Having completed this lesson, you will be able to:

• List five methods commonly used in myofascial approaches (e.g., crossed-hand stretch, fascial spreading, fascial torqueing, fascial cutting, fascial bowing, arm and leg pulling, etc.).
• Match myofascial methods to previously learned application method categories (e.g., crossed-hands stretch is an elongation method, fascial torqueing is a torsion method, etc.).

Following are some key techniques for working with myofascia, but these are not all of the recognized myofascial techniques a massage therapist might use. Additional techniques are covered in upcoming chapters, but others are omitted because they are best reserved for continuing education classes once you have mastered your core massage curriculum and practiced professionally for a certain period of time. The broad categories of techniques demonstrated here include myofascial skin rolling, gross myofascial stretches, and focused myofascial stretches. Passive range of motion is used at the conclusion of work on each body area, while active range of motion is used at the very end of the session to re-educate proprioception.

Myofascial Skin Rolling

The first technique to use in myofascial work, skin rolling, you already know. The difference here is that you do not use lubricant and you will be watching for fascial restrictions and working very slowly. Roll the skin along the fiber direction of the muscle tissue and cover the entire body area (e.g., skin roll the entire back region, or the entire posterior leg). Next, skin roll horizontally across the fibers of the muscle tissue. Now skin roll at oblique angles to the muscle fibers. Roll the skin in the entire area fully so that the tissue is warm and pliable before moving on to the next myofascial technique. Notice that the skin has developed red tracks where you passed over the tissue. This hyperemia is a positive sign that the ground tissue is warmed and moving toward a sol state. Skin rolling is shown in Technique 19 (Pétrissage) in Chapter 13.

Gross Myofascial Stretches

Techniques broadly categorized as gross myofascial stretching include arm and leg pulling and crossed-hand stretches. As the name suggests, these techniques address broad fascial restrictions and help the therapist identify particular areas that need more focused work. Arm pulling is demonstrated in Technique 64 and leg pulling in Technique 65, and crossed-hand stretches are shown in Technique 66. Arm and leg pulling with a client in a side-lying position is not shown here but is another effective way to apply this technique. Contraindications for arm pulling include acute or subacute sprains, strains, or injury in the regions of the shoulder, elbow, or wrist. Leg pulling is contraindicated if the client has acute or subacute sprains, strains, or injury in the region of the hip, knee, ankle, or back. Any local condition such as a skin condition or edema that might be exacerbated by these techniques is also contraindicated, as is any condition that would contraindicate massage. Work slowly and within the comfort level of the client at all times.

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Focused Myofascial Stretches

A number of different techniques can be categorized as focused myofascial stretches. While gross stretches reduce fascial restrictions in broad sheets, focused stretches hone in on particular areas, address the denser fascia around joints, work with deeper fascia in a particular area, or release the tissue of a particular muscle. Focused myofascial stretches include fascial spreading (Technique 67), fascial torquing (Technique 68), fascial cutting (Technique 69), and fascial bowing (Technique 70).

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Passive and Active Range of Motion

Passive range of motion is used at the end of work on a particular body area. Passive joint movement is described in Chapter 13, and shown in Technique 26 in that chapter. At the end of the session when the client has finished dressing, have the client actively move joints through their full range of motion. This takes as little as 5 minutes and can dramatically improve the long-term effects experienced from the session.