MFR

Contents
 Introduction  Contraindications
 Principles  Precautions
 Anatomy of fascia  Therapeutic environment
 Etiology for fascial  Test for vascularity
tightness  Post treatment protocol
 Basic steps for MFR
 Types of stretch and
release
 Indications
Introduction
 Definition
The facilitation of mechanical, neural and
psychosocial adaptive potential as interfaced
via the myofascial system
Kegerreis SK
– It’s a specialized manual therapy stretching
technique used to release tension and realign
the body
– Derived from Latin word
Myo-muscle
Fascia-band
 Its not a massage technique
 Very relaxing
 Its helps in equalizing muscle tension
throughout the body
 Can alter body malalignment if the
structure is not fixed by bone remodeling
 Passive technique
 Developed by Dr.Ida Rolf
 Principles of myofascial release (MFR)
– Break up fascial adhesion
– Manipulation of neuromuscular receptors to
release any tightness of muscles
– MFR releases the tension in the fascia-release

muscle-realign the body mechanics
Anatomy of Fascia
 Fascia is a connective tissue throughout
the body extending from head to toe
without interruption in a three dimensional
web
 Its surrounds muscle tendon ligament
bone nerve blood vessels and internal
organs
 Its has three layers
 Superficial layer (hypodermis layer)
consists of loose connective and
adipose tissue
it provide storage for water and fat,
serves as an insulator, prevent and protect
from mechanical deformation
Provide pathway for nerves and blood
vessels
 Subserous fascia called as potential space
– This space can may be enlarged with edema,
and can be stretched by minor injury
Deep fascia
– dense sheet
– It separate muscle into functional groups
– Fill the space between muscles and organs
– Free movt & attachment of muscles
 Function of fascia
– Support, stability, cushioning,
– Helps in locomotion and dynamic flexibility
Etiology for fascial tightness
 Poor posture,physical injuries and various
illness
Body out of alignment
Leading to intricate web of fascia
tightened and restricted
Losses pliability
Restrict and become source of
tension to the rest of body
 eg:- muscle fiber injury
fascia covering muscle become short and tight
uneven pressure on fascia
bind the fascia on the underlying surface
leads to adhesion or scars or trigger points
pain/limited ROM numbness
Altered motion in joint results in change of
normal neural feed back to CNS
 NMS become less efficient, leads to
premature fatique,c/c pain, injury and less
efficient motor skill
Clinical findings
 Hyperirritable locus with tight bands or
nodes
 Sedentary and middle aged females
 Dull, deep ache
 Low grade discomfort to severe torture
 Painful on compression
 Evoke referred and autonomic responses
 Decrease sleep
 Non segmental pattern of reference
 Tenderness (+)
 MFR –done manually and passively
 Can be done selfMFR using Poz-A balls, fit
balls, bolsters or rolls
 Self correction technique
 MFR-release the uneven tension in fascia
and realign
 Release adhesion
 Restore balance
 Relieve pain and improve circulation
 The MFR depends upon the therapist feed
back from the patients body- a non verbal
communication
 This feed back gives information of force
to be applied, direction of stretch, duration
 Basic steps of MFR
– Feedback
– Stretch
– Hold
– Release
– End feel
 Types of release in MFR
horizontal release
vertical release-take care of nail
 Types of stretch in MFR are
gross stretch
focused stretch
 Sensation of release
Smooth melting away of tightness or
restriction
Autonomic response following to release
Reflex vasodilatation
Core temp falls and pt causing severe chill
and violent shivering-resolve with time
 Good hurt
deep MFR and vertical release are uncomfortable
release described as surgery without the benefit
of anesthesia
release hurts and feels good at the same time
Pt says don’t stop ! “it hurts but feels good”
Never exceed pt’s pain tolerance
Indications
 Patients pain complaint not cured by
traditional physiotherapy
 Patient has a complex ,global or specific
complaint that does not follow
dermatome, myotome or visceral pattern
 Patient with fibromyalgia and post polio
syndrome
 Painful complex postural asymmetries
 Asymmetric muscle weakness due to a/c or c/c
pheripheral or central neuropathy
 Impaired respiration due to c/c respiratory
disease
 CNS diseases
 Faulty mechanical relationship of skeletal
structures or soft tissues
 Headache triggered by myofascial trigger
points,tension in posterior cervical musculature
 Temperomandibular dysfunction
 Asymmetrical muscle tightness
 Impaired mouth closure, swallowing and

phonation resulting in tightness and restricted of
hyoids and the muscles of mastication
 Pt exp non labyrinthine induced vertigo and

dizziness sec to active myofascial trigger points
 To increase speed , accuracy and prevent
injury in extreme range of motion
Contraindication
 Patients
– Cant tolerate close physical contact
– Unstable medical conditions
– Dermatitis
– With contagious or infectious disease
– Does not understand the concept of Good Hurt
– Not trusting the therapist
– Under the influence of drugs or alcohol
– Unable to give informed consent
– Therapist not feeling comfortable with patient
Precautions
 MFR lowers BP, all pt to rest horizontally for
15min Rx
 Lowers blood glucose ,diabetic pt to check the
blood glucose level prior to Rx,deep trigger point
release
 Subjects prone for hypoglycemia must have
snack prior to Rx
 Healing # or wound can receive MFR on
uninvolved side
Precaution
 Compromised vascularity-uninvolved area
treated and involved area treated with close
monitoring
 Patient on anticoagulant-bruise
 Treating children or mentally challenged adult-
always with the caregiver
Therapeutic Environment
 Pt must feel relaxed and comfortable
 Must enable therapist to move efficiently
 Quiet
 No family members or friends inside
 No too bright light –indirect lighting
 Comfortably positioned therapist with good body
mechanics to provide stretching
 Adjustable treatment table, with proper height
 Minimal patient clothing
 No ornaments of accessories like watch etc for
pt and PT
 Proper positioning of pt
Test for vascular integrity
 Assess vascular integrity,
Carotid artery
Test for vertebral artery compression
Radial pulse
Femoral artery
posterior tibial artery
Dorsalis pedis artery
Post treatment protocol
 Drink ----------drink--------------drink…………
 One additional gallon of fluid above his
normal on 0-2 days-prevent soreness
 No caffeinated drinks
 Artificial sweetened drink
 Alcoholic beverages
 Therapist also to drink… drink
……………………………..drink…………

MFR

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Contents

– MFR releases the tension in the fascia-release

 Asymmetrical muscle tightness

 Impaired mouth closure, swallowing and

 Pt exp non labyrinthine induced vertigo and

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