When it comes to the musculoskeletal system most people experience pain, tightness, injury and or a clinical condition several times through their life. If we talk about athletes, managing their musculoskeletal system is a fundamental part of their career, both to perform to the desired level and to keep out of injury. According to Rocio Santiago, a therapist from Inside Clinical Massage, even though athletes are usually the ones able to access the most advanced treatment and training methods, they often overuse and push their musculoskeletal system to the limit. As a result, most athletes experience injury at some point or multiple times during their careers. A good example is tennis player Rafael Nadal and the amount of injuries he’s been able to overcome during his career.

The last couple of decades have witnessed the raising of a relatively new concept in the world of conditioning, injury rehabilitation and musculoskeletal pain treatment; the myofascial tissue. The treatment of this tissue, Myofascial Release (MFR), has shown to be very effective for the treatment of musculoskeletal pain and clinical presentations as well as for injury rehabilitation and conditioning. It’s for this reason that MFR has taken a major role in many treatment rooms around the world and is even slowly earning its place in our very rigid medical system. It’s because of its effectiveness that at INSIDE we use Myofascial Release as a main treatment method. Let’s explain a bit more in detail how MFR has such an important place in so many treatment rooms.

What is the Myofascial tissue?

The myofascial tissue is a connective tissue in our body that hold organs, muscles and bones in place. This tissue is found in the muscles, bones, it goes down to the cellular level, it creates the base for our brain to sit in… it’s everywhere! and it adopts a different composition depending on its function in each area. It can have a gluey consistency or a more solid one (if you think of a chicken breast you can see a representation of the myofascial tissue as that outer thin white layer of tissue that wraps around it).

Although the myofascial tissue has always been there for us to see, it hasn’t been until relatively recently that its important role has being explored and exposed fully, and there is still more to come! Thinking it didn’t play a major role, we used to cut through it in the dissection room. Today we’re starting to recognise its importance when it comes to treating musculoskeletal pain and clinical conditions as well as for conditioning.

Why is the Myofascial tissue so important?

1. It responds to chemical changes

This fascinating tissue, far from being inert, has more nerve endings than the skin itself, making it a living system extremely sensitive to the environment in which it lives and responding not only to pressure changes but also to chemical signals (enzymes, toxins etc). This explains how diet, lifestyle and mental health directly affect the health of our musculoskeletal system.

2. It holds our body together and it’s a single piece of fabric

Another key characteristic of myofascial tissue and a very important one when it comes to dealing with the musculoskeletal system, is that this tissue doesn’t divide. The myofascial tissue consists of a single piece of fabric that connects muscles and bones to one another and to the rest of the organs and other structures in the body. If we were able to remove everything other than the fascial tissue we would be left with a spider web-like structure so detailed that we would probably be able to recognise the person that it belongs to.

Why is this important? Keep reading…

3. Restrictions along the myofascial tissue will affect the balance of the whole body – Tensegrity system concept and compensatory patterns

The body is thought to behave as a tensegrity structure (a design principle that applies when a discontinuous set of compression elements is opposed and balanced by a continuous tensile force, thereby creating an internal prestress that stabilises the entire structure). The myofascial tissue is a fundamental element of that tensegrity balance. As the myofascial tissue is one continuous piece and doesn’t divide, we can understand how a restriction anywhere along it will pull onto the structures attached to it and will cause imbalance through the whole tensegrity structure in a domino-like effect, weakening the system.

Our body can adapt incredibly well to these imbalances, compensating for them. This is one way that compensatory patterns are developed in our body. These patterns are usually a brewing potion for pain and injury and they must be identified and corrected.

If a joint has been pulled out of its neutral position, all the muscles attached to it will be functioning outside of their neutral position as well, increasing the wear and tear and limiting the functionality and potential of these structures.

Very often these compensatory patterns happen as a result of both weakness and restrictions in antagonists structures. For example, someone with a kyphotic pattern (over arched middle back) will often have shortening and restrictions of the chest muscles (amongst others) and weakness of the muscles between the shoulder blades (amongst others). They will require releasing of the shortened structures and strengthening of the weakened ones. This is how Myofascial Release and strength training ( a strength training method fundamented on the myofascial system) go hand in hand.

4. It is very sensitive to Stress and therefore the treatment of this tissue is a powerful tool to manage stress – Hyper-sensitisation concept

As we’ve seen above, the myofascial tissue has a lot of nerve endings. This makes this tissue extremely sensitive to chemical changes in our body. Due to its prevalence in our society it’s important that in this article we include “stress” as one of the biggest detrimental factors to the myofascial tissue. Under constant stress the myofascial tissue can become hyper-sensitised triggering higher levels of pain and discomfort.

Tuning into and releasing the myofascial system during a treatment session can positively impact the nervous system reducing its overly sympathetic activity (”stress” or “fight or flight”) and restoring its parasympathetic activity (”restoration” “immune system”). Myofascial Release has the ability to put the body into healing mode and there’s nothing more powerful than our own body when it comes to healing.

How does Myofascial Release work in practice?

Direct or Indirect Myofascial work

There are several schools of thought when if comes to myofascial techniques, the Rolfing is probably the most known but there are others.

At our clinic we use a combined approach of several techniques to increase the effectiveness of the treatment.

During a Myofascial Release session we release restrictions by applying gentle sustained pressure to the myofascial tissues. This releases the fascia allowing for the joints either to follow or to have more space around them to move better.

We use Direct Myofascial work where we apply pressure in a particular direction and direct the tissue that way. A simple example is a Myofascial stroke from the shoulders and down the back all the way down to the sacrum.

Some other common Myofascial Release techniques use a more indirect approach to obtain a release. An example of this would be what we refer to as the sandwich technique, where the therapist sandwiches a part of the body with both their hands to obtain a release.

We switch between techniques depending on different factors, like the goal of the treatment, the area that we’re working on and the severity of the injury.

Both methods are valid, require different skills and are very effective when done correctly, which will highly depend on the therapist themselves and their ability to tune into this living system.

The role of the myofascial tissue in sports conditioning

In the area of conditioning, the myofascial system is also gaining popularity through functional training. Functional training consists of integrated movements that require the involvement of several muscle groups, rather than isolated strength exercises that work muscles as separate entities. This principle aligns with the concept of the myofascial lines in which muscles work as a continuous entity rather than as separate individual entities.

This type of training mimics the movements that occur in real life, preparing the body to respond better to dynamic situations. Functional training can be fine-tuned for each sport, making it an effective way to improve athletic performance. By incorporating functional training and Myofascial Release into a training program, athletes can improve their muscle function and reduce their risk of injury.

What are the most common conditions we treat with Myofascial Release Therapy?

Myofascial release has been shown to be effective in treating a wide range of musculoskeletal conditions and pain. Here is a list of the conditions we successfully treat in our clinic:

• Neck, back and shoulder pain
• TMJ Disorder/bruxism symptoms
• Rotator cuff injury
• Lower back pain
• Hip and gluteal pain
• Pain radiating down the arm
• Pain radiating down the leg
• Frozen shoulder
• Sciatica
• Tennis/Golfers elbow
• Carpal tunnel syndrome
• Knee pain
• Whiplash
• Plantar fasciitis
• RSI
• Groin pain
• General stiffness
• Anxiety

In conclusion, the Myofascial system is a key element to consider not only in the treatment of musculoskeletal pain and clinical conditions but also in the world of sports conditioning and injury rehabilitation. Myofascial Release is growing in popularity and it has become a top treatment option for musculoskeletal conditions and pain due to its effectiveness, safety, and non-invasiveness. It is a powerful holistic approach that promotes healing and restoration of normal function in the affected area as well as improving the body’s ability to heal itself. Myofascial Release has shown to be a solid treatment option that closes the gap experienced by the traditional medical system when it comes to dealing with chronic pain and clinical conditions.