05/10/2025
Myofascial Release - What is It?
Over the years I have found that the answer to this question is quite variable depending upon whom you are conversing with. For example, I’ve met physical therapists who refer to the concept of instructing an individual to lay on a foam roller as myofascial release. Others would describe performing a Tai Chi pose in a similar fashion. While I do not question the effectiveness of these forms of self treatment, I respectfully disagree that they are examples of myofascial release. This is because I would define myofascial release as a form of manual therapy requiring one person to touch another.
There are many online articles defining the term myofascial. “Myo” refers to muscles, while “fascial” refers to a structure called fascia. Fascia is a type of connective tissue within the body, made up of collagen and elastin fibers that criss-cross in a spider web type arrangement, as well as a fluid based ground substance. Fascia surrounds every single muscle, as well as each muscle fiber, from head to toe. Hence the term “myofascial” refers to muscle and its associated fascia together. The two are inseparable. However, fascia doesn’t stop there: it envelops the entire body. It surrounds each nerve and nerve fiber, each internal organ, and forms the outer coating of each bone.
The definition of “release” is a little more difficult to explain. In fact, many authors ignore the term altogether. There are healthcare practitioners who avoid using the term release, but instead substitute other words such as mobilization, manipulation, or massage, depending on the school of thought and the guru who is teaching. Over the course of many years, I have had the opportunity to receive training in various forms of myofascial work (mobilization, manipulation, and massage), but I believe that myofascial release is the most effective. The person who I would like to acknowledge as a forerunner is a physical therapist named John Barnes. He defines a “release” as a sensation experienced by both clinician and client, in response to sustained, gentle pressure, in which there is a softening, elongation, pulsation, or feeling of warmth. In theory, the result of this release is a positive change in the structure of the fascia, by lengthening and becoming more pliable.
In my opinion, it takes some practice and skill to perceive the muscles and fascia releasing, and this is what makes myofascial release more powerful than other forms of deep tissue work. An example from a past experience that I had may be helpful to illustrate this point. Well over 30 years ago I was employed at a large sports medicine clinic, trying to help an individual (Bob) recover from a lumbar laminectomy back surgery. I had instructed him in various exercises to strengthen his core muscles, and we worked on flexibility. I instructed Bob in using proper body mechanics during activities of daily living. The organization that I worked for rented pool time at a nearby YMCA so that I also had Bob perform water exercises. Despite Bob’s hard work, he was still struggling with a lot of lower back pain, preventing him from being able to return to work. So one day, while treating him in our clinic, I tried to “release” Bob’s surgical incision. He was lying face down on a treatment table while my hands were on either end of the incision. The technique was to spread my hands apart, but I was not having much success. By God’s grace, my co-worker and mentor Leonard Paré PT happened to be walking by the treatment room. He glanced at me, and stopped in his tracks. Lenny (as everyone called him) shook his head and said “Dan, you’re trying too hard and you blew past the barrier.” (The resistance that a clinician perceives when stretching muscles and fascia is referred to as a barrier). So, with Bob’s permission, Lenny entered the room, placed his hands on top of mine (so that he never actually touched Bob) and gently spread his hands apart, engaging the “barrier.” The two of us spent perhaps ten minutes releasing the bound up fascia in Bob’s lower back. I had never felt anything so powerful. It was as though we were tearing Bob’s scar tissue apart, and yet it was gentle and almost effortless. During the treatment, Bob’s response was, “I have needed this for so long, don’t stop!” In the weeks following that ten minute treatment, everything that previously wasn’t working (stretching, exercising, body mechanics training, water exercise, etc.) now worked. He still did need stronger core muscles and so on, but with time he was able to completely recover and return to work full-time.
Past experiences like this have profoundly influenced the trajectory of my career as a physical therapist and I have been greatly blessed to have compassionate and talented mentors like my friend Lenny. Myofascial release can be a very helpful form of treatment. However, like with Bob’s situation, full healing usually requires other forms of care, including exercise.
Training in myofascial release is usually not a large part of the entry-level curriculum for most healthcare workers, but something they seek out after graduation. Typical professions that pursue myofascial release training include massage therapists, occupational therapists, physical therapists, and chiropractors.
If you are struggling with pain, seeking out a clinician trained in myofascial release techniques may be a helpful component to your healing journey.
I hope this article helps.
Dan Elia, PT
