Myofascial Release Insufficient Intervention for Persistent Pain
I remember learning about the gentle manual intervention called myofascial release. I'll share my bias: I grew up on a farm. I've seen a few different species of animals butchered. The whole idea of fascia releasing with gentle pressure never made sense to me.
If you think back to the days in which you dissected cadavers, what do you remember underneath the skin? The subcutaneous fat could be anywhere from 1/4 inch think to 3/4 inch thick, just depending on the body. The amount of pressure described to be used for this technique is so gentle that it it highly unlikely that the pressure ever reaches the fascia depth. Then, even if it did, a knife was needed to separate between the muscles.
I do believe that during any manual intervention, including myofascial release, something happens that may be beneficial for the patient. I just don't believe fascia releases.
Below you will find a quick view of the abstract about the systematic review on effectiveness of myofascial release.
Effectiveness of myofascial release in treatment of chronicmusculoskeletalpain: a systematic review.
To evaluate the evidence on the effectiveness of myofascial release therapy to relieve chronicmusculoskeletalpain and to improve joint mobility, functioning level, andqualityof life in pain sufferers. Data sources and review: Randomized controlled trials were systematically gathered from CENTRAL, Medline, Embase, CINAHL, Scopus, and PEDro databases. The methodologicalqualityof articles was assessed according to the Cochrane Collaboration's domain-based framework. In addition, the effect sizes of main outcomes were calculated based on reported means and variances at baseline and in follow-up.
Of 513 identified records, 8 were relevant. Two trials focused on lateral epicondylitis ( N = 95), two on fibromyalgia ( N = 145), three on low back pain ( N = 152), and one on heel pain ( N = 65). The risk of bias was considered low in three and high in five trials. The duration of therapy was 30-90 minutes 4 to 24 times during 2-20 weeks. The effect sizes did not reach the minimal clinically important difference for pain and disability in the studies of low back pain or fibromyalgia. In another three studies with the high risk of bias, the level of minimal clinically important difference was reached up to two-month follow-up.
Current evidence on myofascial release therapy is not sufficient to warrant this treatment in chronicmusculoskeletalpain.
Clin Rehabil.2017 Sep 1:269215517732820. doi: 10.1177/0269215517732820. [Epub ahead of print]