Myofascial Release: From the Surface to the Depths

Myofascial release involves the specificity of touch coupled with an understanding of anatomy and human beings. The definition of touch is “to put the hand on , so as to feel”.[1] The intention of this manual is to help therapist to improve the specificity of his/her touch. When touch is refined and specific the client will increase his/her awareness and ability to feel.

Myofascial release unlike most manual therapies does not have a founder because it has been around in all civilizations throughout history. The importance of being touched in a healthy way cannot be overlooked. A baby will not thrive if it is not touched and held. The touch we receive as children plays a major role in way we hold ourselves as adults. The body stores all its experiences and memories in its cells. It is important to respect the power our touch can have and honor the resistance clients may demonstrate.

The iliolumbar ligaments attach to the anterior surface of the iliac crest and the transverse processes of L4 and L5. The posterior sacroiliac ligaments are both vertical and horizontal between the sacrum and the ilium. These ligaments blend with the sacrotuberous and the sacrospinous ligaments. The sacrotuberous goes from the inferior lateral angle of the sacrum to the ischial tuberosity of the ilium.

The piriformis, coccygeus, and the iliacus attach to the anterior surface of the sacrum. The erector spinae, gluteus maximus, lattisimus, and the multifidus attach to the posterior surface of the sacrum. Protective muscle spasm of the piriformis can mimic discal symptoms as the peroneal division of the sciatic nerve runs above, under or through this muscle.

Viscerally the ligaments from the uterus, the sacrouterine, and the sigmoid colon attach onto the anterior surface of the sacrum. The position and health of the uterus and the colon will also affect the freedom of the sacrum.

The articular surface of the sacrum to the ilium is ”L” shaped with the angle of the “L” at S2. The sacrum sometimes becomes locked when there is a blow to the head causing the force to move down the spine and become lodged at the sacrum.

What are the qualities that makes one therapist able to feel and make deep changes for their clients with myofacial release? It helps to have felt these changes in our own bodies first to have our own kinesthetic awareness of these releases. We need to be as fully embodied in ourselves as possible. What does it mean to be as fully embodied as possible? Are we in touch with the subtle physical sensations our body gives us during the day, ranging from “ I’m hungry” to “This posture is uncomfortable and I need to change the way I’m sitting”. How about noticing “I get a stomach ache every time I talk to that person.”

Are we in touch with our emotions? Do we easily release our grief when a loved one leaves us? Can we say “no” when we feel as though saying “yes” would be going beyond our boundaries. Can we reach out and express our needs so as to get our needs met? Do we use anger appropriately when it is necessary? All these are emotional skills we all need to have developed. Otherwise our bodies will tighten to not allow the natural flow within. Is some of our clients tightness due not to an injury, but maybe a way they have learned to help themselves when they don’t have the emotional skills they need to get through difficult situations.

Body -Centered Gestalt Therapy is a form of psychology that teaches the practitioner the stages of emotional development from birth on and helps us understand how the body will need to tighten to hold itself if those needs at each stage of development are not met. It teaches 9 different character structures or holding patterns in the body that will commonly become developed depending on which needs have not been met. It then teaches the practitioner how to help the client to move out of these limiting patterns of holding through psychotherapeutic processes. This approach includes a special respect for people’s resistances. It includes working with building supports. It is through the understanding and acceptance of the positive function of these resistances or physical thightnesses that people accept their own life process. We can begin to be able to change old self destructive habits, ways of thinking, or release areas of physical holding and tightness. Practitioners feel if we are to nourish our life, we have to be aware of our childhood and its effect on how we learned to live our bodies, emotions, thoughts and our relationships.

This can be very useful for body workers as we work with our clients areas of resistances because sometimes they were built for emotional reasons and to lose those tightnesses may feel even life threatening at some level. These resistances need deep respect, as if you were dealing with an extremely frightened child. I believe using myofascial release in an indirect method gives more respect to those areas of holding which need a more nuturing feeling in order to feel safe and secure enough to try a new way of being. We need to be careful never to force an area to open. The result may backfire! At times we need to help the client build inner supports physically and emotionally in order to release areas of holding. This physical support may be to balance the pelvis with Muscle Energy Technique, which will give the feeling of a stronger foundation upon which to build We may want to release areas around the key area without touching the key area for many sessions to let the body slowly warm up to the idea of a new way of holding itself.

Emotional support can come in many ways, such as psychotherapy. Or, with the use of imagery. There are hundreds of books and approaches for the use of imagery. Healing Yourself by Martin Rossman, MD and Totem Pole Imagery by Steve Gaegos are two such books. Kitchen Table Wisdom by Rachel Naomi Remen , MD also describes many stories in which imagery was used for healing