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Myofascial release (MFR, self-myofascial release) is an alternative medicine therapy claimed to be useful for treating skeletal muscle immobility and pain by relaxing contracted muscles, improving blood and lymphatic circulation, and stimulating the stretch reflex in muscles.
Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. Osteopathic practice holds that this soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension, and corresponding diminished blood flow.
Description and conceptual basis
Writing for Science-Based Medicine, Harriet Hall described myofascial release as an umbrella term for several types of physical manipulation, and it might more simply be described as a kind of massage based on vaguely-defined scientific notions.
The American Cancer Society states that "There is little scientific evidence available to support proponents' claims that myofascial release relieves pain or restores flexibility" and cautions against using it as a substitute for conventional cancer treatment. The poor quality of research into the use of myofascial release for orthopaedic conditions precludes any conclusions being drawn about its usefulness for this purpose.
In 2011, the UK Advertising Standards Authority (ASA) upheld a complaint regarding the effectiveness claims published in an advertising leaflet produced by the Myofascial Release UK health care service. The ASA Council ruled that materials presented by Myofascial Release UK in support of the claims made in their ad were inadequate to establish a "body of robust scientific evidence" to substantiate Myofascial Release UK's range of claims. In addition, the ASA determined that the ad breached advertising rules by introducing a risk that readers might be discouraged from seeking other essential medical treatments.
Reviews published in 2013 and 2015 evaluating evidence for MFR efficacy found that clinical trials that had been conducted varied in quality, technique, outcome measurements, and had mixed outcomes; the 2015 review noted: "it is time for scientific evidences on MFR to support its clinical use." Another review concluded that the use of foam rollers or a roller massager before or after exercise for self-myofascial release has been observed to decrease soreness due to DOMS and that self-myofascial release appears to have no negative effect on performance. However, the optimal timing and duration of use requires further study.
The approach was promulgated as an alternative medicine concept by Andrew Taylor Still, inventor of osteopathy, and his early students. The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with Ida Rolf, the originator of Rolfing. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release.
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- McKenney, K; Elder, AS; Elder, C; Hutchins, A (2013). "Myofascial release as a treatment for orthopaedic conditions: a systematic review". J Athl Train (Systematic review). 48 (4): 522–7. doi:10.4085/1062-6050-48.3.17. PMC 3718355. PMID 23725488.
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- Hall H (24 November 2014). "Can Airrosti Really Resolve Most Chronic Pain in Just Three Visits?". Science-Based Medicine.
- "ASA Adjudication on Myofascial Release UK". Advertising Standards Authority (United Kingdom). 2011-03-16. Retrieved 2015-04-21.
- Ajimsha, M.S.; Al-Mudahka, Noora R.; Al-Madzhar, J.A. (January 2015). "Effectiveness of myofascial release: Systematic review of randomized controlled trials". Journal of Bodywork and Movement Therapies. 19 (1): 102–112. doi:10.1016/j.jbmt.2014.06.001. PMID 25603749.
- Schroeder, AN; Best, TM (2015). "Is self myofascial release an effective preexercise and recovery strategy? A literature review". Current Sports Medicine Reports. 14 (3): 200–8. doi:10.1249/JSR.0000000000000148. PMID 25968853.
There appears to be some basis for the use of the SMR technique via a foam roller or roller massager for preexercise, for maintenance, and to aid recovery following exercise. SMR has been observed to decrease soreness following DOMS, which may indirectly enhance performance by allowing the individual to exercise longer and harder. The direct effect of SMR on performance may be duration dependent and remains in question. At the very least, SMR appears to have no negative effect on performance, with a few studies showing increase in performance. Yet another benefit of SMR is its ability to increase ROM. There has been little published work on the mechanism of SMR; however, animal studies using MLL following EEX have shown that immediate MLL is more beneficial than delayed MLL but MLL duration has no significant effects on recovery. In conclusion, SMR via a foam roller or roller massager may be a valuable tool for exercising individuals, allowing the individuals to self-treat at a time (i.e., immediately following exercise) and a frequency (i.e., several times a day) convenient for him or her by eliminating the need for a massage therapist. Studies to date suggest that SMR may have beneficial effects on both recovery from EEX and precompetition.
- "Glossary of Osteopathic Terminology". American Association of Colleges of Osteopathic Medicine. April 2009. p. 28. Retrieved 25 August 2012.
- Stillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 151–2. ISBN 978-0-323-05255-9.
- Knaster, Mirka (1996). Discovering the Body's Wisdom: A Comprehensive Guide to More Than Fifty Mind-Body Practices. Bantam. p. 208. ISBN 978-0-307-57550-0.