The Foundations in Myofascial Release Seminars draw from a fairly wide range of health professionals, including physical therapist, occupational therapists, massage therapists, athletic trainers, nurses, and osteopaths. All of these professionals have a huge number of continuing education opportunities to choose from, which led me to wonder “Why take a Foundations in Myofascial Release Seminar?”. Tony Friese is a physical therapist from Wisconsin who recently took the Foundations I Seminar in Illinois. I asked him if he would agree to answer a few questions along this line and he graciously agreed.
Thanks for the interview. As a physical therapist, what drew you to take a Foundations in Myofascial Release Seminar? Have you done any MFR training in the past and how did it compare to the Foundations class you recently took?
In my last few years of practicing PT, I have experienced a renewed interest in the treatment of painful disorders which has led me to update my knowledge and skills accordingly. Some of the more important things I’ve learned are that manual therapy techniques can be very helpful in reducing pain, but not for the reasons we may have originally learned and thought, for example the notion that we can physically stretch connective tissue such as fascia. Also, that when it comes to pain, the nervous system is king. Pain is a protective output of the brain based on its perception of threat to the body, and to reduce pain, reducing this perceived threat must occur. Therefore, therapy techniques, whether manual, exercise or modalities, that are painful, are going to be counter-productive. Finally, patients are going to seek touch-based therapy to help their pain. So, in my attempt to improve my ability to help people in pain, I realized I not only needed to improve my tool bag of hands-on techniques, but that those techniques needed to be mild and gentle enough so as to not be threatening to the person’s nervous system.
Many teachers of myofascial release describe their work as being gentle and non-threatening in nature and in years past I have been to other myofascial release courses. These courses did have some value but overall I found them lacking for a couple of reasons. Firstly, they all continued to promote the scientifically unsupported notion that, by our hands-on pressure, we are able to physically, lastingly stretch tight tissues. Secondly, the courses tended to teach you to look heavily at postural alignment to determine where to treat to relieve pain. I never was able to get the hang of this, and, based on the current science available, it’s a shaky-at-best premise anyway! Finally, and most importantly, I left almost all of those courses being able to “go through the motions” of the techniques that were taught but really didn’t know what I was supposed to use when, or supposed to be feeling for under my hands and how to relate that to the symptoms of the person I was trying to help.
What drew me to the Foundations in MFR seminars was that these seminars include in their description and objectives the gentle nature of the work, the teaching of “getting the feel” of the method, as well as offering explanations for how MFR works that are more plausible in light of the science available at this time. I wanted simple, scientifically sound explanations of what MFR does. I wanted instruction in where to look for problems in the body, what to feel for with my hands, and what to do with what I find. I got the basics of all of that in the Foundations I seminar.
Moving myofascial release from the realm of the pseudoscience, as it is typically explained by many of the popular teachers, has been a mission of mine. That and getting people to understand that this work need not be hard to learn. How far did one Foundations Seminar take you toward improving your effectiveness in dealing with patients in pain?
Taking one Foundations seminar has taken me quite far in helping me better work with patients in pain. The particular aspects of the class that have been most helpful have been the teachings to identify, by touch, areas of distressed tissue, to connect findings of distressed tissue with the patient’s complaints of pain/tightness, to incorporate more of the body in my search for such distressed tissue, and, when treating my findings with MFR, to make sure to engage that tissue for a long enough period of time to facilitate change in mobility and symptoms. I felt the instruction I received in these areas was done in a simple, straightforward manner and the theoretical explanations given for how MFR works were grounded in plausible neuroscience with really very little mention of any specific properties of fascia. I am still a bit overwhelmed at how many different body areas can affect or contribute to a particular painful condition in a given patient, and how to prioritize which areas to check out first for specific conditions, but I feel with further practice this will improve.
Myofascial release has been greatly criticized over the past many years in our physical therapy profession, mainly due to its lack if scientific grounding. Do you see a place for myofascial release in the modern physical therapist’s arsenal?
I don’t know how modern I am, but obviously MFR definitely has a place in my own arsenal as a PT. I would hope it would for others as well, particularly any that are treating people in pain, especially now that some plausible explanations for how MFR works are emerging. Hopefully, though, MFR won’t get lost in the shuffle of “glitzier” methods like dry needling or instrument assisted scraping methods that are in vogue these days but, to my knowledge, don’t have any better science backing than MFR.