Listening With Your Hands

Myofascial Release for Speech-Language Pathologists

A special class that I will be co-teaching with Benjamin Asher, MD.  

Chicago, Illinois

April 27-28, 2013 

NCBTMB CE hours continuing education credits are approved. Physical Therapy CE Hours are available in many circumstances, as well as CE Hours for other professions available; please inquire. 

For full details and to register, please refer to the 

Seminars Page of the website.   

If there were one map of the body for all to follow, a map that showed all areas of injury, trauma, and pain, along with the necessary route to take to eliminate those issues, life would be simple.

I received a new GPS this past Christmas. My old GPS had become unreliable due to a few quirks and I did not have full trust in my iPhone's GPS, given a few wrong turns along the way. While my new GPS offers me nearly a nearly foolproof ability to find my way around while traveling, it lacks in some key areas. I learned this a few years back, while traveling to teach one of my Foundations in Myofascial Release Seminars. My hotel was not terribly far from the seminar venue, but each morning and night, I followed the female mechanical voice on my GPS, dutifully turning when she told me to turn. Prior to this, I had always carried a map while traveling and studied it beforehand, as well as before venturing off on a new destination. While near the end of my trip, my old GPS began exhibiting one of its quirks and forced me to find my own way. After spending nearly 4 days in that city I realized that I had no idea how to get to where I wished to go, even though the distance was small. I had previously relied on some internal ability to see a place on an internal map in my mind. I did find my way to my destination eventually, but it was a very good lesson to me.

In order for us to benefit from a map, we need to decide on our route preferences. What factors go into deciding which road to take? When one initially programs a GPS, it will query you to see if you wish to prioritize shortest distance, shortest time, avoiding highways, etc. However, I think most of us forget about these variables each time we plunk in our destination and follow the voice. If we are reading an old-fashioned paper map, we have choice that is more overt; highway or country road, scenic route or "just get there". If we are curious, we may choose a route that takes us past places of interest.

Choosing a map to follow in the body is no different. Many maps are offered, from the ones we learned in school, which tended to be more simplistic, the maps offered through continuing education, and the ones offered by our own experience. I learned a map of the body and followed this map for many years. That map stated that the body behaved in very specific ways. This method was influenced by the theory that fascia was the "great unknown" when it came to unresolved pain. The mysteries of the fascia were there for anyone to perceive, if you only chose to follow the teacher who taught this work. Sounds a bit mysterious, does it not? My introduction to myofascial release was explained in a manner that made sense, at least from my very superficial level of understanding, as well as cherry picking the available evidence to suit my needs. It really lacked any plausibility from a scientific perspective, but I skipped over any lingering questions I might have, as what I learned to do with my hands was incredibly effective. Occasionally my instincts caused me to question my teachers, but the all-important "results" quickly put any doubts to rest! I know now that much of what I learned was either outdated or wrong. In essence, I became a good listening and follower, but not a good questioner. I began applying the principles with my patients and quickly began to notice things that seemed more important to me that did to my teacher, and things my teacher thought were important mattered less to me. Sounds like maturation, correct? What was apparent to me was that dysfunctional tissue (non-specific tissue), presented with a characteristic density that was easily palpable. At first I attempted (rather successfully, I thought) to equate this density to "fascial restriction", as that was what I was taught. However, over time, the "Feel" became the most important element. Fast-forward a decade or two. A few years back I began to expose myself to a neuroscience approach to pain; one that used basic neurology to explain the changes we feel with bodywork. I at first rejected this as skeptical nonsense; how could the results I saw with MFR be wrong? The results were not wrong, just the explanation. The transition from an old-school mentality of myofascial release to embracing these newer concepts was not difficult, as under my hands I still felt what I had felt in the past. Only now, I had much more plausible explanations to use.

The maps that I now use are based on simple anatomy and mostly neuroanatomy. It is not sexy stuff, like other explanations of body work and MFR, and doesn't try to bridge any chasms between body work and parts of the process that we, as body workers, have no business addressing. I am a huge fan of the Visible Body app. While it can be purchased in modules, the Visible Body Atlas is a comprehensive guide to the body and will be the map we use.

For those of you with an enlightened sense of feel, learning this new form of myofascial release work will come easily. The most difficult part may be asking yourself to put aside your beliefs on how best to make changes in the body. Over the past 20 years, I have lightened my touch considerably and enlightened my mind even more. I do not work to any level of uncomfortable depth and never elicit pain.

There are those who feel that the term "myofascial release" is so scientifically incorrect and unrealistic that it should be abandoned. While I believe we are influencing much more than just the fascia, and that fascia is not the magic tissue it has been made out to be, I do feel there is logic in sticking with it, if nothing more than the name recognition value. Ultimately, I will not try to convince you of anything; your process may be as long and tortuous as mine was. In the end, I hope that you simply come away with a better ability to help someone in pain. That is where we start.

The new myofascial release differs little when it comes to what we do with our hands. But it differs wildly with what we do with our minds. Enjoy!

Walt Fritz, PT