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Have you ever asked a massage therapist to pay special attention to your achy lower back? Or maybe you’ve tried using a foam roller to loosen that tight hamstring that’s been plaguing your workouts. If so, you’ve done a type of physical therapy called myofascial release.
What is myofascial release?
Myofascial release is a technique that involves applying sustained pressure to a specific area to relieve tightness in the muscles and surrounding fascia tissue (Cheatham, 2015). It’s a holistic form of manual therapy commonly used to treat a condition called myofascial pain syndrome (Kalichman, 2017).
Myofascial pain syndrome describes chronic pain caused by tightness in the fascia, which are protective connective tissues that surround and separate muscles.
Healthy fascia feels elastic and malleable. When it becomes tight, it restricts movement and creates pain. You may move differently to compensate for the tightness, which can exacerbate the issue and create a ripple effect of pain elsewhere (Tantanatip, 2021).
Myofascial pain syndrome is usually localized and can affect any muscle group in the body, including your head, neck, shoulders, arms, back, hips, legs, and feet. Often, the pain comes from specific trigger points, which are focal, highly irritable spots within the tight muscle group (Lavelle, 2007).
Myofascial therapy may relieve tightness and sensitivity by stretching and putting continuous pressure on sore areas and nearby fascia. Potential benefits of myofascial release include (Wu, 2021; Ramos-Gonzalez, 2012):
- Less muscle soreness and tension
- Improved range of motion and function
- Pain relief
- Stress relief
- Improved circulation
What happens during myofascial release?
One of the benefits of myofascial release is you can see a professional or try it yourself at home. Massage therapists, chiropractors, and sports medicine specialists may use their hands, elbows, knuckles, and trigger point release tools like a ball, foam roller, or roller massager.
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During a myofascial release treatment, the provider will gently massage your fascia. When they notice a stiff or tight area, they will apply more pressure, stretching and massaging the area for up to five minutes to release tension (Cheatham, 2015; Ajimsha, 2015).
Because specific trigger points can be difficult to find, myofascial massage is usually conducted across a broad area of the body to release tension across several trigger points. Plus, the myofascial system exists as connective tissue throughout the entire body, so tension in one area may be related to stress in another (Ajimsha, 2015).
Myofascial release techniques
Therapists use two main techniques during myofascial release (Boyajian-O’Neill, 2008; Ajimsha, 2015):
- Direct: In the direct approach, they use elbows, knuckles, or tools (like rollers) to apply firm, constant pressure to the trigger point until the muscle relaxes. This approach may be used for warm-ups or during rehab for an injured muscle.
- Indirect: With the indirect technique, they apply less pressure. They glide the muscle more gently until the tension resolves and the muscle relaxes.
Does myofascial release really work?
There’s a lot of anecdotal evidence about the benefits of myofascial release. However, the research itself is mixed.
Studies performed so far have been limited. Some are small or poorly designed, and others didn’t find sufficient evidence to support myofascial release as a treatment for chronic musculoskeletal pain.
Some data supports its use for short-term pain relief, but it’s not conclusive (Cheatham, 2015). Plus, the technique’s effectiveness depends on the therapist providing it (Laimi, 2018).
That said, large-scale reviews found that myofascial release holds promise for the following conditions (Ajimsha, 2015; Laimi 2017):
- Cancer-related fatigue
- Neck pain
- Pelvic rotation
- Plantar fasciitis
- Tight hamstrings
A small review found that myofascial release may significantly improve pain and physical function for people with chronic low back pain, but the evidence is limited (Wu, 2021).
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Can I try myofascial release at home?
Many people report benefits from doing myofascial release in a more casual, DIY manner. Using a foam roller or massager before and after exercise for self-myofascial release may improve the range of motion in your joints (Cheatham, 2015).
Who benefits from myofascial release therapy?
This type of alternative treatment may offer health benefits for people with:
- Myofascial pain syndrome: Targeted myofascial massage may relieve chronic pain and tightness in specific muscle groups.
- Chronic headaches: Massaging the head and neck may reduce discomfort associated with migraines and tension headaches (Rezaeian, 2021; Moraska, 2015).
- Sports-related injuries: Myofascial release may help relieve muscle soreness and improve flexibility and recovery in athletes and physically active individuals (Beardsley, 2015).
- Venous insufficiency: People with venous insufficiency have poor blood flow to the legs, causing pain and aching sensations. One small study of postmenopausal women with venous insufficiency found that myofascial release combined with kinesiotherapy improved blood flow, pain, and quality of life after 20 sessions (Ramos-Gonzalez, 2012).
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Side effects and risks
The likelihood of being injured during a massage is very low (Yin, 2014). However, if you have any of the following risk factors, you may need to take extra care or avoid massage altogether (Westman, 2016):
- Fragile skin
- Frail or broken bones
- Open wounds
- Skin ulcers
Underlying health conditions may also increase your risk of side effects during a massage. People with blood clots (like deep vein thrombosis) and people taking blood thinners may need to steer clear of myofascial therapy (Sutham, 2020; Cabanas-Valdés, 2021).
It’s a good idea to talk to a healthcare professional before starting a new therapy if you have any underlying medical conditions or take medications.
Massage therapy, like myofascial release, offers many benefits ranging from relaxation to pain relief.
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Talk to a healthcare provider or physical therapist if you think you may benefit from myofascial release. Share any allergies you have with them before your treatment to avoid an allergic reaction to any oils or lotions they use, and let them know about any current injuries, health conditions, or medications you are taking. Then, relax and enjoy your massage.
- Ajimsha, M. S., Al-Mudahka, N. R., & Al-Madzhar, J. A. (2015). Effectiveness of myofascial release: systematic review of randomized controlled trials. Journal of Bodywork and Movement Therapies, 19(1), 102–112. doi:10.1016/j.jbmt.2014.06.001. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25603749/
- Beardsley, C. & Škarabot, J. (2015). Effects of self-myofascial release: A systematic review. Journal of Bodywork and Movement Therapies, 19(4), 747–758. doi:10.1016/j.jbmt.2015.08.007. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26592233/
- Boyajian-O’Neill, L. & Cardone, D. (2008). The Sports Medicine Resource Manual Chapter 34, Practical Application of Osteopathic Manipulation in Sports Medicine. Elsiever, Inc. doi:10.1016/B978-141603197-0.10034-5. Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/myofascial-release
- Cabanas-Valdés, R., Calvo-Sanz, J., Serra-Llobet, P., et al. (2021). The effectiveness of massage therapy for improving sequelae in post-stroke survivors. A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 18(9), 4424. doi:10.3390/ijerph18094424. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33919371/
- Cheatham, S. W., Kolber, M. J., Cain, M., et al. (2015). The effects of self-myofascial release using a foam roll or roller massage on joint range of motion, muscle recovery, and performance: A systematic review. International Journal of Sports Physical Therapy, 10(6), 827–838. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637917/
- Kalichman, L. & Ben David, C. (2017). Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: A narrative review. Journal of Bodywork and Movement Therapies, 21(2), 446–451. doi:10.1016/j.jbmt.2016.11.006. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28532889/
- Laimi, K., Mäkilä, A., Bärlund, E., et al. (2018). Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: A systematic review. Clinical Rehabilitation, 32(4), 440–450. doi:10.1177/0269215517732820. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28956477/
- Lavelle, E. D., Lavelle, W., & Smith, H. S. (2007). Myofascial trigger points. Anesthesiology Clinics, 25(4), 841–iii. doi:10.1016/j.anclin.2007.07.003. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18054148/#:~:text=A%20myofascial%20trigger%20point%20is,motor%20dysfunction%2C%20and%20autonomic%20phenomena.
- Moraska, A. F., Stenerson, L., Butryn, N., et al. (2015). Myofascial trigger point-focused head and neck massage for recurrent tension-type headache: A randomized, placebo-controlled clinical trial. The Clinical Journal of Pain, 31(2), 159–168. doi:10.1097/AJP.0000000000000091. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286457/
- Ramos-González, E., Moreno-Lorenzo, C., Matarán-Peñarrocha, G. A., et al. (2012). Comparative study on the effectiveness of myofascial release manual therapy and physical therapy for venous insufficiency in postmenopausal women. Complementary Therapies in Medicine, 20(5), 291–298. doi:10.1016/j.ctim.2012.03.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22863643/
- Rezaeian, T., Ahmadi, M., Mosallanezhad, Z., et al. (2021). The impact of myofascial release and stretching techniques on the clinical outcomes of migraine headache: A randomized controlled trial. Journal of Research in Medical Sciences, 26, 45. doi:10.4103/jrms.JRMS_745_18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384005/
- Sutham, K., Na-Nan, S., Paiboonsithiwong, S., et al. (2020). Leg massage during pregnancy with unrecognized deep vein thrombosis could be life threatening: a case report. BMC Pregnancy and Childbirth, 20(1), 237. doi:10.1186/s12884-020-02924-w. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32321459/
- Tantanatip, A. & Chang, K. V. (2021). Myofascial Pain Syndrome. StatPearls. Retrieved Mar. 31, 2022 from https://pubmed.ncbi.nlm.nih.gov/29763057/
- Westman, K. F. & Blaisdell, C. (2016). Many benefits, little risk: The use of massage in nursing practice. The American Journal of Nursing, 116(1), 34–41. doi:10.1097/01.NAJ.0000476164.97929.f2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26669844/
- Wu, Z., Wang, Y., Ye, X., et al. (2021). Myofascial release for chronic low back pain: A systematic review and Meta-Analysis. Frontiers in Medicine, 8, 697986. doi:10.3389/fmed.2021.697986. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34395477/
- Yin, P., Gao, N., Wu, J., et al. (2014). Adverse events of massage therapy in pain-related conditions: A systematic review. Evidence-Based Complementary and Alternative Medicine, 480956. doi:10.1155/2014/480956. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25197310/