Invasive methods of intervention have always been a part of various types of body work, physical therapy, and massage therapy. Whether it is termed deep tissue massage, soft tissue mobilization, or one of many other variants, the principle is the same. Manually and forcefully break up tightness of the soft tissue. Many clients crave this type of work, feeling that the deeper the therapist goes, the greater the impact. These forceful interventions can have benefit, sometimes great benefit, but come at a cost to the comfort of the patient and the longevity of the therapist.
Myofascial Release (MFR) can be used effectively at a variety of pressures, but there are times when the restriction or scar tissue is so entrenched that alternative methods are required. The typical partner to MFR is soft tissue mobilization, where the therapist reaches deeply into the patient with fingers, knuckles, or elbows and forcefully tries to break up the tightness.
In my years of practice I have found another option to break up the deeper restriction, which I call Myomobilization™. There is nothing complex or hard to learn about Myomobilization. It simply requires you to rethink your methods.
Let’s look at a typical scenario where deep tissue massage or soft tissue mobilization is utilized: Tightness of the iliopsoas. When presented with injury, scarring, or overall poor flexibility, there are few who would disagree when I say that traditional stretching, myofascial release, or any other gentle modality will break up this type of restriction without resorting to more aggressive means. I was taught to go slowly but deeply to the restriction and strum across the direction of the psoas fibers, in an attempt to break things up so they can be more effectively lengthened. Deep tissue massage takes a similar route. What I am proposing is to simply reach gently but deeply to the barrier and remain there. In the case of the psoas, with hand over hand, move into the regioin, palpating for density, etc. When you encounter the restrictioin, instead of strumming, simply remain at the barrier, not forcing, but waiting for it to let go. You will find that it work just as well, if not better than soft tissue mobilization, without the pain and effort. Always work within the patient’s tolerance; do not make it so they have to “breathe” through it.
The same principles apply to any situation when you are tempted to pull out your elbow or fingertips to break things up. The elbow can still be used, but instead of forcing you way, hold a firm but tolerable level of pressure. You will feel the change.
Can you picture how this would work for you?
Yes! That is the way I tend to work, to wait for a change to happen. For some people, I feel that the force has a negative impact making the tissue tighten up even more. It is encouraging to hear that patience works just as well as force as it easy to end up injuring oneself!
Thanks, Elizabeth!
One of the deeper insights into the nature of fascial change comes from a paper by Robert Schleip, a German Rolfer and fascia researcher, titled “Fascial Plasticity – a new neurobiological explanation. (This article can be found on the Research Page of http://www.FounationsinMFR.com) In this paper he talks of the limitations in the mechanical explanations as to how fascia releases and proposes neurobiological rationales. Given the type of myofascial release that I teach and practice, one line (pg 12) concerns me: “Rarely is a practitioner seen – or is taught – to apply uninterrupted manual pressure for more than 2 minutes.”
Rolfing may follow this model, but the form of myofascial release that I am most familiar TYPICALLY exceeds 2 minutes of sustained manual pressure. With such an in-depth look at fascial change, I question whether mechanical models are invalid, if the release is ONLY held for up to 2 minutes.