, Akta Bhalara2 1Lecturer, SPB Physiotherapy College, Ugat-Bhesan Road, Surat, Gujarat 2Lecturer, Shree Swaminarayan Physiotherapy College, Khambhaliya highway, Jamnagar. *Correspondence Email: [email protected] Received: 10/04//2012 Revised: 28/04/2012 Accepted: 5/05/2012 ABSTRACT Myofascial release (MFR) refers to the manual massage technique for stretching the fascia and releasing bonds between fascia and integuments, muscles, bones, with the goal of eliminating pain, increasing range of motion and balancing the body. The fascia is manipulated, directly or indirectly, allowing the connective tissue fibers to reorganize themselves in to a more flexible, functional fashion. The purpose of the myofascial release is to release restrictions (barriers) within the deeper layers of fascia. This is accomplished by a stretching of the muscular elastic component of the fascia, along with the crosslink, and changing the viscosity of the ground substance of the fascia. Evidence shows that MFR is safe, effective and designated to be utilized with appropriate modalities, mobilization, exercise and flexibility programs, neurodevelopment treatment (NDT), sensory integration and movement therapy. Key words: MFR, fascia, flexibility INTRODUCTION Muscle and fascia are united forming the myofascial system. Myofascial therapy can be defined as The purpose of deep myofascial “the facilitation of mechanical, neural and release is to release restrictions (barriers) psycho physiological adaptive potential as within the deeper layers of fascia. This is interfaced by the myofascial system”. [1] accomplished by a stretching of the Fascia is located between the skin muscular elastic components of the fascia, and the underlying structure of muscle and along with the crosslinks, and changing the bone, it is a seamless web of connective viscosity of the ground substance of fascia. tissue that covers and connects the muscles, [2] Myofascial release is a collection of organs, and skeletal structures in our body. techniques used for the purpose of relieving International Journal of Health Sciences & Research (www.ijhsr.org) 69 Vol.2; Issue: 2; May 2012 soft tissue from an abnormal hold of a tight stress. Ground substance is a gel like fascia. [3] consistency of raw egg white. It reduces Direct bodily effects range from friction between muscle fibers creating ease alleviation of pain, improvement of athletic of motion. These single collagen molecules performance, and greater flexibility and ease line up side by side overlapping in a of movement to more subjective concerns staggered pattern akin to a brick wall. They such as better posture. More indirect goals are attached to each other through a process include emotional release, deep relaxation, of hydrogen bonding forming a tough stable or general feelings of connection and well- fabric. being. Rather than being a specific Throughout once life, fibroblasts retain technique, MFR is better understood as a the ability to migrate any point in the body. goal-oriented approach to working with They alter their internal chemistry in tissue-based restrictions and their two-way response to local conditions, manufacturing interactions with movement and posture. [4] specific forms of tissue according to needs of the body. Scar tissue is new collagen that Fascial system [5] has been secreted by ground substance, Fascia is a three dimensional web of which is manufactured by fibroblasts, will connective tissue which runs continuously help determine the way the molecules will throughout the body. This fascial continuity join together. The viscosity or density of the means that there is: ground substance can vary from very thick Continuous networking from head to to watery. The thicker the ground substance, toe, the thicker and less mobile the tissue is. Continuous networking from The fascia can be simply described as superficial to deep, consisting of three layers. Continuous networking from 1. Superficial fascia microscopic to macroscopic. 2. Deep fascia Therefore, the fascial system is not 3. Subserous fascia segmented or divided structurally. However Subserous fascia lines the body cavities the tissue quality within this single system and surrounds the organs. It surrounds blood varies in terms of density and function. vessels and nerves as well. Here the ratio in Fascia is composed of an the number of fibers to fluid is low, giving it elastocollagenous complex with elastin a soft, flexible quality. This is the type of fibers, and collagen fibers, embedded in a tissue that supports shunts and gastric tubes. gelatinous ground substance which allows The superficial fascia lay directly under the fiber mobility, as well as cellular circulation. skin. It has a greater ratio of fiber to fluid The collagen molecule begins as a than the subserous but the fibers are fragile protein chain produced in a fibroblast arranged in a loose, irregular lattice pattern cell. This single protein chain is twisted into allowing for great mobility in all the a left handed spiral and floats inside the directions. With long term spasticity the fibroblast until it comes in contact with superficial layer losses its mobility, the skin other two single chains. These three single become shiny and taut. This is especially chains will align and spiral or twist around evident in the web space of the thumb in the each other toward the right, consequently spastic hand, over the flexor surface of the increasing its structural strength. This triple elbow and the adductor surface of the hip in helix forms the single collagen molecule. spastic diplegia. When released from the fibroblast, it The deep fascia has a more compact migrates through the body’s ground weave with a high fiber to fluid ratio. It has substance to the site of injury, infection or a irregular arrangement of fibers that modify itself depending upon the forces placed on it. International Journal of Health Sciences & Research (www.ijhsr.org) 70 Vol.2; Issue: 2; May 2012 Muscles are embedded in deep fascia. When bracing patterns encourage the development in the healthy state, this fascia is soft and of myofascial restriction. pliable, allowing the muscle fibers to The patterns of fascial restriction are contract and lengthen efficiently. This same like an historical account of the patients deep fascia, in a more compact form, creates adoptions to gravitational forces. When compartment that separate muscle from using myofascial release, the therapist alters muscle. It forms regional sheaths or the density of the ground substance, thus wrapping around the trunk and extremities. allowing the collagen fibers to separate. The It aligns itself in a compact, more orderly therapist gently lengthens the fibers, and parallel fashion to create tendons and following the release of associated ligaments. The deepest fascia forms the restriction throughout the body. Keep in dural tube which surrounds and supports the mind that the elastin allows the tissue to central nervous system. In children with return to its original form and flexibility, spasticity the deep fascia also becomes tight. thus returning the skeleton to proper biomechanical alignment. As we add graded Myofascial restriction [5] movement the patients immediately learns to Unwanted bonding may occur with use this new mobility, carrying it over into inflammation, injury, postural stress (such as functional skills. Combining the concepts of found in cerebral palsy) or lack of full, myofascial release and neuro-development active range of motion. In an attempt to treatment allows the patients to let go of the support the body, the system contracts and past and move forward towards independent bonds to neighboring structures in the same functions. shape and form as the asymmetrical skeleton. Structures that were originally Concepts in Myofascial release technique designed to be functionally separate will [6] form adhesions which will impair their The first concept in this system is ability to slide freely over one another. that of tight loose. This concept is tightness Where these adhesions develop, individual creates and weakness permits asymmetry. muscle action is impaired. Adhesions in the There are both biomechanical and neural neurologically impaired patients develop reflexive elements to this tight loose secondary to the imbalance in postural tone. concept. Increased stimulation causes an Unwanted bonding creates excessive agonist muscle to become tight, and the deposits of tissue. This results in thick tighter it becomes, the looser its antagonist bandaging around joints, fibrous masses, becomes by reciprocal inhibition. along with tough fibrotic ropes and cysts in Shortening of the fascia surrounding the the muscle bellies. hypertonic, contracted muscle requires Myofascial restriction weakens the loosening of the fascia in the opposite muscle and holds the skeleton in an direction in accommodation. In acute inefficient alignment, altering the condition the cycle can be described as kinesiological angle of pull. Excessive continuing spasm- pain-spasm. This results deposits of connective tissue correlate with in tightness and can progress from the acute areas of spasticity. Adhesions branch out to condition of the muscle contraction to actual neighboring structures from these central contracture of the muscle leading to points. chronicity. In chronic condition the cycle is Unwanted bonding can be the
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