Whatever Ever Happened to the MYO in Myofascial Release?
This is a commentary on the role of Fascia in the structurally-related functions of the body. [Originally written in the mid-1,990s, with additions in the early and late 2,000s as new research came out.]
This article is not exhaustive, but meant to dispel some of the modern Myth-Conceptions in musculo-fascial therapy and related therapies that have a major focus on fascia. So far in the following article, I have mostly referred to John Barnes of Myofascial Release fame, and his point of view on fascia. Now, I don’t mean to deny the fact that John has done a lot of good for the Musculo-Fascial Therapy and Bodywork Communities.
NOTE: I tend to prefer “musculo-fascial” instead of “myofascial” as the 2nd term has tended to become more associated with the fascial component alone rather than BOTH the fascia AND the muscle as an integrated unit. But it depends on who you’re reading or listening to. But as Tom Myers says, both terms should be considered synonymous.
Even if the science is not correct, a lot of people have gotten excellent results from myofascial therapy treatment, even if it was not working for the reasons they thought.There are many others, such as Ida P. Rolf, founder of Rolf® Structural Integration, and Joseph Heller, as well. (Ida probably got the whole *ball of fascia* thing rolling well, and is most widely known for her work.) Joe Heller worked for the Rolf Institute for a number of years, then went off on his own to found Hellerwork, an offshoot of Rolfing.
However, there are some long-standing points-of-view I consider to be very misleading when it comes to the nature of fascia. I address some of them here.
In Short Summary, muscle cells and fascia are so closely related and integrated, I doubt that, except for the layer of superficial fascia just under the skin, directly perceiving significant differences between muscle fibers and fascia by way of maul palpation is highly unlikely. Individual muscle cells being microscopic, is it reasonable to think you can actually feel the differences between such highly integrated yet tiny tissues tissues? …
I must state that I believe MOST of the changes in body tissue many manual therapists attribute to changes in the fascia are actually occurring primarily by way of in the changes in the neuro-musculo-fascial units in general and the muscle cells (actin-myosin units) in specific.
The hardness or tension people feel in the tissues is a product of the muscle cells, when in a contracted state, exerting outward hydrostatic forces, putting outward pressures on their casings. The casings are indeed the fascial sheaths every muscle cell and groups of muscle cells in the body.
The hardness felt in “fascia” is, to a great degree, if not in total, this outward hydrostatic pressure increasing as the actin-myosin units are activated by nerve impulses. The shortening action of the actin-myosin decreases the interstitial space within the cell, which increases the outward pressure within the cell. Increased pressure on the water within the cell will cause tissue to feel hardened. As soon as the actin-myosin unit relaxes, the outward water pressure reduces; the tissue feels less hard.
While the physical properties of fascia and muscle cells are very different, from a practical, treatment point-of-view, the muscle cells & fascia must be addressed as an integrated whole, not two different tissues that are addressed separate from each other. Fortunately, there are ways of treating the neuro-musculo-fascial tissues, effectively & efficiently addressing unique properties of both muscle cells and fascia. … More on that later.
Now, on to the Near-Myth-Conceptions of Fascia …
in Myofascial Release, Rolfing® and Other Similar Systems
Back in the mid-1990s, I was sitting on an airplane with Linda J. Calandro (one of THE top neuromuscular therapists and teachers at the time), flying across country to teach a workshop. I was reading an article in Massage Magazine written by John Barnes, founder of the very well-known MyoFascial Release Technique. In the article, he stated, there is really no such thing as muscle, that there is only fascia, or connective tissue. This, after previously in the very same article, his lengthy attempt at philosophical discussion on the dangers of “reductionism” in modern science. He bemoaned the artificial breaking down (reduction) of the body into separate parts by medical science and he attempts to pontificate on this topic as a “wholistic philosopher.”
SPECIAL NOTE: It is instructive to note that the 37th Edition of Gray’s Anatomy, Elsevier: Churchill Livingston, stated that the word fascia had become so over-used as to become nearly meaningless. Yet that phrase has been removed since the new editor revised the 39th Edition of the book. But the term fascia is quite ambiguous, as there are so many tissues that can rightly be considered to be “fascia.”
Barnes is by all means correct to point out that modern medical science has gone way too far in treating every system and component of the human body as significantly or even at times completely separate and denying the all to obvious and important, intimate relationships between them. This destructive characteristic is present in much of so-called science (and described well by Candace Pert in her excellent book Molecules of Emotion).
I should say that one chapter in Pert’s book goes, in my view, too far. Her philosophical point-of-view borders on “mind creates everything” (solipsism). But if so, why did she spend so much time using physical sciences to explain why molecules in the blood cause so many phenomena? However, I do believe most of her book is indeed excellent, and well describes quite valid physiological research. ~DSL
On Specialization: This is a great and necessary thing for humans to progress with. Yet when one has gotten SO specialized they lose sight of the inter-relations between phenomena and things, and nearly everything else, then perspective narrows and all we see is a tree, and don’t notice the forest….
A Healthy Focus runs the risk of becoming Pathological Obsession. … A healthy balance is necessary.
So then, after warning us of the dangers of reductionism, Mr. Barnes then turns around and reduces all the many different muscles and connective tissues of the body down to the single name of fascia!
Fascially Induced Reductionism: Pros & Cons
Yet to deny the individual characteristics of various components and systems is itself reductionist in the opposite direction, and is equally misleading at best, intellectually destructive at worst. Worse, in more extreme therapeutic challenges, such thinking can lead to misevaluation and/or mistreatment.
Generally speaking, the average client or patient with mild to average aches, pains or dysfunctions is going to get better just by the fact of being manually treated in a more-or-less conscious & competent way. That’s because therapeutic touch is very healing in and of itself, even if the evaluation of the therapist is not correct.
HOWEVER, in more extreme cases, the errors developing from incorrect understandings of what does what in the human body can be either non-effectual, or at times, make clients or patients even worse.
Given what we are often told by Barnes and others about fascia and how it wraps around every structure of the body, this “fascia is everything” model of reality is the equivalent of saying that since all the food (muscle cells) in my refrigerator is wrapped in Saran Wrap (fascia), then, there is no such thing as food, there is only Saran Wrap.
But if you treat Saran Wrap as if it were food, making no distinctions between them, you will, in more extreme therapeutic challenges, get a more inferior result than if you treat Saran Wrap as Saran Wrap and food as food. If for no other reason, I do not expect that Saran Wrap is very tasty compared to actual food. … Although, to be honest, I’ve not conducted actual experiments on that question.
What this description by Barnes actually was is a great example of Reductionism in Reverse. This is a very common occurrence in the so-called “wholistic” or “alternative” fields of thought & therapy and the incessant quest for oneness at all cost.The bias against analytical or linear thought, which requires varying levels and aspects of reductionist thinking in order to understand certain problems, shows up in many ways.
In this case, Barnes attacks reductionism, praises wholism, then turns around and engages in the ultimate reductionism by calling ALL the tissues in question by one name: fascia.
Since the characteristics of fascia and muscle are almost completely different, neither can be effectively addressed or even thought about when their individual realities are obscured or denied by a linguistic or semantic sleight-of-hand. (Even the various kinds of fascia are considerably different in nature, even though some fundamental, structural similarities.)
Giving Fascia Its Due Attention
In the tradition of Ida Rolf — founder of Rolfing®, also known as Structural Integration — John Barnes correctly puts a lot of attention onto fascia that was formerly lacking. Fascia is a very important organ of metabolism and structural support with important implications to the health of the human bodymind. Until Rolf and Barnes, fascia was probably very understated in its importance.
Its wide range of important functions are well described, with great scientific precision, in Deane Juhan’s exceedingly great book Job’s Body: A Handbook for Bodywork.
Fascia is, however, quite distinct from muscle and must be thought of and treated with a significantly different set of considerations and understandings.
It is clear that Barnes is (or was at the time of writing his article) psychologically biased toward the idea of fascia being the prime tissue of postural & structural support (his professional reputation is in large part based upon this). His possibly (hopefully?) unconscious bias prevents his philosophical viewpoints from being complete or fully accurate. Ida Rolf was also biased toward fascia being the prime factor in postural distortion, as was Joseph Heller, founder of Hellerwork, an offshoot of Rolfing. (Heller was the president of the Rolf Institute for several years, and is fully open with the fact that Hellerwork is quite a bit based on Rolfing, with some modifications and additions.)
I think much of Ida Rolf’s points-of-view were greatly influenced by Alfred Korzybski (author of Manhood of Humanity and Science & Sanity). I think Korzybski was a genius, but I also think some of his conjectures were taken a bit too far by his followers. But that’s a whole other article in itself. … And of course, there was Andrew Taylor Still, MD, who was an early 20th Century advocate of focusing on fascia.
In an article in the Journal of Bodywork, published by Leon Chaitow in England, the issue of fascia was discussed along the same lines that Barnes, Rolf and Heller appear to think. Interestingly, the article sites, as references in support of the ideas in the article, the writings of Rolf, Barnes, etc. They do not quote outside sources, they merely quote each other.
Some would say that’s a bit intellectually incestuous, to say the least. That does NOT mean then are necessarily wrong, only that they are not providing much in the way of outside corroboration of their ideas. Yet scholarly, academic discussions of fascia and related tissues that are widely accepted in the medical community are hard to come by, however, because the medical establishment has not invested significant resources into such questions. (And unless “they” figure out a way to generate derivative profits from the practice of massage, it is unlikely they ever will spend much on real research.)
It bears repeating, the 37th Edition of the well-respected, English publication of Gray’s Anatomy (not the more common version you can buy at the local bookstore) stated that the term fascia has been so widely and loosely used to have lost much or most of its meaning. (And again, that statement was removed in the 39th Edition by a new editorial staff.)
Facts & Fallacies of Fascial Function
A lot is known about fascia, but not all of it is necessary to know from the point-of-view of a manual bodyworker or yoga therapist. Like bone, fascia is structurally passive,* it has no ability to execute or generate an action on its own. Although it has many functions, fascia cannot DO anything in the sense that the actin-myosin cells within muscle fiber can produce movement.
Muscle can execute an action because it has contractile fibers (made of the actin-myosin cells) that, according to well established medical science, function similar to “ratchets” that shorten and lengthen to achieve movement. Fascia, on the other hand, has no contractile fibre.**
Fascia, therefore, cannot “contract” or “shorten” in the same way actin-myosin units can.
* A structural engineer once took me to task for using the word “passive” when referring to structural components. From a strictly engineering point-of-view, I think I know what she meant. Even apparently “passive” elements have a kind of “contribution” to the structure. Although I think she was overdoing her point, I am here, however, referring to the ability of an entity to actually internally produce its own movement or action.
** UPDATE: Recent research has found contractile fibers in the fascia, yet these turns out to be tiny numbers of contractile muscle fibers that have grown in after some kind of an injury. It is hypothesized that these new fibers help hold the surrounding tissues together as they heal. … Yet these are smooth muscle fibers, which cannot produce anywhere near the degree of pulling power the striated muscle fibers can.
It has also been suggested that certain ligaments have a rudimentary form of contractile fibre, but this appears to actually be striated muscle fibers embedded within the ligaments. For example, the deepest layers of gluteus maximus embedded in the sacrotuberous ligament (connecting the sacrum with the lower aspects of the pelvis).
Therefore, the ability of fascia itself to create movement or substantial functional change in length or structural relationships is quite limited. Any change in shape or size is reliant on changes of plasticity within its fibers (colloidal fibers) through chemical change (heat, motion, etc.). Levels of hydration probably play a big part, as well.
With many sensory but few or no motor nerves apparent in the fascial structures, there is no way for a human to consciously — or even unconsciously, for that matter — produce a change in length of their fascia the way they can a muscle. Fascia, like bone, only goes along for the ride when it comes to actual mobility or movement.
But, and a critical but, fascia is THE tissue (tendons) by which the pulling power of the muscle is delivered to the bones. And, it is the LACK of elasticity making fascia so useful in this critical function. Therefore, fascia IS, for this and many other reasons, vitally important, but NOT because it can (allegedly) “contract.” When it comes to significant amounts of overt movement & action, muscle without fascia is pretty useless, and vice versa.
UPDATE: I DO, however, believe that fascia can, POSSIBLY, via its (maybe) potential piezo-electric characteristics (if this is indeed an accurate discovery by recent research), create certain kinds of micro-movements causing it to slightly “contract” or harden with certain bio-chemical or electrical stimulus. It can also shrink a small percentage with dehydration. But this “contraction” is similar to a sponge “contacting” when it dries out (dehydrates).
And some research indicates it might even have a capacity of some kind of basic memory.
This memory is proposed to be performed by micro-tiny “tubules,” with molecules capable of rearranging themselves in something along the lines of a series of plus or minus charges or positionings able to store certain levels of basic information. This could have minor to major implications for the structure and function of fascia at the microscopic level, and remains elusive at this time, especially relative to the macro levels of structure and overt movement of the gross structure.
But just as quantum physics (at the micro-level) did NOT replace or overturn Newtonian physics (the macro-level), but added to physics understandings of physics in general, so to fascial contraction at the microscopic level does not necessarily nor directly translate into macroscopic actions. They are, of course, related. Yet science has not progressed sufficiently to fully understand the relationship between micro and macro as of yet. In fact, it is not really well understood at all, except by a few who take a very practical approach. Unfortunately, many speculations as to the nature of this relationship have been described, often masquerading as “fact.”
Since so many advocates of Fascial Therapy also are advocates of the more mystical interpretation of Quantum Physics, here is an excellent article on Quantum Physics in practical application:
Elasticity: Bend-ability (flexible) versus Extensibility (stretchable)
As well, one of the primary features of fascia is that it is VERY flexible (bendable) but also VERY resistant to lengthening out. It does not actually “stretch” much. This is one of the things making it very useful. The most common estimates I’ve seen in recent and common physiology textbooks are that connective tissues — tendons, ligaments and fascia — have a maximum of 4 to 7 per cent of extensibility, meaning the capacity to lengthen without tearing or permanently distorting.
One error in pseudo-science is to interpret that elasticity of tissues is necessarily all inclusive in meaning. In reality, elasticity can mean bend-ability (flexibility), OR extensibility (stretch-ability), OR resilience (absorbing of forces) OR all of them together. A particular tissue might well be called “elastic” yet only have one or two of those characteristics, and not necessarily all three.
It has also been pointed out* that when a person, even a very aged one, with significant postural distortion, such as scoliosis or a hunch-back (kyphosis), receives full-body anesthesia for surgery, their postural distortions significantly disappear as the muscles relax and lengthen out. Then, as the anesthesia wears off and the person becomes more conscious, the postural distortions return as the muscles tighten back up and shorten again.
Since fascia has little or no neurological motor inputs or contractile fibre reactive to anesthesia, allowing it to “relax” dramatically and in such a short period of time the way muscle cells do, nor return to a contracted state as the anesthesia wears off, the fascia would not respond to anesthesia in a way that would allow the postural distortions to dissolve and then return.
Muscle cells, however, do have such contractile characteristics — to relax or contract based on how much nerve charge arrives, or not, at the motor endplate in the muscle — making it perfectly fit those circumstances.
* Deane Juhan explains this in his excellent book Job’s Body.
Does The Human Body Look or Act Like A Sweater?
Another favorite idea of the fascia crowd is the illustration of a sweater. They point out that if one pulls on a thread in one corner of a sweater, that thread will pull all the way through the whole sweater, creating some degree of distortion. Of course, only some sweaters are knitted in such a fashion that this will happen, but it does neatly illustrate a potentially valid concept.
The question is, does this concept, valid for certain kinds of sweaters, apply to ANY of the fascial structures of the human body … at all?
This is, again, reminiscent of a New Age or pseudo-wholistic physics concept saying that when a butterfly flaps its wings, it could start a hurricane in some other part of the world. Even the originator of this idea said the idea is purely theoretical and is more about mathematics & probability than hurricane creation. The “theory” (more accurately an explanatory story) leaves out important factors, such as localized friction in the atmosphere, that would limit the ability of air pressure from vibrations generated by butterfly wings to travel through the atmosphere with sufficient force to move a nearby tree-leaf anywhere at all … let alone start a hurricane at a long distance.
But this, like the also mythical Hundredth Monkey Theory does not stop the fuzzy thinkers of the world who will ignore much in order to prove a little. (With the little often masquerading as an answer to everything.)
Anyway, the dense construction, the toughness, the very structure of fascia, as well as the functions it has to do, are such that it’s very usefulness requires that it NOT be very much extensible, and the way it’s attached to various other structures and other factors also indicates that it performs no such actions as often ascribed, be it monkeys, hurricanes or sweater threads.
UPDATE: Dr. Robert Schleip, Ph.D., was one of the Key Organizers of the first Fascia Research Congress and is a highly respected researcher. Although among the proponents of the fascial theories of postural distortion, he has gone on record:
In his two-part article, “Fascial Plasticity: a new neurobiological explanation,” published in 2003 in the Journal of Bodywork and Movement Therapies, [published by Leon Chaitow, D.O.] Schleip points to studies which contradict the notion that we can change the shape of fascia with our hands. One study found that collagen fibers would only begin to stretch shortly before they reached the breaking point, something that would not be desirable in a living human being. In other studies, Schleip, Trager, and others have done Rolfing under anesthesia and found that it produced no results. If the application of manual pressure had the ability to stretch fascia, there should have been a change in spite of anesthesia blocking any neural response. Why, then, was there no change when anesthesia took the nervous system out of the picture?
I think that quote well summarizes some of the points I’ve made above. And the same principles apply to those who believe stretching or yoga somehow “changes the fascia.” Yes, there are unique effects, but not what we’re usually told it is.
The Big Question Is, in my mind anyway, why cannot the Pro-Fascia people accept that fascia has some unique and VERY important characteristics while not doing everything they think it could or should remotely do?
Anyway, the chemical and non-contractile properties of fascia have led me to believe quite strongly that the primary source of postural distortion is the actin-myosin muscle cells, not the fascia.
Yet, rather than talking about the muscle system OR the fascial system, I prefer to discuss the:
Psycho-Neuro-Musculo-Fascial & Joint System
You can read all about that on my various websites and in my e-books and e-courses.
Short Story: The Hellerworkers in L.A.
I was teaching, with Linda J. Calandro, a 3 Hour introductory seminar on what I now call DSL EdgeWork in the Greater Los Angeles area (I think it was in Venice Beach) in the early 1990’s, which a couple of Hellerwork practitioners attended.
(Joe Heller, NOT in attendance, was president of the Rolf Institute for 12 years before going off on his own, and openly admits that his work, Hellerwork, is heavily based on Rolfing, with some modifications and innovations.)
One of the Hellerworkers in attendance had a small degree of single curve scoliosis (sideways curvature of the spine) for a number of years. Several Hellerworkers had tried to straighten it, including Joseph Heller himself. When I described in the seminar how I worked on scoliosis, the Hellerworker was intrigued because, since the Hellerwork model is (or at least was at the time) based on the idea of fascia as the primary cause of postural distortion, they had always worked on the opposite side than I would have.
So he came in for a session the next day. If I remember correctly, he only had a little less than an hour available, which is an awfully short time to straighten a scoliosis. But his was not severe. So I worked on the side with the shortened muscles, opposite of the side they had been working on and, sure enough, it began to straighten right then and there.
Previous Hellerworkers, including Joe Heller, had treated him on the basis that the fascia on the convex side of the spine was pulling the spine laterally toward the convex side. I, on the other hand, used the idea that the over-shortened muscles on the concave side were pulling and bending the spine over.
It’s important to note I did not say over-TIGHT muscles. Because you can have very tight muscles that are actually not over-shortened, but over-lengthened.
In fact, in scoliosis, the over-lengthened muscles are usually much tighter to the touch, and more painful, than the over-shortened muscles, because the over-lengthened muscles are working much harder. They are also more bulked up and bulging out, so they get everyone’s attention. And where the attention goes, the therapy tends to go.
Now, the Hellerworker with the scoliosis happened to be the head instructor of a well-known, local massage school (in Santa Monica), and he participated in a local Hellerwork study group. As a result, I was subsequently asked to come lecture to the local Hellerwork support group on my system of structural analysis & postural evaluation. But, because I was living and working mostly in the Southeastern United States, I could not at the time. And, unfortunately, most of my contact numbers from that time were lost, so I never recovered the opportunity again.
Last I heard, though, they were paying a lot more attention to those over-shortened muscles, and had moved somewhat away from the alleged “shortened fascia” strategies!!! … I think practitioners of Myofascial Release should pay attention to this.
Dr. Michael Koplen was a very successful Massage Therapist who went on to chiropractic school. He became Chiropractor of the Year in his management organization in 1990s. After reviewing David Scott Lynn’s e-book, Dr. Koplen said:
WOW! – Just skimmed thru David’s book on yoga and it could easily be a recommended nuts and bolts myofascial physiology book for Massage Therapists! It’s loaded with super clear understandings about neuromuscular interaction, the truth about stretching vs elongating myofascia, how to properly work with over-facilitated and weak muscle groups, and lots of other juicy info. It would have saved me lots of time trying to piece much of this together thru lengthy, time consuming and often tortuous discussions. Okay, I’m starting to sound like paid advertising agent (I’m not!).
Thanks for Reading and Take Care,
David Scott Lynn (DSL*)
* DSL: Your Hi-Touch Up-Link to the Inner-Net
Inner-Net: Your Psycho-Neuro-Musculo-Fascial System