Don Quixote, Miguel de Cervantes’ character and book of the same name, threatened to “tilt at windmills” that he believed were enemies. The term “tilting at windmills” often refers to describe confrontations where adversaries are incorrectly perceived (1). Incorrect perceptions in Myofascial Release are often the result of incomplete (or lack of) evaluation prior to initiation of treatment.
It is no secret that I believe Myofascial Release to be a powerful treatment modality. But, without something to base your treatment plan upon, you are unwinding at windmills. This is why I so strongly stress the importance of a thorough evaluation before treatment is initiated. To some therapists, this only makes sense, but to others, thorough evaluation is a luxury that they are not given (or they do not take). Many of us work on a fee for service-type arrangement, where the client is paying out of pocket for the treatment. Thus, many therapists (or their employer) feel that they must provide hands-on treatment during the full allotted session time. Simply beginning treatment based solely on location of pain is often too myopic, missing the larger picture of proper treatment. And, allowing unwinding to guide you to what you believe to be the issue is nonsense.
Many, many people teach that properly applied Myofascial Release often finds the cause of pain/dysfunction in places other than where the pain resides. This is quite often true, but one needs a reliable and valid method for determining where to begin. My evaluation is a combination of solid orthopedic testing, accompanied by an informed sense of “The Feel” for soft tissue tightness. I have spoken at length about this “Feel” in past posts, as well as in my seminars. Only after a thorough evaluation can one determine what needs treatment. Treating based only on pain serves only to discredit your talents as a therapist and often leads to only temporary results. Find the pain, look deeper for the cause, but by all means fully evaluate to confirm the cause.
I have made a three part series of videos on my idea of Myofascial Release Evaluation and Treatment Planning. I would love to hear your thoughts.