This document provides information on myofascial release technique and fascia. It discusses that fascia is a connective tissue that covers and connects muscles, bones, and organs throughout the body. There are three layers of fascia - superficial, deep, and subserous. Myofascial release is a gentle technique that applies sustained pressure and stretching to fascia to reduce tightness and restrictions. It works by stimulating mechanoreceptors in the fascia to cause a neuroreflexive relaxation response. Various techniques are used including cross-hand stretches, thumb presses, and traction stretches. Myofascial release can help treat pain, posture issues, and restricted movement caused by tight or asymmetrical fascia.

1. Myofascial Release
Technique

2. Fascia
• Fascia is a tough connective tissue lining, covering and investing
muscles, bone, nerve, blood vessels and indeed all cells, tissues and
organs of the body.
• Fascia is a three dimensional structure and is continuous throughout
the body without interruption.
• Specialized connective tissue.
• Contains closely packed bundles of collagen fibers oriented in wavy
pattern.

4. Fascia
• Consists of 3 layers
– Superficial fascia: fibro elastic, loosely knit
– Deep fascia: compact, tight and tough
– Subserous fascia: loose areolar tissue

5. Superficial fascia
• Superficial fascia is attached to the undersurface of the skin and is loosely
knit, fibro elastic, areolar tissue.
• Superficial fascia are found vascular structures (including capillary
network and lymphatic channel) and nervous tissues, particularly the
pacinian corpuscles referred to as skin receptor.

6. Deep fascia
• Deep fascia envelops and separates muscles, surrounds and separates
internal visceral organs, and contributes greatly to the contour and
function of the body.

7. Subserous fascia
• Sub serous fascia - loose areolar tissue that covers internal visceral
organs.
• It holds the rich network of blood and lymph vessels that keep them
moist.

8. Functions of fascia
• Provide stability and contour
• Support for vessels and nerve throughout body
• Provide sliding and gliding movement for muscle
• Transmit movement from muscle to bone

9. Facts of fascia
• Fascia covers all organs of the body
• Muscle and fascia cannot be separated
• All muscle stretching is myofascial stretching
• Release of tightness and restriction can affect other body organs
• MFR can change body alignment if soft tissue asymmetries not fixed

10. Facts of fascia
• There are four major planes of the fascia in the body that are oriented
in more of transverse plane are: Pelvic, Respiratory diaphragm,
thoracic inlet and Cranial base.

11. Facts of fascia
• Myofascial pain is probably the most common cause of
musculoskeletal pain in medical practice.
• Therefore, malfunction of the fascia due to trauma, posture or
inflammation can create pain or malfunction throughout the body,
leads to abnormal pressure on nerve, muscles, bones or organs.

12. • Myofascial release
• Applies principles of biomechanical loading of soft tissues and neural
reflex modification by stimulation of mechanoreceptors in the fascia.
• Myofascial Release is generally gentle sustained pressure and gentle
form of stretching that has a profound effect upon the body tissues.

13. Concepts in myofascial release technique
1. Concept of tight – loose
– Within the myofascial system
• Tightness creates and weakness permits asymmetry
– Biomechanical and neural reflexive elements

14. 2. Concept is use of palpation

15. • Pincer Palpation
• Flat Palpation

16. 3. Concept is neuro reflexive change
– Afferent stimulation of stretch is applied during a MFR results in
relaxation of tight tissues by efferent inhibition.

17. • The neuro reflexive response is highly variable and modified by the
amount of pain, the patient's pain behavior, the level of wellness, the
nutritional status, stress response, and basic life - style of the
individual, including the use and abuse of alcohol, tobacco, and drugs,
including prescription medication

18. 4. Concept is release phenomenon
Appropriate
application of
stress on tissue
Results in tissue
relaxation both of
muscle and fascia
Release of
tightness,
improvement in
symmetry of form
and function

19. Superficial back line Superficial front line

20. Myofascial Chains (line of connective tissue)
• Tom Myers, a distinguished Rolfer, has described a number of
clinically useful sets of myofascial chains.
• They are of particular importance in helping draw attention to (for
example) dysfunctional patterns in the lower limb which impact
directly (via these chains) on structures in the upper body.

21. Superficial back line
• The superficial back line involves a chain which starts with: The plantar
fascia, linking the plantar surface of the toes to the calcaneus
• Gastrocnemius, linking calcaneus to the femoral condyles
• Hamstrings, linking the femoral condyles to the ischial tuberosities
• Subcutaneous ligament, linking the ischial tuberosities to sacrum
• Lumbosacral fascia, erector spinae and nuchal ligament, linking the
sacrum to the occiput
• Scalp fascia, linking the occiput to the brow ridge.

22. Superficial front line
• The superficial front line involves a chain which starts with: The
anterior compartment and the periosteum of the tibia, linking the
dorsal surface of the toes to the tibial tuberosity.
• Rectus femoris, linking the tibial tuberosity to the anterior inferior
iliac spine and pubic Tubercle.
• Rectus abdominis as well as pectoralis and sternalis fascia, linking the
pubic tubercle and the anterior inferior iliac spine with the
manubrium,
• Sternocleidomastoid, linking the manubrium with the mastoid
process of the temporal bone.

23. Lateral line Spiral line

24. Superficial front line
• The lateral line involves a chain which starts with:
• Peroneal muscles, linking the 1st and 5th metatarsal bases with the
fibular head.
• Iliotibial tract, tensor fascia lata and gluteus maximus, linking the
fibular head with the iliac crest
• External obliques, internal obliques and (deeper) quadratus
lumborum, linking the iliac crest with the lower ribs.
• External intercostals and internal intercostals, linking the lower ribs
with the remaining ribs
• Splenius cervicis, iliocostalis cervicis, sternocleidomastoid and
(deeper) scalenes, linking the ribs with the mastoid process of the
temporal bone.

25. Superficial front line
The spiral lines (Figure 2.5) involve a chain which starts with:
• Splenius capitis, which wraps across from one side to the other, linking the occipital ridge
(say on the right) with the spinous processes of the lower cervical and upper thoracic spine
on the left.
• Continuing in this direction, the rhomboids (on the left) link via the medial border of the
scapula with serratus anterior and the ribs (still on the left), wrapping around the trunk via
the external obliques and the abdominal aponeurosis on the left, to connect with the
internal obliques on the right and then to a strong anchor point on the anterior superior
iliac spine (right side).
• From the ASIS, the tensor fascia lata and the iliotibial tract link to the lateral tibial condyle
• Tibialis anterior links the lateral tibial condyle with the 1st metatarsal and cuneiform.
• From this apparent end point of the chain (1st metatarsal and cuneiform), peroneus longus
rises to link with the fibular head.
• Biceps femoris connects the fibular head to the ischial tuberosity.
• The sacrotuberous ligament links the ischial tuberosity to the sacrum.
• The sacral fascia and the erector spinae link the sacrum to the occipital ridge.

26. Indications
• Complex, global pain that does not follow dermatomes or myotomes
patterns.
• Painful postural asymmetry.
• Asymmetrical muscle weakness due to acute or chronic neuropathy.
• Underlying chronic condition that causes tightness and restrictions
• Impaired respiration and inflexible rib cage

27. Contraindications
• The patient does not tolerate close physical contact or touch
• Not able to understand
• Unstable medical condition e.g. Unstable Angina
• Dermatitis
• Not trusting the therapist
• Contagious infection
• The patient is under the influence of drugs or alcohol.

28. Precautions
• MFR lowers BP particularly when release deep trigger point releases
are performed.
• Individual who are diabetic should check their blood sugar levels prior
to treatment.
• Medication that increase blood clotting time and can cause patient to
bruise easily.

29. Pre treatment protocol
• Therapeutic environment
– Quiet room
– Appropriate lightening
– Proper height of treatment table
– Position of patient
– Body mechanics of therapist

30. Treatment

31. Enigma of “good hurt”
• Deep myofascial stretching and vertical releases might be painful
• Release hurts and feels good at the same time

32. Onion metaphor
• Treatment with MFR starts with superficial stretches (outer layer of
onion)
• Feedback from gross stretches lead to next layer

33. Principles of fascial release Rx
• P O E T(2)
• POE- point of entry
• T- twist
• T- traction

34. Basic steps of MFR
• Stretch is held until slack is released and new slack is felt
• Stretching force is increased to take up the new slack, held until next
release occurs
• Repeated until no more slack is felt and end feel is reached
• Responding to feedback, next area of restriction is addressed

35. Techniques of MFR
• Cross Hand Stretch
• I-Stretch
• S-Stretch
• W-Stretch
• Palm
• Thumb
• Double Thumb

36. • Heel
• Planted Stretch
• L-Stretch
• Joint Stretch
• Traction Stretch
• Knukle
• Thumb Spread
• Finger Stretch
Techniques of MFR

37. • Gross stretch of any muscle
• Focused stretch of any muscle

38. Gross stretch using cross hands

39. Gross stretch using ulnar border

40. Gross stretch using lateral surface of thumb