Is Myofascial Release Right For YOU?
by Derrin Kluth, PT, DPT, RMT
Over my greater than ten years’ experience treating all kinds of pain and other symptoms, I’ve found that many times a successful therapeutic course of treatment is largely dependent on whether the expectations of the patient match what the therapist is trying to do. In that spirit, if you are thinking about trying Myofascial Release treatment, here are a few things to consider to help you get the most healing possible out of the process from the very beginning.
Myofascial Release is appropriate for any stage of healing.
The first thing I’d like to clarify is that Myofascial Release truly is for almost any patient at any stage in the healing process. In the early stages of healing it can be useful for managing pain and setting up a solid base for the next phases of healing to build on. In the intermediate stage of healing it can potentially help make the healing process more effective and also potentially speed up this phase. In the final stages it can potentially be used to be sure the “finishing up” portion of the return to a normal tissue state is done efficiently and completely. And finally, even after the final stages have completed and we get into the chronic phase of a problem, Myofascial Release can potentially go back and “hit the reset button” on errors or mistakes in the prior healing process and allow them to restore themselves more correctly and completely. I would say most of the time I see patients in the chronic phase of their problem, but I do want to make it clear that it can be useful in any phase of healing.
That being said, you may have noticed I used the word “potentially” several times in the above paragraph, and that is for an important reason. The chance of any of those potential gains and benefits coming to fruition is significantly affected by the frame of mind and expectations of the patient both going into treatment and during the course of treatment. If someone is not in the right frame or has expectations that do not meet what Myofascial Release offers, they are much less likely to dedicate the time and effort necessary to maximize the attainment of those healing goals and therefore Myofascial Release is much less likely to be of value to them.
Although the difference between Myofascial Release and other therapeutic techniques is obvious to most people who have had a few visits, it’s hard before the fact to explain because so much of it is that is made clear in the clinic due to the nature of the differences being experiential and what is felt by the patient. Just like pain varies from person to person, so too is the nature of the healing techniques individualized to a person. This is because the sum of the habits, injuries, compensations, tissue changes, old habits, bad habits, and other things that have led to the chronic pain is unique to everyone.
Real healing is dictated by lasting behavioural changes
I like to use the metaphor of weight loss to help explain that difference. If you go on a crash diet, you may see some results for awhile and be happy with them, but almost inevitably the results will be lost over time and further even sometimes may be made worse by the changes the body makes to adapt to the unhealthy manner of weight loss. However, many times if weight is lost slow and steadily, it stays off because the body adapts in ways that support the changes and also, maybe most importantly, because the slow and steady method is usually not just a “quick fix” but a “lifestyle change.” By that I mean the results are reinforced by lasting behavioural changes that make their persistence much more likely. Myofascial Release is like the slow and steady version of weight loss to other techniques’ crash diets. It is a process – a steady unravelling of layers built up over time. In most cases it is impossible to unravel all of the connected parts in a day or even a few visits. Many times important connections or portions are revealed one portion at a time. This makes it hard if not impossible to truly resolve roots of the problem in a visit or two.
True Myofascial Release is the John Barnes Sustained Pressure Method (JBMFR) and not one of many competing techniques that claim to be Myofascial Release in order to appropriate some cache from JBMFR’s long history of success. These tend to fall into the “come in and tune out” variety (i.e. deep tissue massage or therapist assisted stretching) where the patient is promised that all they have to do is be present and the therapist will take care of everything with no effort needed on their part. JBMFR is not just a treatment method but a lifestyle change – it considers every angle in the person of what is causing the phenomenon we call chronic pain and attempts to address as many of those angles as necessary and/or possible. Some of the other Fascial treatment techniques do have useful and relevant portions to them, but JBMFR is the only one of many that I’ve come across that truly considers all angles of the chronic pain phenomenon and attempts to address the whole of the problem thereby. Honestly, this is the biggest reason I chose to specialize in JBMFR over any of the other possible candidates.
So given all of the above, I’ve made some short lists of who Myofascial Release is more likely to work for, and who Myofascial Release is less likely to work for. Some of the differences between the two are simply that they are polar opposite concepts, but some important ones bear further explanation.
Myofascial Release is More Likely to Work For:
1) People Motivated to Make Real and Lasting Change: By far the kind of person Myofascial Release works best for is one who is sick of not seeing results with other types of “quick fix” techniques, and that experience has made them more committed to finding what does work. I find this kind of patient is engaged in understanding the problem and using that knowledge to fully develop the skill of independent self treatment with guidance over time.
2) People Willing to Put in Time to Make That Change: Related to #1, but worthy of a mention in its own right. Another trait of a person who Myofascial Release works best for is that they take that motivation and use it as fuel to find ways to structure their schedule in order to make room for the time to accomplish that lifestyle change. That means either the person makes the effort to commit to a course of treatment in clinic or, if they are unable to come in as often, to take the time to practice the techniques between visits to maintain and advance the progress made in the clinic.
3) People Willing and Ready to Take Control Over Their Symptoms: Along with the above two considerations, Myofascial Release works best for people who really do want to have agency over the cause of their pain phenomenon in order to change the effects they feel from it. In true Myofascial Release, over the course of treatment there should always be an element of the idea that all of the work in clinic is leading to an end result where the patient feels confident in their own ability to control that Cause–Effect relationship. Sometimes it takes longer and sometimes shorter, but no matter what, the patient should eventually be able to do so independently and without the need to rely on the therapist. True Myofascial Release is a lifestyle change of self empowerment, not dependence.
Healing is a journey that requires motivation, willingness to change, and drive to take control with the help of the right treatments.
Myofascial Release is Less Likely to Work For:
1) People Who Want the “Quick Fix”: The opposite of #1 above is the patient who expects Myofascial Release to work in one or two sessions. This almost never leads to satisfaction due to Myofascial Release being almost categorically unable to meet these expectations because it is meant to uncover and remove the root cause over time. To use the diet metaphor from above, this is like a person expecting to see quick results from the “slow and steady but lasting” version of weight loss and then being disappointed. That being said, there are often cases where a patient does come in and feels significantly or totally better after one or two sessions of treatment and utilizing the techniques taught therein, but that is not the before-the-fact expectation when initiating Myofascial Release treatment.
2) People Who Want “Someone to Fix Them”: The opposite of #3 above is a potential patient who expects to have all the work towards lasting change happen exclusively done by the therapist in the clinic. It is true that the more time spent in clinic in the beginning of a course of treatment usually leads to the results manifesting more quickly due to the therapist being able to have more frequent opportunities to observe changes, treat them as they happen, and educate the patient in what to do. But even given that, there has to be some element of engagement by the patient to, at the very least, be educated in the “Why” of what is causing their pain phenomenon so that they can make the lifestyle changes that contribute to a successful and lasting improvement in their healing journey. As a metaphor, most people would think a patient who went to the Dentist to get a cavity filled would be in error to not listen when the Dentist tells them how to avoid having to have the cavity worked on again. Similarly, a Myofascial Release therapist is going to try to educate their patient in how to avoid doing the things that may bring the chronic pain back. In the end it’s up to the patient whether they listen or not, but it behooves the Myofascial Release therapist to at least try to help the patient in that way.
3) People Who Want to “Come In and Tune Out”: Somewhat related to #2 in this list, I believe it is a factor worthy of its own consideration. The Myofascial Release therapist may and often does encourage the patient to go into a state of deep concentration and/or even meditation somewhere between fully awake and completely asleep. However, the point of a session of Myofascial Release treatment is not to be like a relaxation massage where the assumption is that in such a tuned out state that the patient may fall asleep. In fact, this works against true Myofascial Release because some element of deep, focused awareness on the part of the patient is necessary in order for them to begin to overcome the connections between the sensitized tissue areas and the “Fight-Or-Flight” portion of the brain. Without some element of this focus, a large portion of the relevant potential changes in systems that are underlying the pain phenomenon are not addressed, and this can lead to less effective outcomes of a visit or course of treatment.
4) People Coming in With Conceptions of What Myofascial Release Is Based On Previous Experiences With Non-MFR Treatments: Not exactly related to any of the above, but important enough to be mentioned. Rarely I will see a patient who has had, or more often believes they have had, some form of Fascial therapy before and was satisfied with those results. That is well and good,, and often those patients are open minded to trying true Myofascial Release and all is well. However, sometimes a patient for whatever reason is irrationally committed to expecting JBMFR to be exactly like whatever treatment they had in the past that was calling itself Myofascial Release. In these cases it is almost impossible to meet the patients’ expectations because JBMFR is so different from all other types of treatment, Fascial or not. Often these patients are attached to the idea of that technique because nothing else worked as well as it did for them prior, and they come in for Myofascial Release treatment and try to retrofit that “best so far” experience into JBMFR. Due to the differences, some are unable to “cleanse their palate” of the prior experience and try something else, even if it is potentially better. Needless to say, this conflict between the past and the potential future almost always leads to unmet expectations on the part of the patient.
Myofascial Release is not a “quick fix”.
I hope reading the above discussion and presented lists help someone considering Myofascial Release to decide if it is right for them at this time. Oftentimes someone who is looking for “the quick fix” will come back to Myofascial Release when they don’t see the hoped-for results from other techniques, so sometimes even if the patient isn’t ready for it right now, they may be in the future. The beauty of Myofascial Release is that it is flexible and relevant to someone who is at a state where they manifest the above characteristics, but also is there for when someone is willing to walk the path toward true healing in their healing journey. I hope that the reader feels they are ready to commit to that journey now, and if not now will reach a place in the future when these words will resonate with them. If that is now or ever becomes the case, book your first session with us.