I believe curiosity is one of the strongest assets that make a therapist successful. But, curiosity on the part of my patients can reap even bigger outcomes.

I have an acquaintance who is a mental health therapist. In her office she keeps a toy magic wand. Among others things, she will often give it to a client, often a child, and ask them if they could do anything, what would they do to fix things. It is not an uncommon approach in mental health, and it often gives the client freedom to dream and wish. I use a similar strategy during myofascial release treatment. Picture this scenario…your client has seen a vast number of “specialists” all whom have proclaimed what is wrong (diagnosis), or what should be done (previously unsuccessful treatment history). Our client sits there, listening to the experts come up with one more thing that probably will not work, at least completely. Many, if not all, of our clients hold inside what they really think is wrong or what should be done, but what do they know, they are not the expert. So they follow along, like a dog on a leash, from one dead end to another.

What if you asked them what they think they needed; give them the credit they deserve? I will frequently ask my clients “If I could do anything for you, what would it be?” After they say “fix my pain” (they usually say this!), I ask them to feel and think; what could I do that would help. With uncanny accuracy, they come up with helpful advice for me. Me, the expert.

Be curious. Get out your magic wand.

For Now,

Walt Fritz, PT

A funny thing happens when you use a modality long enough; technique seems less important. In the beginning, the techniques were everything. How many classes could I take and how many new techniques could I learn? Of course there were plenty of new seminars to fill my needs, each promising more and more. But after a point I realized that the techniques were the easy part of myofascial release. What was the essence of this work was the development of the feel. I’ve written about this feel in the past, as it is the basis of what I do on a daily basis, as well as what I try to give to each therapist that takes one of my seminars.

The feel is making a complete feedback loop. Touching into your patient, sensing an area of tightness that feels like the cause of pain. You then make your patient aware of the area you located and seek their feedback. Confirmation completes the loop. This sounds simple, it sounds like what we all do daily, and for some of us it is. But I believe that there s a deeper awareness that therapists need to hone in themselves before they can fully sense and connect to this feel.

Techniques are easy, we make them up each day, based on situation and need. Moving your hand, direction, or intent ever so slightly can drastically change the effect. Knowing the anatomy is helpful, but not essential. Whether you are a believer of the fascia’s influence on pain or not, the interconnectedness of the body blurs the line between one structure and another. We develop hundreds of variations on what we already know every time we touch and treat a patient. See if you can deepen technique, by honing your feel.

For now,

Walt Fritz, PT

1.6%

That is the percentage of people who have a perfectly straight spine; one with no lateral deviation whatsoever. Those were the findings of Dr. William P. Bunnell, Professor and Chairperson, Loma Linda University Medical Center, who in 1992 published his paper; Outcome of Spinal Screening. The study looked at 1000 physically mature high school students. A full 80% of the students had three of more degrees of rotation at one or more levels of the spine. An interview with Dr. Bunnell is posted here. With simple math, would mean that 98.4% of these students had a scoliosis of some degree. This fact flies in the face of oft reported figures, such as “Scoliosis affects approximately 2% of the population”, as reported on the American Academy of Orthopaedic Surgeons (AAOS) website. So who is correct?

The webpage of the AAOS gives no determining criteria for what degree of curvature constitutes being given the diagnosis of scoliosis, but one can assume that it is a spinal curve greater than the 3 degrees cited above, and certainly does not apply to ANY degree of spinal curvature.

There are also widely varying opinions on how scoliosis effects pain. Searching GoogleScholar will bring up a number of articles addressing scoliosis and low back pain, but few seem to apply to the more subtle effects that I believe exist when normal scapular motion is impaired by posterior thoracic rib asymmetries.

In both treatment, as well as in my Foundations in Myofascial Release Seminars, I encourage fully evaluating what effects an asymmetrical thorax can have on pain and limitations in function. There will be times when you find wild asymmetries that seem to have little connection with pain, while other times subtle asymmetries seem to profoundly impact pain and function. Don’t jump to conclusions too soon that that asymmetries you see in evaluation connect with the presenting issue, but don’ t ignore the obvious either.

1.6%…..that is your starting point.

For now,

Walt Fritz, PT

I just completed posting another dozen or so new therapists listings to the Myofascial Release and Bodyworker Practitioner Directory. (sidebar: If you have not signed up for this free directory, what are you waiting for?) As I enter information for therapists and practices literally from around the world I am struck with the wide variety of training these therapists possess. I was trained in myofascial release in a sheltered world of thought. I had heard of other trainings but was told that all of these were inferior. It wasn’t until I broke from that trainer that I realized there were dozens of excellent and effective seminar lines out there teaching myofascial release to the world. Whether direct or indirect methods, with or without emotional work, myofascial release IS effective.

A few tips for therapists, when it comes to promoting your practice:

- Market your strengths, not the words “myofascial release” or your mentor’s name. I made this mistake the first few years of my private practice. I was out to convert every doctor in my city to the wonders of MFR, all the while attaching my teacher’s name to it as well. I quickly realized the general population does not care what it was that I did, or who I trained with. They cared about what I could do for them. My practice changed from the “Myofascial Pain Relief Center” to just the “Pain Relief Center”, and business grew. Know your strengths and make that your marketing tool. The name “Tulip Petal Therapy” may have great meaning to you, but it will be completely lost on someone looking for help.

- Today, a website should be considered mandatory. Place a professional photo of yourself on that website. There are many good sources for website design, but as I check out various sites across the country I see a few glaring flaws. Fix those spelling and grammatical errors. If your website design program does not show these errors, cut and paste your text to Word, or other similar word processor, and check for those mistakes. Have a friend proof read things. These simple to correct mistakes can turn off a potential client very quickly.

- While postcards, and similar mailings can be effective, consider switching to an online newsletter program, such as Constant Contact. By collecting email addresses from clients, you can reach out at any time. It also gives them an opportunity to share your newsletter with a friend, expanding your reach.

Simple tips, such as these, can make a difference.

For now,

Walt Fritz, PT

(Or, why does committing to this line of seminars feel like multilevel marketing?)

I think most of us have done this; start looking into a line of continuing education seminars and wonder why so many courses are needed? Then you start doing the math. “No way am I going to pay that much to learn that work, just to be classified as an expert or become certified”. Some seminar lines make it less painful ($100 a month for life) to become “certified”, and just what does certification give you? Others rely on more subtle practices of coercion, once they get you to the first class. (been there, done that). Don’t get me wrong, there is much to be learned from every teacher.

So, how many seminars WILL it take you to become an expert? For those of you who have been around for a while, you know there is no answer to this question. Some therapists pick up things (therapy or otherwise) very quickly, while others require lots of repetition (Oh, did I mention those classes you can re-take that seminar again and again for half price???). It does all feel a bit like a used car lot, at times.

Certification matters little to most therapists, unless you are the type who needs those extra initials after your name to find your self-worth. And those who see the carrot at the end of the stick as being able to call themselves an expert ______ therapist by completing all 15 seminars, I say “go for it”. To all of the rest of you, forget the titles. Learning myofascial release, or other modalities, is a process of being introduced to the work, including the importance of “Feel”, along with a few core techniques to get you started, then finding the courage to actually begin to use it. Many fail in this last aspect, and return to another seminar, hoping to regain the magic once again. It does work for some, but it need not be this way.

Remember that feeling you have when you leave many seminars, the feeling that you can help just about anyone right now? What causes that feeling to fade? It doesn’t for everyone, but does for many. I would say that it fades for those who do not immediately put the new found principles into practice. Certainly you will still have a lot to learn, both from yourself and your patients, in addition to more coursework, but you are the key, not the teacher.

I’ve gotten a few emails over the years asking if I offer a certification program or asking why I do not offer a lot more seminars. The answer is easy; I don’t think it needs to work that way. Take a training from someone you trust, someone who can teach you the basics of the work. If it feels like the first seminar is more of a sales pitch for future seminars, be wary; they often are. And, certification…certification to whom? There is no requirement to be certified to practice myofascial release, so why offer it?

The expert is typically self built, not made by spending money.

For now,

Walt Fritz

The palpatory sense that good therapist develops never ceases to amaze. This sense of feeling or seeing inside is the basis of my therapy and my Foundations in Myofascial Release Seminars. I’ve written about touch frequently, but a revisit is in order.

Many years back a retired professional football player was referred to me for treatment due to knee pain. He had retired from football after his eighth knee surgery. Thirty years had passed and he now described his life as one of pain while standing and needing to use his arms on handrails climb stairs. Still fit at age sixty, he seemed to pride himself in having retained his athletic physique. He made this known to me when I was performing my normal assessment. As I reached his quadriceps, I noticed the remarkable density in both thighs. I mentioned this to him and he made a remark about trying to keep them “in shape”. I kept my mouth shut and continued the assessment.

When laying relaxed in supine, the patella should be at its most relaxed state and able to move both medial/lateral and cephalad/caudal with great ease. Needless to say, my client lacked any appreciable movement of either patella. It felt like someone had poured glue under each kneecap. These two signs, increased quadriceps tightness/density and diminished patellar mobility are typically remarkable predictors of knee pain.

As I returned to his quads, I felt around in the depths, finding rather strange scar-like areas. When I quizzed my client a bit, he came to the conclusion that they must have been due to the numerous helmet hits, etc. that he had received over the years.  So, I spent a few sessions working away on my findings. After five to six sessions, he came in to tell me that he was doing surprisingly well. His knee pain had greatly diminished, could stand all day without major issues, and could walk up and down stairs without relying on his arm power. He was concerned, though, as he felt that he need to get back into the gym. He was worried that his thighs were getting “flabby”! They lacked the tightness and firmness that he had had for most of his life. What he took for strength was in fact soft tissue restriction. I spent a bit of time trying to explain to him why this “tone” was not a good thing, but I do not believe for one minute he believed me. I am fairly certain that his beliefs got the best of him and he turned to the gym to get back into shape. Despite all, his goals for therapy were met.

Trust what you feel with your hands. Learn to see inside with your hands, as they have much to teach you. Know what “normal” soft tissue feels like, which can only be learned by touching hundreds of people. Seek out those areas of tightness, density, ropy quality, etc. Isolate your pressure into these areas and seek feedback; does palpation here reproduce a portion of your client’s pain? Get to know these areas. They have much to teach you.

For Now,

All articles copyright Walt Fritz, PT and Foundations in Myofascial Release Seminars

One of the many things I love about my work is the opportunity to interact with and treat a very wide variety of conditions. If I dealt with nothing but low back pain all day/every day, I would be bored rather quickly. Women’s health issues have always been a strong part of my practice, including pelvic organ prolapse. I recently came to know Sherry Palm, who heads a wonderful non-profit organization called the Association for Pelvic Organ Prolapse Support, Inc.  (APOPS). Sherrie acknowledges the benefit of myofascial release in the treatment of pelvic organ prolapse (POP) and even provides a list of MFR therapists on the website. Also, she has written a book, titled “Pelvic Organ Prolapse: The Silent Epidemic”. Myofascial release has the ability to address issues of tightness within the abdomen and pelvis which can lead to organ prolapse.

Please check out the APOPS website. There is a huge amount of information there that may benefit you or your clients.

For now,

Walt Fritz

A recent New York Times article, titled “How Yoga Can Wreck Your Body“  has gotten a huge amount of coverage around the internet. Posts from some people are accompanied by an “I told you so” while those from others call it junk journalism. Whichever your belief, it is an interesting read and, to me, simply represents a trend of injuries “acquired” from any popular exercise routine. I wrote an article on my blog a year or so back about “My Issue With Core Strengthening“, that called into question some of the practices that are utilized by the therapeutic community and the popular modality of Pilates™.

When I began my private practice years back, combining myofascial release with my background as a physical therapist, exercising at Curves™ was quite popular. My caseload quickly became populated by women (Curves is a women only program) who injured themselves while working out at Curves. Initially I cast dispersions on Curves, thinking there must be something inherently wrong with this style of workout. But as trends changed, so did choices in exercise. Weight training, core strengthening/Pilates, Yoga, and even simple exercise walking emerged as more popular choices. But, curiously, my injured population did not dwindle. Each new exercise option seemed to produce its fair share of injured participant. My rocket science degree taught me to look at the patterns and trends. It was more about the people who were pursuing exercise that it was about the exercise modality itself.

Now if you read the Yoga article, you will see some specific and valid concerns about certain Yoga positions and practices. I’ve highlighted some of my own regarding Pilates and Core strengthening in the referenced blog. These are real concerns and are independent of t relative level of fitness of the participant. EVERY modality can be dangerous, even in our line of work. Beware of anyone in life who tells you that anything is completely safe.

So, what does this all have to do with myofascial release? Maybe nothing, though these are trends you will be exposed to daily, if you pay attention.

For now,

Walt Fritz

This blog first appeared on my MassageMagazine.com blog.

I opened my blog series with a few comments regarding what make my “brand” of myofascial release different, or new. Over a few posts, I want to elaborate. And, I believe that the concept of humility is a great place to start.

What does humility have to do with myofascial release? Lots! Myofascial release is a strong modality, but it is not the answer to world peace. (For a very good perspective on our overplaying fascia’s importance/significance, please read Sandy Fritz’s recent blog post on “Fads, Trends, and Gimmicks”. No, we are not related, I just have to support someone who has the same last name as mine!) There are many therapists who condemn the “Tool Bag” approach to therapy. Some feel that understanding the science behind a modality is of the utmost importance and simply adding another tool to the tool bag is pointless without a well grounded explanation for how that modality works. I understand where they are coming from; but having options, or tools, is also needed.

There are some in my field who will have you believe that myofascial release (MFR) is the ultimate treatment modality. While I have witnessed some amazing things happen as a result of my MFR sessions, I am humble enough to know that I cannot help everyone, and it has nothing to do with them “being ready” for my treatment. I am also humble enough to know that my close group of associates in the chiropractic, acupuncture, massage, physical therapy, traditional medical, and other fields are, at times, more able to help someone whom I cannot. Marketing within the filed of MFR has made some folks believe that they are the top of the therapy food chain. If that is what brings more therapists into a seminar, so be it. I think honesty and humility work better. Myofascial release IS a powerful modality, but it, like all modalities, it has limitations, or at least the therapists learning this work should be made aware of them.

Humility is the quality of being modest and respectful. I believe I can be a powerful therapist without moving beyond modesty. I believe Sandy Fritz is correct in how fascia has become the amazing tissue that is the cause all ills (my words, not hers). There just has to be a balance. What are your thoughts?

For now,

Walt Fritz

This blog post originally appeared on my new MassageMagazine.com Blog.

Massage therapists and body workers have a vast number of reasons for doing what they do. Your list would be different from mine. Long ago I realized what I was very good at and what I wished to specialize in; treating pain. When I broke away from the mold of traditional physical therapy and entered into a world that is more commonly populated by massage therapists, I felt that I needed to educate the world, or at least my small corner of it, what myofascial release was. Not only what it was, but how great it was. I sent out mailings to doctor’s offices, made phone calls and visited those offices. I pleaded for articles in the local newspaper, touting my successes with myofascial release. All of these efforts paid little dividends. My best referral source were satisfied clients (they still are to this day). For what did I wish to be known?

I took some time and stepped back from my “marketing” efforts and realized it was not what I did that was most important, but what I was able to accomplish. I am very good at reducing or eliminating pain. This was what was important to prospective clients and referral sources, not what modality I used. For what did I wish to be known?

Being a generalist is fine. The world needs them, whether it is a physician or therapist. But specialists are also needed and SKILLED specialists are in high demand, again, no matter the profession. Do you have a specialty? How do you market that specialty?  Is your specialty designated by the modality which you use or the skill that that modality gives to you? There is a huge difference between the two and I believe when you make the transition from the former to the latter, your success will shift dramatically as well. For what do YOU wish to be known?

We all compete in a saturated market. Make yourself known. Know exactly for what YOU wish to be known for.

For now,

Walt Fritz, PT