Myofascial Release (MFR) is an extremely popular manual therapy approach used by therapists in many professions treating neuromusculoskeletal problems. It is so popular, in fact, that the most well known MFR educator, John F. Barnes, claims to have instructed over 50,000 therapists worldwide in his approach. With so many therapists using MFR and, according to Barnes, “the consistent, profound results of myofascial release are so impressive, even when all else has failed, critics have said it is impossible because it breaks the laws of science.”, the results of a systematic review published by Remvig et al. are somewhat surprising.
The researchers conducted a literature search on PubMed, the Cochrane Library and on www.fasciaresearch.com. They also conducted an assessment of the rationale for the treatment within the studies. The search on PubMed resulted in 71 references, but only 23 were about manual MFR. A similar search in The Cochrane Library gave 13 hits, 5 about MFR and all of these already included in the 23 PubMed references. No futher supplements were found at www.fasciaresearch.com.
According to their results:
No studies were found with which to determine reliability of the diagnostic method. Four randomised controlled studies of the treatment were identified. Two of the efficacy studies comprised several different modalities of treatment, so that no conclusions could be drawn. In one further study, the numbers were too small to allow safe conclusions; in the other, the myofascial release treatment was inferior to an isometric contract-relax technique. Overall, no good evidence of efficacy has been shown.
The current evidence did not allow conclusions on the diagnostic criteria and methods or demonstrate any efficacy of myofascial release. Remvig et al. strongly recommended that “reliability studies be performed on diagnostic tests for myofascial dysfunction (tightness/looseness), so that efficacy studies can be performed on a more solid diagnostic foundation”.