Liberação Miofascial Técnicas

Prévia do material em texto

S:\2011 official handouts\Sessions handouts\Myofascial Release Techniques.doc1/28/2015 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MMYYOOFFAASSCCIIAALL RREELLEEAASSEE 
TTEECCHHNNIIQQUUEESS 
 
S:\2011 official handouts\Sessions handouts\Myofascial Release Techniques.doc1/28/2015 
 
S:\2011 official handouts\Sessions handouts\Myofascial Release Techniques.doc1/28/2015 
TABLE OF CONTENTS 
 
 
Myofascial Technique Overview 
 
Superficial Back Line 
 
Plantar Fascia 1-2 
Gastrocnemius/Soleus 3 
Hamstrings 4-5 
Erector Spinae Prone 16 
 Seated 11-12 
 Mountains & Valleys 13-15 
Scalp 17 
Cervical Posterior 18 
Suboccipital Traction 19 
 
 
Superficial Front Line 
 
Dorsal Foot 6-7 
Anterior Tibialis 8-9 
Rectus Femoris 10 
Trunk 20-21 
Neck Anterior & lateral 22-24 
 
 
Leg Traction 25 
 
Anatomy 
 
Superficial Back Line 26-27 
Superficial Front Line 28-29 
 
 
This handout is laid out as it will be presented in class-lower body: superficial back and front line, the 
upper body: superficial back and front line. It was documented this way for the student’s benefit so we 
do not leave class feeling unbalanced. 
 
S:\2011 official handouts\Sessions handouts\Myofascial Release Techniques.doc1/28/2015 
Myofascial Techniques 
 
 
 
In the following techniques we will be looking at affecting the fascia and myofascia of the body. This 
in turn will affect the muscles increasing movement and generally creating space for not only muscle 
but bones, nerves, blood and lymphatic vessels and organs to function unencumbered. 
 
Fascia is the most abundant of tissues in the human body. It invests, surrounds, separates, and supports 
other structures of the body. Dr. John Upledger, DO refers to it as “the inner body stocking”. When 
healthy and non-restricting it could be described as a similar to a mesh much like a piece of cheese 
cloth soaked in a semi-dried glue with a great amount of tensile strength. It can be stretched and return 
to its original state. It can be shortened and returned to its original state. However, with lack of 
movement, sustained lengthening or shortening or sudden injury over-stressing it’s anatomy it can 
retain its new found position and take on the consistency of cheese cloth whose glue has hardened. 
 
There are many varied techniques to treat the fascia ranging from John Barnes’ slow sustained 
stretching and tractioning, CranioSacral’s even more subtle manipulations to more aggressive 
interventions such as Rolfing. 
 
In these classes you will be learning very simple techniques that you can apply in the context of a full 
myofascial session or integrate pieces of this work into your myomassology sessions. The individual 
techniques are not as important as is your general understanding of working with the fascial system 
to enhance your effectiveness in soft tissue release and normalization. 
 
The main differences between myofascial and other massage strokes are as follows: 
 
 
 Use little or no lubricant (Still staying within the clients tolerance) 
 Stroke with specific intent to affect the fascia (lengthen, widen, make more pliable) 
 Keep the fascia engaged (stroke/stretch) 
 Be aware of the connectiveness of this tissue to other tissues. 
 
Finally, “Put it where it belongs and call for movement”. This quote from Ida Rolf, simple as it is, 
leads us to a complex concept when applied to a case by case application. We will use it in its 
simplest interpretation and applied to the work presented here to mean- 
 
 Stroke down on the tissues of the Superficial Back Line 
 Stroke up on the tissues of the Superficial Front Line 
 
 
We will be following the concept and theory of Thomas Myers’ Anatomy Trains. We will only be 
scratching the surface and this is intended to be an introduction to this work. If interested it is 
suggested that you delve further into his writings and theories. 
 
 
 
 1 
 
Superficial Back Line 
Plantar Fascia 
 
Clients Position- Prone with foot hanging off the table 
 
Area of Treatment- Plantar fascia lateral arch 
 
Using the knuckles stroke from the anterior calcaneus to base of 
 the fifth phalange 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Area of Treatment- Plantar fascia medial arch 
 
Using the knuckles stroke from the anterior calcaneus to base of the first 
phalange 
 
 
 
 
 
 
 
 
 
 
 
 
Note: You may hyperextend the toes and then stroke 
Clients Position- Prone with foot hanging off the table 
 
 2 
 
Area of Treatment- Plantar fascia midline 
 
Using the knuckles stroke from the anterior calcaneus to base of the third phalange 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Area of Treatment- Plantar fascia distal transverse arch 
 
Using the knuckles beginning just medial to the fifth metatarsal head stroke across the arch ending just 
medial to the first metatarsal head. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 3 
Gastrocnemius/Soleus 
 
Area of Treatment- Gastrocnemius and soleus stroke 
 
Using the posterior proximal phalanges of the “soft, conforming, open handed fists” to stroke 
beginning 1-1 ½ “distal to the knee ending at the ankle. This stroke is performed by leaning your 
weight over your arms until your hands glide in the desired direction. As the leg narrows taper your 
stroke and focus to the index fingers. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 
Hamstrings 
 
 
Area of Treatment- 
Biceps femoris, semitendinosus, semimembranosus 
 
 
Stroke from the ischial tuberosity to the lateral aspect of the knee 
in the same manner used previously for the calf muscles. 
 
Do not stroke into the popliteal space (behind the knee). 
 
 
 
 
 
 
 
 
 
 
 
Area of Treatment- 
Biceps femoris, semitendinosus, semimembranosus 
 
With clients knee flexed palpate for the apex of the muscles outlining the popliteal (where the medial 
and lateral hamstrings separate). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 5 
Utilizing three fingers of each hand place your fingertips into the “valley” between the medial and 
lateral hamstrings. Perform a deep gliding friction movement in a superior then inferior direction. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Most inferior finger 
 
 
 
 
 
 
 
 
 
 
 
As you perform this friction movement have 
client medially then laterally rotate the lower leg. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 6 
Superficial Front Line 
Dorsal Foot 
 
Area of Treatment- Extensor tendons of the foot 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Engage the fascia of the tendons and stroke from the toes to the ankle. 
 
 
 
Area of Treatment- Intrinsic muscles of the foot 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Stroke betweenthe metatarsals from the toe web to the tarsals. 
 
 
 
 7 
Extensor Retinaculum 
 
Area of Treatment- Anterior ankle 
 
 
 
 
Using a molding-conforming non-fist stroke from the 
tarsals up over the retinaculum. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 8 
Anterior Tibialis 
 
Area of Treatment- Anterior leg compartment between anterior tibialis and the tibia 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Using knuckles engage and stroke the area just lateral 
to the tibialis and medial to the anterior tibialis from the 
ankle to the tibial condyle. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 9 
 
Area of Treatment- Anterior leg compartment between anterior tibialis and the tibia 
 
 
Place knuckles (or fingertips as shown below) Into 
the space between the tibia and the anterior tibialis. 
Allow them to sink into the tissues. While applying 
pressure without movement instruct client to plantar 
then dorsiflex their foot. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Area of Treatment- Anterior tibial fascia 
 
 
 
 
 
 
 
 
 
 
Place knuckles together forming a “roof”. Place this 
roof over the tibia with the lateral edge of the tibia 
riding in the peak of the roof. Engage and stroke from 
the ankle to the tibial condyles then separate hands as 
you spread laterally and medially. 
 
 
 
 
 
 10 
Thigh 
 
Area of Treatment- Rectus Femoris 
 
 
 
Using either the fist surface of the hand or your forearm stroke 
from 1-11/2” above the knee to the ASIS (anterior superior iliac 
spine) of the ilium. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
You may wish to repeat this stroke over the lateral 
quadriceps muscles if either feels more toned than the 
other. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Instruct client to raise their knee from the table and lower with the stroke. 
 
 
 
 
 
 
 
 11 
Superficial Back Line 
 
 
The following movement is performed with client in a seated position as shown: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Hips above knees Feet together 
 Slight extension at knees Weight forward on fe 
 
 
 
Area of Treatment- Longissimus, iliocostals, spinalis, semispinalis rotatores & multifidus 
 
 
Standing behind client place flat of fists along both sides of the spine on level of C7. 
 
 
 
 
 
 
 
Instruct client to perform the following movements in progression slowly, one vertebra at a time: 
 
1. tilt their head forward 
2. using the weight of the head round their neck 
3. using the weight of the neck and shoulders arch their back 
4. using the weight of the torso round the lumbar and posteriorly rotate/tilt their pelvis 
 
 
Keep the fascia of each region engaged as you stroke from C7 as far down the spine as possible. 
 
(See following page) 
 
 
 12 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
This movement should be performed by keeping your body weight over the 
client and not forcing but allowing your hands to move down along the spine. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 13 
 
Next we evaluate for “valleys and mountains”. 
 
A valley is an area of the spine whereby the spine seems to sit in a “valley” of muscle (more anterior). 
This is commonly found where there is a lordotic spine. 
 
 
 
 
 
 
 
 
 Valley 
 
 
 
 
 
 
 
 
 
The opposite a mountain is where the spine is projected posterior to the paraspinal muscle 
 
 
 
 
 
 
 
 
 
 
 Mountains 
 
 
 
 
 
 
 
 
 
Evaluate for mountains and valleys in a seated or standing position only (not while they are bent 
over). Take note of your findings and treat accordingly. 
 
 
 
 
 14 
 
A simple rule is used for treatment- Pile up on the mountains –Dig out the valleys 
 
Following assessment instruct the client to perform the movement on the previous page. 
 
. 
 
 
 
 
 
As they do- Pile up on the mountains –Dig out the valleys in the following manner 
 
 
 
Stroke diagonally into the lateral aspect of the 
erector spinae “piling up on the mountains”. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 15 
 
 
 
 
 
 
 
 
 
 
Place knuckles medial to the muscles on both 
Sides of the valley and stroke laterally 
“digging out the valley”. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 16 
Erector Spinae 
 
 
Area of Treatment- Longissimus, iliocostals, spinalis, semispinalis rotatores & multifidus 
 
 
Using the flat of the forearm near the elbow stroke from the upper 
trapezius to the iliac crest and over the sacral fascia 
 
 
 
 
 
 
 
 
 
 
 
 
 At level of scapular inferior angle 
 “turn the corner” and stroke with 
 position shown 
 
 
 
 
 
 
 
 
 
 
 
 Ask client to inhale and hold their 
 breath as you continue to stroke 
 over the lumbar onto the sacrum. 
 Have client exhale. 
 
 
 
 
 
 
 
 
 
 
 
 
 17 
 
Scalp Fascia 
 
 
Area of Treatment- Galea aponeurotica 
 
 
 
 
 
 
 
 
 
 
 
 
 Galea aponeurotica 
 
 
Client positioned supine as you sit at the head of the 
table place your fingers on the posterior skull feeling 
for ridges in the scalp. To do this have fingers contact 
the scalp through the hair. If found take these fascial 
ridges and stretch them slowly and gently in an inferior 
direction. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 18 
 
 
Cervical Region 
 
Area of Treatment- Erector spinae (Longissimus cervicis, spinalis, semispinalis, etc.) 
 
 
 
 
Contact the erector spinae muscles (anterior to the 
upper trapezius and behind the sternocleidomastoid) 
on level of C6 and stroke up to the occiput. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Swing your elbow using the entire arm for this move. 
 
 
 
 
 
You may also reverse the direction by un-curling 
your fingers and stroking down the erector spinae. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 19 
 
 
Suboccipital Region 
 
Area of Treatment- Erector spinae (Longissimus cervicis, spinalis, semispinalis, etc.) 
 
 
 
 
Cup clients head in your pals and curl your 
fingers back to almost 180° and contact the 
occipital “ledge” gently with your fingertips.Next bring your hands down and into the 
table. As you do so traction the head toward 
you. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 20 
Superficial Front Line 
 
Trunk 
 
Area of Treatment- Rectus Abdominis 
 
 
 
 
 
 
 
 
 
Begin this technique with your fingers curled 
placed on level of the umbilicus just off the 
midsaggital line. 
 
 
 
 
 
 
 
 
 
 
 
Uncurl your fingers, engaging the fascia, and stroke up over the costal cartilage to approx. the fifth rib. 
Do not stroke or put pressure on the xiphoid process. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 21 
Area of Treatment- Obliques and sternal fascia 
 
 
Stroke just inferior to the lower margin of the costal 
cartilage following the contour moving onto the cartilage 
just lateral to the sternum to the clavicle. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Continue just inferior to the clavicle laterally ending 
at the pectoralis major insertion on the arm. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Neck 
 
 22 
 
Area of Treatment- Sternocleidomastoid and posterior neck 
Do not contact the neck anterior to the sternocleidomastoid! 
 
 
Use your conforming non-fist to contact the lateral neck 
with your knuckles resting at the anterior border of the 
sternocleidomastoid (see below). Pressure should be 
sufficient to engage the fascia using little compressive force. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Instruct client to rotate head/neck away from you (rotate on the midsaggital plane – not rolling the 
back of their head on the table) as their movement stretches the fascia. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As they rotate head/neck lower elbow and stroke across back of neck 
Alternate technique 
Area of Treatment- Sternocleidomastoid and posterior neck 
 
 
 23 
 
 
 
 
 
 
 
 
 
 
 
With clients head rotated to the opposite side place your non-fist on the sternocleidomastoid, engage 
and stroke accross the posterior neck. 
 
 
NOTE: When rotating clients head or asking them to do so their head/neck should be kept in line with 
the long axis of the spine. To do so lift head from table and turnhead. Remember the head rotates 
from the C1-C2 joint (Figure 1). Do not allow client to “roll head” on table moving off the midsaggital 
line. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Figure 1 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Figure 2 
 
Area of Treatment- Sternocleidomastoid 
 
 
 24 
 
With the head turned engage then stroke from the sterrnomastoid origin to the insertion. Using very 
little compressive force and by lowering your elbow use a “scooping” motion to lift as you stroke and 
stretch the fascia. Take your stroke over the mastoid and onto the occiput. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 25 
To integrate the superficial back line cup clients calcaneus’ and traction with focus of stretching the 
achilles tendon. Then allow the stretch to travel up the back line. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 26 
 
 
 
 
 BONY STATIONS 
 
 
 
 
13. Frontal brow ridge 
 
 
 
 
11. Occipital ridge 
 
 
 
9. Sacrum 
 
 
 
7. Ischial tuberosity 
 
 
 
5. Condyles of femur 
 
 
 
3. Calcaneus 
 
 
 
1. Plantar surface of toe phalanges 
 
 
 
 
 
 
 
 
 
 
 
 MYOFASCIAL TRACKS 
 
 
 
 
 
 
12. Galea aponeurotica/scalp fascia 
 
 
 
10. Sacrolumbar fascia/erector spinae 
 
 
 
 
8. Sacrotuberous ligament 
 
 
 
6. Hamstrings 
 
 
 
4. Gastrocnemius/Achilles tendon 
 
 
 
2. Plantar fascia and short toe flexors 
 
 
 
 
 
 
 
 
 
 
 27 
 
 
 
 
13 
11 
9 
7 
5 
3 
1 
2. Plantar fascia and short toe flexors 
 
4. Gastrocnemius/ 
 Achilles tendon 
 
6. Hamstrings 
8. Sacrotuberous ligament 
 
 10. Erector spinae/ 
 Sacrolumbar fascia 
 
 
12. Galea aponeurotica/scalp fascia 
 
 
 28 
 
 
 BONY STATIONS 
 
 
 
 
12. Mastoid process 
 
 
 
 
10. Sternal manubrium 
 
 
 
 
8. 5
th
 rib 
 
 
 
 
6. Pubic tubercle 
5. Anterior inferior iliac spine 
 
 
 
 
Patella 
 
 
 
 
3. Tibial tuberosity 
 
 
 
 
1. Dorsal surface of toe phalanges 
 
 
 
 
 
 
 
 
 
 
 
 MYOFASCIAL TRACKS 
 
 Scalp fascia 
 
 
 
 
11. Sternocleidomastoid 
 
 
 
 
9. Sternalis/stenochondral fascia 
 
 
 
 
7. Rectus abdominis 
 
 
 
 
 
4. Rectus femoris/quadriceps 
 
 
 
 
Subpatellar tendon 
 
 
 
 
2. Short and long toe extensors, tibialis 
 anterior, anterior crural compartment 
 
 
 
 
 
 
 
 
 
 
 29 
 
 
1 
3 
5 
6 
8 
10 
12 
2. Short and long toe extensors, tibialis 
 anterior, anterior crural compartment 
4. Rectus femoris/quadriceps 
 
7. Rectus abdominis 
 
9. Sternalis/stenochondral fascia 
 
11. Sternocleidomastoid 
 
Patella 
 Subpatellar tendon