Myofascial release (MFR)

Myofascial (pronounced my-o-FASH-e-ul) release (MFR) is a type of physical therapy used to relieve pain and ease movement restrictions. The procedure was popularized in the 1960s, although related manual therapy techniques had been practiced earlier. It is used to treat myofascial pain syndrome, a chronic pain condition of the muscles and fascia. The fascia is a long, thin connective tissue that surrounds and supports the muscles and bones of the body. Chiropractors, physical therapists, massage therapists, and some physicians perform MFR. However, some physicians doubt the effectiveness of MFR and consider it a type of alternative medicine.

Background

Touch and pressure were used on the body to reduce pain and soothe anxiety for many centuries. Andrew Taylor Still, who founded osteopathic medicine, used manual therapeutic techniques in the late nineteenth century that influenced later myofascial approaches. Osteopathic medicine is based on the physical manipulation of the body.

Mabel Elsworth Todd studied the body and movement in the 1920s. She published her findings in the 1937 work The Thinking Body. In it, she wrote about the importance of posture, movement patterns, and the role of the fascia within the body.

Using much of Todd’s thinking, Ida P. Rolf invented a form of manual therapy called structural integration in the 1940s. She worked with several osteopaths on the approach. Robert Ward, a physician who practiced osteopathy drew much of his research from Rolf’s work. Ward learned about MFR concepts in the early 1950s from physicians Wilbur Cole and Esther Smoot. Ward coined the term myofascial release during the 1960s. Myo means “muscle,” and fascial means “covering.”

Other physicians began to practice physical therapy at this time. Physical therapist John Barnes began to concentrate on the procedure in the 1960s and developed his own version of MFR called the Myofascial Release Approach. He taught seminars and trained other healthcare professionals on the approach.

Overview

The fascia is one continuous tissue that covers the entire internal body from head to toe. It resembles a stretchy spider web and is attached to and interwoven around every organ, muscle, bone, nerve, artery, and vein. The fascia is an important structure within the body. It is designed to stretch and move without issue to allow normal mobility. However, its elasticity can be interrupted by physical trauma, scarring, or inflammation. Once damaged, the fascia loses its flexibility, and this begins to affect the body’s stability. It becomes tight and tense, causing pain in the body. This pain can interfere with a person’s ability to perform simple daily activities. This damage cannot be seen on standard tests such as X-rays and computed tomography (CAT) scans, and sometimes pain goes undiagnosed.

With myofascial pain syndrome, pain originates from pressure that sets off points in the muscles, known as trigger points. The syndrome can occur when muscles are injured. For example, a trigger point may develop near a strained muscle. Overuse and repetitive movements of the muscles can also cause myofascial pain syndrome. Jobs that require a person to make the same movements repeatedly throughout the day can be the culprit. Poor posture, stress, and anxiety may also increase the risk of developing the syndrome since these put repeated strain on muscles that could lead to trigger points.

Symptoms of myofascial pain syndrome include deep aches and tender knots in the muscles. The discomfort felt is different from typical muscle tension pain. It typically does not go away and may worsen. It can cause other issues, such as sleep problems, as individuals struggle to find a comfortable sleeping position or are awakened by pain. It may also develop into fibromyalgia, although the two are distinct conditions. Fibromyalgia is a chronic pain condition in which a person’s brain is more sensitive to perceiving pain signals.

MFR can be used to treat myofascial pain syndrome by reducing pain and increasing mobility. It can also be used to restore function to the muscles following an injury; for chronic pain in the neck, back, shoulders, or hip; carpal tunnel syndrome; migraine headaches; or temporomandibular joint (TMJ) disorder. Patients who experience venous insufficiency, a condition of blood pooling in the veins of the legs, may benefit from MFR,  especially when combined with other physical therapies.

The massage procedure helps to release the tightness and tension in the trigger points of the muscle. Determining which trigger point is responsible for the pain can be difficult. Therapists usually focus on large areas of the fascia rather than single points.

During the procedure, patients lie on their backs on a table. A therapist massages against the grain of the muscles without the use of oils or creams. This allows the therapist to feel for rigid or tight areas of the fascia. The therapist will apply light pressure to these areas and begin to massage. The therapist will stretch these areas until the tension is released.

Therapists may provide traction by pulling on the arms, legs, or head; static (still) pressure; or positioning the joints in a certain way to create a natural stretch. The areas focused on might not be where the patient feels pain since trigger points can refer pain to other areas of the body. After MFR, a patient may feel muscle soreness.

The procedure is sometimes used in conjunction with other types of massage and physical therapy to treat patients. MFR is not recommended for all patients. People with certain medical conditions, including burns, wounds, broken or fractured bones, weak or fragile bones, or certain deep vein issues, should not use MFR as a treatment option. In addition, individuals who take blood thinners should not receive MFR therapy.

MFR could benefit from increased study. Because research is still emerging, some physicians do not support the therapy. They may recommend traditional physical therapy treatments instead of MFR for certain conditions.

Bibliography

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“What is Fascia?” Myofascial Release Treatment Centers & Seminars, www.myofascialrelease.com/about/fascia-definition.aspx. Accessed 21 Mar. 2026.