Shiny New Things
As a veteran of the manual therapy wars (here and here), I've seen the fascial debate from both sides, first as an avid believer and later as a wizened skeptic. Today I'm jaded after seeing how education models divide us into camps, each claiming dominance over a specific tissue or pathology. For a few decades, fascia and fascially-explained therapies were hot in the physical and massage therapy worlds and, to some extent, remain so, and big-box educators continue to teach MFR in all its various incarnations. MFR is helpful, but why? Is it because trained clinicians can selectively access fascial problems? So far, the research has done little to support those views. Does the hands-on work describe as MFR help people move with greater ease? Indeed, as do dozens of other named and unnamed modalities, though this is one thing seldom compared; a head-to-head comparison of modalities under controlled conditions. Therapeutic interactions tend to help the person seeking help.
In 1992, I discovered a shiny new thing—myofascial release (MFR). Based on advice from my professional physical therapy association, I was skeptical, but I enjoyed the training and saw promise for the model. That MFR model carried a lot of baggage, such as the teaching that emotional trauma is stored in the fascia and that a person can heal (mind and body) only through a trained MFR therapist. MFR "worked," but I did little to compare it with other models. I used my shiny new thing with every patient who came my way. Positive outcomes were seen as proof of the model's explanations. It took some hard decisions to move on from that model, but I finally did.
When I finally broke free of the MFR tribe, I hesitated to grab the next shiny object, though I did tinker with a few. Shiny bright objects are sold to us with the hopes that we keep coming back for more. Instead, I'm now able to see that the results of any intervention, be it manual therapy, exercise-based, or behavioral/education interventions, across the spectrum of allied health professions tend to be influenced by factors such as therapeutic alliance. From a practical perspective, claiming to be able to select and treat a single tissue or pathology beneath the skin is impossible, though many speak of these metaphoric concepts as fact. However, this concept seems lost on the purveyors of fascial (and other) interventions.
I've lived through that phase of my life when the MFR shiny things mattered, though, over time, its luster dulled. It took me many years to toss that object away, but it is done.
My movement as an educator with speech pathologists, RDHs, and others working with oral motor, voice, tongue, swallowing, breathing, and related problems took me into a field where fascia was still a factor, though to a much smaller degree. However...
Recently I noticed that fascia has become a bright shiny thing in the orofacial myofunctional communities, with tentacles into the SLP domain. The concepts have been passed around many online groups by recycling a graphic purportedly showing the direct reach of fascia from the underside of the tongue that extends down to the toes. Such representations can generate a lot of buzz (which is their point), but what are they showing? We are interconnected, head to toe, and in any other direction you wish to present. There remains a basic problem with these memes. The only way to physically change that tongue-to-toe interconnectedness is by a tongue tie release, laser, or otherwise. I understand that such recommendations are often made