Myofascial Release and the Disconnect from the Physical Therapy Community
I am a physical therapist, though my job is unlike most physical therapists'. Myofascial Release (MFR) has been a modality approved by the medical community and insurance companies for many years. At one time it even had it's own CPT code. So why are so few physical therapists drawn to this work?
When I started learning MFR in the early 1990's seminar classes were filled with Physical Therapists, along with Occupational Therapists and Massage Therapists. That trend slowly changed in the past twenty years. I believe a number of factors are to blame: Changing reimbursement for payment of continuing education dollars to therapists from their employers had an impact, though there was an increase in requirements for CE Hours to renew licensure. Evidence based practice (EBP) trends certainly has played a part, as my profession attempts to elevate itself to a level above where they think they were at. Myofascial Release has always struggled with hard "proof" of its mechanism of action and response. While much has been published over the past decade, the basic science of MFR still remains somewhat unanswered. This does not even take into account some of t more esoteric aspects of MFR, such as unwinding, which is simply a means of self correction. Many "experts" have woven intricate tales linking this phenomenon to energy science, but these tales further distance them from the physical therapy profession. Myofascial Release is now considered a joke amongst many therapy professionals.
I think it is time to bring Myofascial Release back to the physical therapy profession. This would certainly require me to abandon much of the New Age explanation models that have become common. I don't have a problem with this, as I always try my best to use what science is available to best explain what is happening under my hands. Myofascial Release, as a physical modality, does have a great deal of supporting research (see my research page). Maybe it is time to start thinking forward. Though there are those who say they are far ahead of the rest when it comes to MFR, what they are doing is setting us back.I think it is time for this to change.