Should You Try Myofascial Release Therapy?

Close-Up Of Women Undergoing Massage
Myofascial release usually involves applying pressure to tight muscles and fascia in an effort to get them to “release” and alleviate pain. (Getty Images)
All Debra Firestone wanted to know was the time. But craning her head to look at the clock always caused the same, terrifying reaction: A black curtain would fall over her vision, her sense of balance would vanish and she'd nearly topple over. If she then got up to walk, she looked like a drunken sailor, weaving from side to side.
The mysterious symptoms were just one set of many the 49-year-old reference librarian had experienced for decades, and that had significantly worsened over the past six months. She'd also frequently lose her train of thought, forget which exit to turn off on for work and call friends by the wrong name. She saw primary care doctors, neurologists and even traveled from her home in East Meadow, New York, to the Mayo Clinic in Minnesota, but didn't get a clear diagnosis or treatment that worked. "No one could figure out what was happening to me," Firestone says.
Then, per a recommendation from her husband's business associate, she visited Ming Chew, a physical therapist in New York City. He practiced myofascial release, a type of hands-on therapy that manipulates the fascia – a saran wrap-like layer of tissue that surrounds the body’s muscles and other organs – in an effort to reduce pain and dysfunction. "I didn't think it would do anything, but [I told my husband,] 'I'm doing this to make you happy,'" she remembers. But after Chew discovered – and pressed into – a knot of fascia at the base of the skull, which he believed was interrupting both blood flow and nerve signals between the brain and the rest of her body, Firestone could turn her head without feeling like she was going to pass out, and walked straighter than she had in years.
She's continued to visit him on a diminishing basis (first it was twice weekly, now it's every other month) and today, about a year later, Firestone says she's 95 percent of the way to full health. "I can have full conversations again, I'm working and when it's nice out, my husband and I take mile-and-a-half walks," she says. "I'm back to being my normal self."
What Is It?
Myofascial release means different things to different people, but it usually involves applying pressure – either via a therapist's body part like a thumb or elbow or a tool like a foam roller or even rolling pin – to tight muscles and fascia in an effort to get them to “release” and alleviate pain, says Dr. Garry Ho, director of Virginia Commonwealth University’s sports medicine fellowship program. The Ming Method, Graston Technique, Melt Method, Active Release Technique and Rolfing are all proprietary varieties of MFR.

The therapy has some overlapping qualities with massage, but rather than kneading muscles or stroking them up and down, practitioners press into them – often very hard. When leaving sessions, for instance, Firestone says she feels energized, clear-headed – "and sore as hell." And, MFR practitioners are theoretically targeting balled up fascia more than the muscle underneath. “The difference between what I do and [massage therapists] do is I specifically look to break up adhesions and soften up scar tissues and initiate non-firing nerves to start firing again,” Chew says.
Firestone isn’t the only one finding it works. Chew has also treated Cleveland Cavaliers’ Kevin Love, New York Yankees’ Jason Giambi and actor Gerard Butler. New England Patriots’ Tom Brady and obstacle course racing champion Amelia Boone have used similar techniques. Even “industrial athletes” – aka desk jockeys – can find relief from neck, shoulder and hand pain and tension via MFR, Ho says. Chew goes as far to say, “If you are a human being, you will benefit.”
What Does the Science Say?
It’s pretty clear that MFR works for some people, but what exactly it is and why and how it works isn’t so straightforward. One 2013 review of 10 studies on the topic, for example, found that the technique did lead to positive outcomes in general, but the studies weren't high-quality enough to draw any conclusions. In fact, of the 88 studies collected on the topic, the study authors only found 10 to meet their relatively low bar for inclusion in the review. A more recent review of MFR's effectiveness in treating chronic pain had the same issue: 5 out of 8 studies were deemed biased. “There are lots of theories as to why it works and how it works, but the research is still really murky,” Ho says.
That’s why Beret Kirkeby, owner of the massage therapy practice Body Mechanics in New York City, shies away from using the term MFR in her marketing or when talking to patients. While she may use similar techniques, she’s uncomfortable claiming that the fascia is something that can be torn, accumulate scar tissue – and relieved by the pressure of a human hand.
“If we were just accumulating loads of scar tissues in our bodies every time we hit something, we’d just be riddled with it. Our body is a wonderful, adaptive thing, and as long as we’re moving, it’s continuously changing,” she says. “If you have scar tissue, it’s because you did something like a tour in Iraq.”
Kirkeby suspects that, like massage, MFR can help people manage pain mostly because it can help them relax. “Laying hands on someone – we’re asking someone to relax, and there’s a physiological and neurological response to that,” she says.
Know Before You Go
Finding an MFR practitioner is tricky, since what MFR entails exactly is as convoluted as the research on it. In fact, you don’t need any particular credential to practice MFR, and it isn’t overseen by any one credentialing organization. Physical therapists, massage therapists, sports medicine doctors, athletic trainers, chiropractors and osteopathic physicians are among the professionals who may practice versions of it, Ho says.
Insurance also doesn’t typically cover the practice, although it may if it’s lumped into your physical therapy treatment. “Seeing somebody who is credentialed in some form of MFR, that’s great, it can be costly and time-consuming,” says Ho, who recommends trying it the cheap way – yourself with tools. He uses foam rollers, a massage cane and massage blocks a couple times a week, for example, to ease tightness from running, practicing karate and chasing his kids around. “It doesn’t have to be expensive,” he says.
Just be sure to read the directions and ease into it, Ho warns. The most common risks are soreness and bruising from overzealousness, he says, but you can also apply pressure to the wrong place – like a bone – and create a new problem rather than solving one. “If you don’t choose the area to apply the technique to carefully, you might injure [yourself],” he says.
For Firestone, who also sees a neurologist and performs some exercises and stretches at home per Chew's recommendations, paying for the therapy from a pro is well worth it. Alternatives were dishing out $32,000 for a pain rehab program at the Mayo Clinic that wasn't covered by her insurance, or hiring someone to take care of her at home. Now, Firestone says, "I take every day as a blessing."