Frequently Asked Questions About Physical Therapy

Fascia (also called connective tissue) holds us all together and has been virtually ignored in the past. Fascia is a multidimensional web-like tissue that extends throughout the body. It is composed of two types of fibers:

A) Collagenous fibers, which are very tough and have little stretchability B) Elastic fibers, which are stretchable. Fascia is not muscle, but muscle is comprised of approximately 80% fascia. From the functional point of view, the body fascia may be regarded as a continuous three dimensional web of connective tissue that extends without interruption from the top of the head to the tip of the toes. It surrounds and invades every other tissue and organ of the body, including nerves, vessels, muscle and bone. It has been estimated that fascia has a tensile strength of as much as 2000 pounds per square inch.

The fascial system is made up of microtubules and marries all the other structures of the body, such as veins, nerves, other body systems (lymphatic system, endocrine system, etc.). It does not just exist in one place. It penetrates every cell from the brain to skin. Restrictions or adhesions affect the fascial system by binding it down, causing thickening, hardening and increased pressure. This may result in pain and other symptoms anywhere in the body. Working with the fascial system requires much experience and an extremely sensitive touch.

John F. Barnes Myofascial Release, (JFB-MFR) is a full body, hands on technique that releases the fascial system. The myofascial release approach is an intensive, generally mild and gentle form of stretching performed by qualified therapists who have been highly trained. These techniques have profound effects upon the body tissues. Because of its gentleness, many individuals wonder how it could possibly work. Because the facial system is interconnected, symptoms may appear in areas of the body one might assume are unrelated to the actual restricted area. Myofascial restrictions do not show up on any of the standard tests (x- rays, CAT scans, MRI’s etc.) so these myofascial restrictions have been ignored or misdiagnosed.

For example; when scars harden in one area following injury, inflammation, disease, surgery, etc. it can put tension on adjacent pain-sensitive structures as well as on structures in far-away areas. Some patients have b pain symptoms that appear to be unrelated to the original or primary complaint. These symptoms can now often be understood in relationship to our understanding the fascial system. Effective MFR treatment involves various techniques that are frequently applied to several different areas of the body. This is, therefore, a whole body approach to evaluation and treatment. The therapist needs to use “skin on skin” contact to provide the friction interface needed to release the fascia effectively. Release of these fascial restrictions includes specific specialized manual techniques of holding the tissue for a minimum 90 –120 seconds allowing for mechanical and biomechanical reaction to begin. Full release of the restriction may take five minutes or longer. Successive releases, through each layer, also require this time element. Our approach is successful because we treat a system in the body that no one else treats, the fascial system. JFB-MFR has been developing and refining MFR over the past 40 years to make this approach the most advanced and effective hands-on care available, particularly for patients who have not responded to traditional medical or surgical interventions Once the fascial system is addressed, these same patients begin to make progress in a matter of weeks with intensive MFR treatments and are on their way to a pain free, active lifestyle.

Through (1) trauma, (2) repetitive motion or (3) poor postures over time (sitting all day), (4) surgery, and scar tissue - restrictions can form in the fascial system. These restrictions can exert force of up to 2000 pounds per square inch on the body’s sensitive tissues and organs. This force can literally crush any of the vital structures that are near it. Since the fascial system runs throughout your entire body, these restrictions can cause pain anywhere in the body and compromise any system. By system I mean, vascular, neurologic, muscular, circulatory, digestive, etc. Fascial restrictions can cause digestive problems, fertility problems, circulation problems, neurological problems, etc. These restrictions can become tighter over time, literally making you feel like you are in a strait jacket and sending symptoms throughout your body.

When the cause of these symptoms, myofascial restriction, is left untreated, these symptoms often progress to the point of some type of chronic pain syndrome. In some patients, blood vessels and nerve roots can become caught which creates entrapment syndromes and ischemic like conditions.

Excessive pressure such as this can explain why some symptoms develop. Conventional treatment methods do not affect the myofascial system and at best produce only temporary symptomatic changes. MFR is a structural approach that treats the cause of the problems not just the symptoms and this is what produces long lasting results.

MFR at Integrated Physical Therapy is not forceful. It is a whole body approach tailored to each individual. The body is allowed to release, not forced to release. This does not mean that the releases will not be painful. Many times during a release pain and/or many other sensations will be felt. This is described as your fascial voice. IPT MFR treatments are minimum one hour with your therapist working with you, one on one, on your body’s restrictions. Some traditional settings feel like a production line, and are not very private. IPT MFR is all encompassing ie.: mind, body and spirit. The fascial system stores memory from physical, mental, and emotional traumas.

In traditional therapy, scheduled time with each patient is dictated by the insurance carriers. Individual treatment is not the norm and it is not uncommon to have three or four patients per hour per therapist and most times you are performing your exercise program independently. Modalities have their purpose but should remain an adjunct to the therapy process to enhance healing, not become the therapy process. In traditional physical therapy settings there is sometimes overuse of modalities like ultrasound and electrical stimulation which have no effect on the cause of the symptoms which is actually ischemic pressure from myofascial restrictions.

IPT myofascial release is a whole body approach to treating the cause of the symptoms not just palliative treating symptoms. MFR has long lasting often permanent effects on the body with self-treatment practice daily. The decrease in pain and increase in movement and flexibility restores your bodies balance and energy leaving you feeling restored and ready to live an active life.

Each person will heal and progress as individuals. Some patients have relief after their first treatment and others do not. This is highly individual based on diagnosis, chronicity of symptoms, motivation to heal, personal belief system of health and healing, and cultural beliefs can all effect outcomes. Rome was not built in one day and it was not destroyed overnight. Similarly chronic health problems will not turn around overnight.

The good news is that with MFR you can get permanent results.

Usually you will feel great after your myofascial release sessions, especially early on in treatment. But, there may be times when your body will respond to treatment with soreness. Once the fascial system has been affected, increased circulation enters the area through blood flow, carrying oxygen and nutrients critical to the healing process, as well as pushing out the stagnated blood and build-up of lactic acid. Remember our bodies are fluid filled and require movement of fluid in our systems to function in harmony, and maintain homeostasis. Tell the therapist about sore areas because this is valuable information. It tells us where your restrictions are, and where else your body needs treatment. We encourage all of our patients to drink more water, especially after treatments, to help your body flush out the toxins that have been build up in your system over time. This will also help prevent any soreness.

This is what we refer to as a “healing crisis”. It can happen because your awareness has increased and you actually feel how much pain is really there. Most of us have tuned our pain out, and now you are fully feeling it. This increase in signs and symptoms is your body’s way of bringing your awareness into what you are dealing with every day, but you “tune out” and don’t allow yourself to feel. Another reason is that you are getting into the deeper layers of the restrictions. The deeper you go into the restrictions, the closer you get to sensitive areas and as you go into the deeper layers the symptoms intensify and emotions may surface. There will be ups and downs which is normal. The body is not linear. Always remember JFB-MFR is not injurious.

Using self-treatment techniques that your therapist taught you will help you through this process. A regular self-treatment program combined with your therapy session of MFR will help speed your healing process. Spending quiet time bringing awareness into your body will help you get in touch with what lies beneath the layers. Give your body permission to let go of anything that is no longer serving you, and give yourself permission to do and feel whatever you need in order to heal. The post treatment soreness gives the patient and therapist valuable information about where the restrictions are located. So make a note of what you feel and communicate it to your therapist to enhance your treatment experience, speed your results and feel better faster.

Myofascial restrictions can create the symptoms of every diagnosis there is. At times well-meaning clinicians and patients, get caught up in the ”diagnosis”. Remember most diagnosis are just naming of symptoms. It is a label placed on a person’s dysfunction. When you focus on a diagnosis and not the whole body you limit your results. The answer to the question, “Can MFR help with every diagnosis?” Well of course it can. Can it cure every diagnosis? No it cannot. As MFR therapists we learn that freeing up the body from restrictions will allow the body to function more efficiently, and many times correct itself. Not only will this help for acute trauma but also systemic, neural or chronic conditions. JFB-MFR will help peel back and free up not only the physical system restrictions but the emotions that are holding the straight jacket in place.

Yes. You will be given an appropriate individualized self-treatment and home exercise program. Your evaluating therapist will make the decision initially regarding what will benefit you best to begin your healing journey. Then as you progress your home program may change or be expanded upon to meet your current needs.

We encourage you to share changes you have observed in your function between treatments at the beginning of each session. Then to benefit from the MFR process we encourage you to quiet your mind and relax your body so authentic healing can occur.

No. What you are experiencing is what is referred to as a “healing crisis”. It can happen because your awareness has increased and you actually feel how much pain is really there. Most of us have tuned our pain out, and now you are fully feeling it. This increase in signs and symptoms is your body’s way of bringing your awareness into what you are dealing with every day, but you “tune out” and don’t allow yourself to feel. Another reason is that you are getting into the deeper layers of the restrictions. The deeper you go into the restrictions, the closer you get to sensitive areas and as you go into the deeper layers the symptoms intensify and emotions may surface. There will be ups and downs which is normal. The body is not linear. Always remember JFB-MFR is not injurious.

Using self-treatment techniques that your therapist taught you will help you through this process. A regular self-treatment program combined with your therapy session of MFR will help speed your healing process. Spending quiet time bringing awareness into your body will help you get in touch with what lies beneath the layers. Give your body permission to let go of anything that is no longer serving you, and give yourself permission to do and feel whatever you need in order to heal.

The post treatment soreness gives the patient and therapist valuable information about where the restrictions are located. So make a note of what you feel and communicate it to your therapist to enhance your treatment experience, speed your results and feel better faster.