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Hironobu Kuruma, PT, PhD, OMT1), Hitoshi Takei, PT, PhD, OMT1),
Osamu Nitta, PT, PhD1), Yorimitsu Furukawa, PT, PhD1), Nami Shida, PT, MS1),
Hiroyo K amio, PT, MS1), K en Yanagisawa, PT, PhD1)
1) Divisionof Physical Therapy, Tokyo Metropolitan University: 7-2-10 Higashiogu, Arakawa-ku,
Tokyo, Japan. TEL: +81 3-3819-1211, E-mail: kuruma@hs.tmu.ac.jp
Abstract. [Purpose] Myofascial release is a manual soft tissue technique that is frequently used in physical ther-
apy, but few reports on the effectiveness of myofascial release are available. We compared the effects of myofas-
cial release and stretching on range of motion, muscle stiffness, and reaction time. [Subjects and Methods] Forty
healthy individuals were randomly allocated to four groups: myofascial release for quadriceps; myofascial release
for hamstrings; stretch for quadriceps; and controls. [Results] Active range of motion was significantly increased
in the two myofascial release groups and the stretch group. Passive range of motion was significantly increased by
myofascial release in the quadriceps and stretching groups. No significant differences in muscle stiffness were seen
between before and after the interventions. However, premotor time was significantly reduced by myofascial release
in the quadriceps and hamstrings groups, with significant differences observed in this parameter between both the
quadriceps and hamstrings groups and controls after the interventions. Compared to controls, reaction time was
significantly lower after the interventions in the quadriceps and hamstrings groups. [Conclusion] Myofascial release
improves not only range of motion, but also ease of movement.
Key words: Myofascial release, Stretching, Reaction time
(This article was submitted Aug. 22, 2012, and was accepted Oct. 19, 2012)
among the groups. The MFR-Q group participants lay in the and several reports have shown that this technique improves
supine position and received MFR for the quadriceps muscles P-ROM1012). Similar to these results, the present findings
for 8min. Similarly, the MFR-H group participants lay in also showed an increase in P-ROM after MFR. Furthermore,
the supine position and received MFR for the hamstrings for as has been reported for stretching, MFR has also been
8min. The stretch group subjects lay in the prone position shown to improve A-ROM. MFR realigns the fascial planes,
and received static stretching of the quadriceps muscles for resets the soft tissue proprioceptive sensory mechanism,
8min. The control group participants lay supine for 8min. and ensures a normal functional range of motion13). MFR-Q
Before and after these interventions, active ROM, passive realigned the fascia around the quadriceps, allowing
ROM, muscle stiffness, and RT were measured. Active knee increases in A-ROM and P-ROM of knee flexion.
flexion ROM (A-ROM) was measured with a universal Interestingly, MFR-H also increased the ROM of knee
goniometer (accurate to 1) three times with participants flexion. Fascia represents connective tissue that is present
in the prone position. Passive knee flexion ROM (P-ROM) throughout the body in a three-dimensional web. If the
was measured in a similar manner. Muscle stiffness was fasciae lose their pliability and become restricted, the rest
measured three times using a durometer (Type FP; Asker, of the body becomes tense1). If fascia in the hamstring area
Kyoto, Japan) at points 10, 15, and 20cm above the lateral loses pliability, the range of knee flexion is affected. Thus,
knee joint space. RT of knee extension was measured using MFR-H may have increased the ROM of knee flexion.
an electromyogram (Polygraph RM-7000; Nihon Kohden, No significant differences in muscle stiffness were
Tokyo, Japan and Power Lab; AD Instruments, Nagoya, identified among the groups. Mahieu et al. compared the
Japan) and a Biodex system 3 (Biodex Medical Systems, effects of static and ballistic stretching14). The training
New York, USA). Subjects sat on the Biodex system with program involved self-administered calf muscle stretching
the hip and knee joints flexed at 90, and were asked to every day for 6 weeks. The passive stiffness of the Achilles
contract the quadriceps muscles as quickly as possible after tendon decreased significantly in the ballistic group after
a sound signal. Before the signal was presented, the muscles treatment. However, no significant changes were found in
were at rest. Three trials were carried out at different time the static group. LaRoche et al. also investigated the effects
periods, and mean latency between the sound signal and of stretching with a training program that involved passive
electromyogram (EMG) onset, premotor time (PMT), mean hamstring stretching using an isokinetic dynamometer for 4
motor time (MT), and mean reaction time (RT) between weeks12). They found no changes in muscle stiffness after
stimulus and onset of force generation were measured. treatment. Our present study investigated the effects of static
The significance of the differences between measurements stretching and our results in terms of muscle stiffness are
before and after intervention was analyzed using Students in agreement with those of these previous studies. MFR
t test. Differences between the different techniques used showed no effects on muscle stiffness.
were evaluated by two-way repeated analysis of variance. The stretch group in our study showed no significant
The least squares differences method was used for post-hoc decrease in RT after treatment. Alpkaya and Koceja inves-
analysis. Values of p < 0.05 were considered statistically tigated the effects of static stretching of the calf muscles
significant. All statistical analyses were performed using on RT15). They concluded that static stretching had neither
SPSS version 15 software (SPSS, Tokyo, Japan). positive nor negative effects on RT, similar to the findings
of the present study. On the other hand, we found that MFR
RESULTS decreased PMT and RT. MFR realigns the collagen fibers,
and may also improve the sliding of actin and myosin during
A-ROM was significantly increased in the MFR-Q, contraction. Thus, after MFR for the quadriceps, subjects
MFR-H, and stretch groups (Table 1), and significant may find contraction of the quadriceps muscles easier, thus
differences were evident between these three groups and decreasing PMT and RT. MFR-H reduced the resistance of
the controls after interventions. P-ROM was significantly the hamstrings, also reducing PMT and RT.
increased in the MFR-Q and stretch groups (Table 2). Both MFR and static stretching improved ROM by
Furthermore, significant differences were identified between improving muscle and myofascial tension. Only MFR
the MFR-Q, MFR-H, stretch groups and the controls after improved RT. Since stretching exercises only increase muscle
the interventions. No significant differences in muscle length, only ROM is improved. MFR techniques, on the other
stiffness were observed among the groups (Table 3). The hand, influence fascial restrictions and realign the fascial
results for PMT, MT, and RT are shown in Table 4. PMT was planes, thereby resetting the soft tissue proprioceptive sensory
significantly lower after MFR-Q and MFR-H compared to mechanism, improving both ROM and ease of movement.
the pre-intervention values. Significant differences in PMT
were observed between the MFR-Q, MFR-H groups and the References
controls after the interventions. RT was significantly lower
1) Barnes MF: The basic science of myofascial release: morphologic change
after MFR-Q and MFR-H compared to the post-intervention
in connective tissue. J Bodyw Mov Ther, 1997, 1: 231238. [CrossRef]
values of controls. 2) Schleip R: Fascial plasticity- a new neurobiological explanation: part1. J
Bodyw Mov Ther, 2003, 7: 1119. [CrossRef]
DISCUSSION 3) Williams PE, Goldspink G: Connective tissue changes in immobilized
muscle. J Anat, 1984, 138: 343350. [Medline]
4) Williams PE: Effect of intermittent stretch on immobilised muscle. Ann
Many studies have investigated the effects of stretching, Rheum Dis, 1988, 47: 10141016. [Medline] [CrossRef]
171
Table 1. Active range of motion before and after intervention () Table 2. Passive range of motion before and after intervention ()
Before After Before After
MFR-Q 140.0 (1.7) 144.1 (1.5) * MFR-Q 148.3 (2.0) 151.9 (1.5) *
MFR-H 140.1 (2.2) 143.2 (1.8) * MFR-H 149.1 (2.5) 151.3 (2.2)
Stretch 141.5 (1.0) 145.0 (0.8) * Stretch 148.2 (1.0) 151.4 (1.1) *
Control 140.8 (2.7) 141.3 (2.6) Control 148.9 (2.7) 148.43 (2.8)
Students t test was perfomed before and after intervention (*<0.05) Students t test was perfomed before and after intervention (*<0.05)
Repeated mesures ANOVA was performed (compared control <0.05) Repeated mesures ANOVA was performed (compared control <0.05)
Before After
MFR-Q 267.4 (66.5) 223.3 (46.7) *
MFR-H 267.2 (86.5) 200.7 (45.3) *
Premotor time (PMT)
Stretch 239.6 (46.6) 232.1 (53.2)
Control 247.6 (71.3) 230.3 (44.8)
MFR-Q 177.3 (49.1) 170.2 (50.5)
MFR-H 142.8 (47.2) 141.7 (22.5)*
Motor time (MT)
Stretch 149.1 (40.7) 136.4 (11.2)
Control 160.4 (22.2) 165.0 (25.9)
MFR-Q 443.9 (82.9) 383.6 (66.0) *
MFR-H 412.3 (65.5) 342.4 (48.7) *
Reaction time (RT)
Stretch 388.8 (76.9) 368.4 (56.3)
Control 408.1 (83.4) 387.9 (64.2)
Students t test was perfomed before and after intervention (*<0.05). Repeated
mesures ANOVA was performed. (compared control <0.05)
5) Takei H: Myofascial release. Rigakuryouhou Kagaku, 2001, 16: 103107 of the hamstring muscles. Phys Ther, 1994, 74: 845850. [Medline]
(in Japanese). 11) Bandy WD, Irion JM, Briggler M: The effect of time and frequency of
6) Hanten WP: Effects of myofascial release leg pull and sagittal plane static stretching on flexibility of the hamstring muscles. Phys Ther, 1997,
isometric contract-relax techniques on passive straight-leg raise angle. J 77: 10901096. [Medline]
Orthop Sports Phys Ther, 1994, 20: 138144. [Medline] 12) LaRoche DP, Connolly DA: Effects of stretching on passive muscle
7) Tozzi P, Bongiorno D, Vitturini C: Fascial release effects on patients tension and response to eccentric exercise. Am J Sports Med, 2006, 34:
with non-specific cervical or lumbar pain. J Bodyw Mov Ther, 2011, 15: 10001007. [Medline] [CrossRef]
405416. [Medline] [CrossRef] 13) Barns JF: Myofascial release: the search for excellence. Paoli: National
8) Martin MM: Effects of myofascial release in diffuse systemic sclerosis. J Library of Medicine, 1990.
Bodyw Mov Ther, 2009, 13: 320327. [Medline] [CrossRef] 14) Mahieu NN, Mcnair P, Muynck MD, et al.: Effect of static and ballistic
9) Ajimsha MS, Chithra S, Thulasyammal RP: Effectiveness of myofascial stretching on the muscle-tendon tissue properties. Med Sci Sports Exerc,
release in the management of lateral epicondylitis in computer profes- 2007, 39: 494501. [Medline] [CrossRef]
sionals. Arch Phys Med Rehabil, 2012, 93: 604609. [Medline] [CrossRef] 15) Alpkaya U, Koceja D: The effects of acute static stretching on reaction
10) Bandy WD, Irion JM: The effect of time on static stretch on the flexibility time and force. J Sports Med Phys Fitness, 2007, 47: 147150. [Medline]