4th Edition

The Myofascial Release Manual

By Carol Manheim Copyright 2008

    Continuing the tradition that started over 20 years ago and with a new focus on the current terminology regarding each technique, The Myofascial Release Manual is now available in a completely updated and comprehensive Fourth Edition.

    Carol J. Manheim has taken years of knowledge and expertise and incorporated them with the actual intent and result of the myofascial release treatment techniques to bring to the pages of this Fourth Edition essential information for the student and clinician in search of basic information or wanting to refine more experienced skills of these manual therapy techniques.

    Features inside the Fourth Edition:

    -Techniques re-titled to reflect the sensation felt by both the therapist and the patient -More than 75 new photographs—Over 450 in total -Some photographs are shown as a series to allow for movement to be seen during some techniques -Bolded text to call attention to major warnings, contraindications, and target vital information -Italicized text to call attention to important words and key points -More synthesized use of text and photographs to allow for ease of reading and reference -User-friendly organization throughout the text -Photographs use arrows to show direction of stretch and movement -“Carol’s Nuggets” of pearls of wisdom are included throughout the text -Contributions from renowned experts Sam Kegerreis, Robert O. Ward, and Steven Nowicki 

    The Myofascial Release Manual, Fourth Edition continues in the tradition of past editions and presents expert hand placement for the upper quarter, lower quarter, cervical region, abdominal muscles, back muscles, and many more.

    Sections include:

    -Introduction to Myofascial Release -Basic Myofascial Release Techniques -Advanced Myofascial Release Techniques -Evaluation -Additional Resources 

    The description and photographs in The Myofascial Release Manual, Fourth Edition help the therapist experience the technique, making this the continued go-to reference for students and clinicians in physical therapy, manual therapy, and occupational therapy alike.

    Contents

    Dedication

    Acknowledgments

    About the Author

    Preface

    Section I: Introduction to Myofascial Release

    Introduction to Myofascial Release

    Myofascial Therapy

    Sam Kegerreis, MS, PT, ATC

    Biomedical and Infomedical Models

    Pathological Distinctions

    Structural Concepts

    Tensegrity

    Myofascial Restrictions

    Anatomy of Fascia

    Soft Tissue Injuries and Myofascial Pain

    Tightness and Restriction

    Conceptual Models

    Fascia as a Balloon

    Fascia as Plastic Wrap

    Fascia and Muscle as Red Elastic Bands

    Myofascial Release: A Brief History

    Robert C.Ward, DO

    Understanding Myofascial Release

    Trust Feelings

    Basic Principles

    Assumptions

    Process of Change

    Learning Myofascial Release

    Basic Steps: An Overview of Treatment

    Onion Metaphor

    Gross Release of Any Muscle

    Focused Release of Any Muscle

    Gross Versus Focused Release

    Sensation of a Release

    Autonomic Response to a Release

    Response to Myofascial Release

    End-Feel

    Psychological Effects of Myofascial Release and Other Manual Therapies

    Essence of Myofascial Release

    Special Considerations

    Enigma of the \u201cGood Hurt\u201d

    Boundaries

    Significance of Touch and Nonverbal Communication

    Steven Nowicki, PhD

    Focusing on Feedback: Communication Exercises

    Exercise 1. Communicating Emotions

    Touch As Communication

    Exercise 2. Personal Space

    Protocols for Myofascial Release

    Indications

    Contraindications

    Precautions

    Pre-Treatment Protocols

    Establishing the Therapeutic Environment

    Testing for Vascular Integrity

    Post-Treatment Protocols

    Drink... Drink... Drink

    Be Kind to Your Hands

    Section II: Basic Myofascial Release Techniques

    Upper Quarter Release

    Release of the Shoulder Rotators

    A Learning Exercise: Focusing on Feedback

    Sidelying Release of the Parascapular Muscles

    Lower Quarter Release

    Sidelying Release of the Gluteal Muscles

    Trapezius

    Bilateral Release of the Upper Trapezii

    Unilateral Release of the Upper Tr apezius

    Focused Release of the Upper Trapezius

    Release of the Splenius Capitis and Semispinalis Capitis

    Bilateral Release of the Middle Trapezii

    Unilateral Release of the Middle Trapezius

    Focused Release of the Middle Trapezius

    Release of the Lower Trapezius

    Focused Release of the Lower Trapezius

    Cervical Region

    Release of the Posterior Cervical Musculature

    Cranial Base Release

    Gross Release of the Sternocleidomastoid

    Focused Release of the Sternocleidomastoid

    Gross Release of the Scalp Muscles: Hair Release

    Gross Release of the Face Muscles: Ear Release

    Gross and Focused Release of the Scalp and Face Muscles

    Release of the Hyoids

    Pectoralis Major and Minor

    Release of the Horizontal Fibers of the Pectoralis Major

    Release of the Diagonal Fibers of the Pectoralis Major

    Release of the Pectoralis Minor

    Intercostals and the Rib Cage

    Gross and Focused Release of the Intercostal Muscles

    Release of the Rib Cage

    Gross Release of the Quadratus Lumborum

    Abdominal Muscles

    Gross Release of the Rectus Abdominis

    Gross Release of the Abdominal Obliques

    Gross Release of the Tranversus Abdominis

    Iliopsoas

    Gross Release of the Iliopsoas

    Focused Release of the Iliacus

    Pectineus

    Focused Release of the Pectineus

    Piriformis

    Focused Release of the Piriformis

    Lower Extremity Muscles

    Gross Release of the Quadriceps Femoris

    Gross Release of the Sartorius

    Gross and Focused Release of the Tensor Fascia Lata

    Gross and Vertical Gross Release of the Hamstrings

    Gross Release of the Anterior Tibialis

    Focused Release of the Peroneus Longus

    Gross Release of the Soft Tissue of the Forefoot and Toes

    Gross and Focused Release of the Plantar Fascia

    Gross and Focused Release of the Gastrocnemius

    Gross Release of the Soleus

    Gross Release of Both Legs and the Lower Trunk

    Back Muscles

    Gross Release of the Levator Scapula

    Gross Release of the Rhomboids

    Focused Release of the Supraspinatus

    Focused Release of the Infraspinatus

    Gross and Focused Release of the Teres Major and Minor

    Gross Release of the Subscapularis

    Gross and Focused Release of the Erector Spinae

    Sidelying Gross Release of the Quadratus Lumborum

    Sidelying Gross Release of the Latissimus Dorsi

    Sidelying Gross Release of the Iliocostalis Lumborum

    Upper Extremity Muscles

    Gross Release of the Deltoids

    Gross and Focused Release of the Biceps Brachii

    Gross and Focused Release of the Brachialis

    Gross and Focused Release of the Brachioradialis

    Gross Release of the Wrist and Finger Extensors

    Gross Release of the Extensor Carpi Radialis

    Focused Release of the Extensor Carpi Ulnaris

    Gross Release of the Pronator Teres

    Focused Release of the Wrist and Finger Flexors

    Focused Release of the Flexor Carpi Radialis

    Focused Release of the Flexor Carpi Ulnaris

    Focused Release of the Adductor Pollicis

    Focused Release of the flexor Pollicis Brevis

    Focused Release of the Interosseus

    Gross Release of the Abductor Digiti Minimi

    Gross Release of the Soft Tissue of Each Finger

    Gross Release of the Triceps

    Focused Release of the Triceps

    Gross Release of Both Arms and the Upper Trunk

    Section III: Advanced Myofascial Release Techniques

    Anterior Chest Wall Release

    Thoracic Fascia Release

    Diaphragm Release

    Pelvic Floor Release

    Sacral Fascia Release

    Myofascial Trigger Points

    Trigger Point Release

    Tender Points

    Tender Point Release

    Skin and Scar Restrictions

    Evaluating Skin and Scar Mobility

    Skin Roll Release

    \u201cJ\u201d Stroke Release

    Scars

    Indirect Gross Scar Release

    Direct Gross Scar Release

    Vertical Direct Gross Scar Release

    Direct Scar Skin Roll Release

    Indirect Scar Skin Roll Release

    Direct Focused Scar Release

    Myofascial Strum Release

    Long Stroke Strum Release

    Short Stroke Strum Release

    Dural Tube Dysfunction

    Testing for Dural Tube Dysfunction

    Criteria for Performing a Dural Tube Release

    Dural Tube Anatomy Metaphor

    Dural Tube Release

    Combination Releases

    Treatment in Three Dimensions

    Section IV: Evaluation: Initial Assessment

    General Considerations

    Initial Interview

    Posture Evaluation

    Pain Assessment

    Headaches

    Section V: Additional Resources

    Posture Evaluation

    Standing—Facing Forward

    Standing—Facing Right

    Standing—Facing Left

    Standing—Facing Backward

    Sitting—Front View

    Sitting—Right View

    Sitting—Left View

    Sitting—Back View

    Supine—Observation and Palpation

    Prone—Observation and Palpation

    References

    Additional References

    Index

    Biography

    Carol J. Manheim, MS, MEd, PT, LPC, received her MS degree from Case Western Reserve University and her MEd in clinical counseling from The Citadel. Ms. Manheim is a physical therapist and licensed professional counselor in private practice in Charleston, South Carolina.

     "…the manual style format allows users to access various techniques efficiently, based upon anatomical category."  

    — Lynee Dewar, MCSP