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|Manipulative and body-based methods - edit|
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Myofascial release is a soft tissue therapy for the treatment of skeletal muscle immobility and pain. This alternative medicine therapy aims to relax contracted muscles, improve blood and lymphatic circulation, and stimulate the stretch reflex in muscles.
Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. Osteopathic theory proposes that this soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension, and corresponding diminished blood flow. Although fascia and its corresponding muscle are the main targets of myofascial release, other tissue may be addressed as well, including other connective tissue. The underlying theory is not supported by medicine, and myofascial release has not been demonstrated effective for any condition.
The approach was first described by osteopath Andrew Taylor Still and his early students. The term "myofascial" was first used in medical literature by Janet G. Travell in the 1940s in reference to musculoskeletal pain syndromes and trigger points. In 1976, Travell began using the term "myofascial trigger point" and in 1983 published the reference Myofascial Pain & Dysfunction: The Trigger Point Manual. The exact phrase "myofascial release" was coined in the 1960s by Robert Ward, an osteopath who studied with Ida Rolf, the originator of Rolfing. Ward, along with physical therapist John Barnes, are considered the two primary founders of Myofascial Release. 
Some practitioners use the term "myofascial therapy" or "myofascial trigger point therapy" referring to the treatment of trigger points. The phrase has also been loosely used for different manual therapy techniques, including soft tissue manipulation work such as connective tissue massage, soft tissue mobilization, foam rolling, and strain-counterstrain techniques.
Myofascial techniques can be described as passive (patient stays completely relaxed) or active (patient provides resistance as necessary), with direct and indirect techniques used in each.
The direct myofascial release method claims to engage the myofascial tissue "restrictive barrier" (tension). The tissue is loaded with a constant force until "release" occurs. Direct release is sometimes called "deep tissue work", a misnomer as some of the important tissues are quite superficial. Practitioners use knuckles, elbows, or other tools to slowly stretch the fascia by applying a few kilograms-force or tens of newtons. Direct myofascial release is an attempt to bring about changes in the myofascial structures by stretching or elongation of fascia, or mobilizing adhesive tissues. The practitioner moves slowly through the layers of the fascia until the deeper tissues are reached.
Robert Ward suggested that the intermolecular forces direct method came from the osteopathy school in the 1920s by William Neidner, at which point it was called "fascial twist". German physiotherapist Elizabeth Dicke developed connective tissue massage (German: Bindegewebsmassage) in the 1920s, which involved superficial stretching of the myofascia. Ida Rolf developed structural integration in the 1940s, a holistic system of connective tissue manipulation and movement education, with the goal of balancing the body. She proposed that she could improve a patient's body posture and movement by bringing the myofascial system toward its optimal pattern. Since Rolf's death in 1979, over a dozen structural integration schools have split off from Rolfing with minor variations on the theme from her original teachings. Rolf's schools maintain that their lineage is distinct from the massage profession, but myofascial release and the larger massage profession have been significantly influenced by her ideas and methods.
Michael Stanborough borrows principles from Rolfing which can be applied for direct myofascial release technique:
The indirect method involves a gentle stretch, with only a few grams of pressure, which is said to allow the fascia to "unwind" itself, guiding the dysfunctional tissue "along the path of least resistance until free movement is achieved."
Carol Manheim summarized the assumptions underlying the practice of myofascial release:
The indirect myofascial release technique, according to Barnes, is as follows: