So over the past several years, I have gotten alot of junk mail for continuing education courses. A frequent advertisement that comes to my house is one promoting “Principles of the John F. Barnes’ Myofascial Release Approach”. I have contacted this company by both phone and email to request to be taken off of the list. But I still get their advertisements (too bad this type of paper doesn’t work in the bathroom…). Anyways, from the advertisement it appears that 75,000 therapists use the approach and a statement that it is “the wave of the future”. So I went to the literature to investigate these claims…
A search @ http://www.scholar.google.com for “John F Barnes Myofascial Release Approach” yielded 261 results. The first citation is a 2004 article called The “Missing Link” in Your Treatment by John F. Barnes.
In this article, he states: “Therapists tired of working in “assembly line” atmospheres, focusing on quick symptomatic treatment, and who are overloaded with burdensome paperwork are joining facilities and private practices that focus on myofascial release.” He goes on to state “the health professions had ignored the importance of an entire physiological system, the fascial system that profoundly influences all other structures of the body.” He discusses some anatomy and more importance of fascia and concludes by telling us how “Physical therapists of the near future will function quite differently from those of the past…The therapist skilled in Myofascial Release is concerned with releasing and reorganizing the body’s fascial restrictions mechanically and reorganizing the neuromuscular system.” No citations were included in any of the statements. (This reference appears to be an ad for Saskatoon Massage Therapy which states it must be cited as “John F. Barnes book the Search for Excellence”)
As I sifted through the other citations, there were alot of non-peer reviewed entries similiar to this. I did find a RCT entitled “Effectivess of Myofascial Release in Treatment of Plantar Fasciitis: A RCT”. This study was a randomized controlled trial that involved 30 subjects who received either therapeutic ultrasound, contrast bath, strengthening and stretching compared to a group that additionally received myofascial release. The MFR group did better (was it the unwinding of fascia or simply the no-specific effects of manual therapy?).
My questions to the readers of this blog are:
1. Do you believe fascia to be important in diminishing pain?
2. If yes to #1, can you provide sound scientific rationale to support your answer as well as describe how the effects are not due to the cutaneous receptors within the skin, placebo or another comparable explanation…