Myofascial Release Techniques in the Physiotherapy Setting

Mulugeta Bayisa Chala
Ph.D. student
School of Rehabilitation Therapy
Queen’s University, Canada

My colleagues and I at the department of physiotherapy, University of Gondar, Ethiopia regularly encounter patients with challenging and complex musculoskeletal health conditions, such as chronic pain. Chronic pain of musculoskeletal origin is often hard to treat using conventional treatment approaches such as stretching or other manual therapy techniques such as mobilization that we physical therapists use. However, since we started to augment our treatment techniques with myofascial release techniques, our confidence to treat these patients improved. 

 

As fascia is often tricky to release just by stretching, it requires a different approach.  Even though connective tissues such as fascia are essential in the health of musculoskeletal health, we (physical therapists) either ignore to pay attention to these connective tissues or we simply do not have the knowledge and skills of treating it. We often used stretching to treat shortened and tight muscles without paying attention to the fascia. But, after we got the myofascial training, and as we later realized in our clinical practice, the myofascial network is difficult to treat by the conventional stretching techniques. 

We combined myofascial techniques with other physical therapy and/ or manual therapy technique to treat conditions such as back pain, chronic pain, neck and shoulder problems, athletic injuries, plantar fasciitis, trigger points, soft tissue scarring as a result of injuries, and so forth in my clinical practice while I was in Gondar. We also used to correct postural problems that arise from chronic pain or a tight connective tissues. 

How we integrated this technique into the existing physio protocol? 

Some of our patients with chronic pain hesitate to engage in the exercise programs we design for them. Especially, patients with fear of movements or those with a high level of pain avoidance behavior display lack of motivation to take initiation in functional training. In order to treat patients with these types of problems, we often integrate myofascial release techniques to help them relax and gain confidence in the rehabilitation programs we design for them. Moreover, it helped us increase our patients’ adherence to treatment. 

Patients with lower limb fractures are kept on long traction for up to 3 months or put in Plaster of Paris cast (POP) depending on the nature of injuries at our university hospital. Once the bone heals, the doctors take the plaster or traction off and send the patients for physiotherapy. By the time the patients start physiotherapy, their joint is already stiff and their soft tissues tight, which is very difficult to treat only by joint mobilization or stretching techniques. We often combine myofascial release techniques to soften the tight connective tissues before we start aggressive physical therapy regiments. 

We are also teaching our students during their clinical placement a few myofascial release skills, and when and why they should consider it as the best option to use while treating their patients. In general, the myofascial release techniques training by Michael Stanborough helped our understanding of the importance of fascia in musculoskeletal health. The training served as a lens to deeply understand musculoskeletal pain and the suffering related to it. Most importantly, it helped us give proper patient care for our patients.