Fascial Therapy

November 15, 2012

There are plenty of opportunities to renew your outlook, refresh your practice and deepen your knowledge and understanding of massage therapy.

Learning a new way to work with clients—like adding a different modality to your toolbox—is a great way to both keep you excited about the profession you love and broaden your reach with consumers.

We talked to three massage therapists who share their expertise on fascial therapy. From the benefits offered to marketing ideas, we’ve got what you need to start exploring the fundamentals of this technique.

How Fascial Therapy Works

Pete Pfannerstill, owner of Ultrasports Massage in Tampa, Florida, describes fascial therapy this way: “The goal of any therapist’s fascial work is to reduce the restrictions,” he says. “Once they do, the tissues and joints are able to move better and there are fewer structural dysfunctions and imbalances.”

In simple terms, fascial therapy stretches the fascia and can be used anywhere there are fascial restrictions. “You’re grasping the tissue and moving the underlying structures,” explains Pfannerstill. “You’re changing the consistency of the tissue.”

How this goal is accomplished may vary, explains Steve Jurch, director of massage therapy for the Women’s Tennis Association. “Restrictions are determined by assessing the tissue and then a force is applied to affect a change,” he says. “The therapist feels for the change in the tissue and then follows the release into the next barrier. All the methods utilize pushes and pulls, similar hand positions, and have the same general philosophies about the fascial system.”

For example, massage therapists might use a crosshand technique, stretching the fascia in opposite directions and combining sustained pressure and stretching to decrease pain and increase range of motion. Or, they may focus on easing trigger points and adhesions to enhance flexibility.

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Who's the Demographic?

“I get asked a lot about when fascial therapy should be used as opposed to other techniques,” Jurch says. “The short answer is everyone can benefit from some aspect of fascial therapy. I incorporate it into every massage that I do, whether they are general techniques at the start of a session or more directed methods to address a specific concern.”

The other experts we spoke with agreed, too. “There are very few disorders where I have seen myofascial release to be ineffective,” says Walt Fritz, physical therapist and founder of the Foundations in Myofascial Release Seminar series. Fritz treats clients for back, neck and foot pain, general joint pain, headaches, nerve entrapment issues, and pain and dysfunction associated with scar tissue.

When you’re considering how fascial therapy might fit into your current work, however, thinking in less general terms can help you more easily imagine the clients who might benefi t from this work. Here are a few conditions that can benefit from fascial therapy:

Postural inefficiencies

"Due to its relationship to the musculoskeletal system, fascia ultimately determines the length of our muscles,” Jurch says. “If the fascial tissue is holding our bodies in a poor position, our muscles become less efficient in holding us in correct alignment. This leads to an adaptive change where the connective tissue takes over the role of support, which can lead to numerous problems.”

In other words, poor posture and gravity can place unnecessary stress and strain on the body, leading to discomfort that can be helped by fascial therapy.

Movement dysfunction

Movement dysfunction is another area fascial therapy can help, including strength and range of motion issues. Similarly, repetitively asking a muscle to contract, consciously or subconsciously, can cause tissue to become stressed, resulting in fascial restrictions over time.

And, according to Pfannerstill, repetitive movement is part of a wide variety of activities. “Whether it’s from poor posture in the office, the repetitive movement from a factory job or climbing up and down a ladder all day, fascial restrictions form as a result of the stress a person has placed on their body,” he says.

Scar tissue

While not all scars are equal, they are all composed of the same substance, Jurch says. “The connective tissue they are comprised of is laid down in a random pattern and can have numerous effects on the entire body,” he says. “As scars develop and mature, they pull on the surrounding tissue, increasing the area that is affected.”

Using fascial therapy on clients suffering from scar tissue dysfunction pains can change their attitude, and can help create a more functional scar.

Athletes

Athletes commonly suffer from muscle strain due to the repetitive stresses placed on their bodies, which can lead to restrictions in flexibility and muscle pain. Fascial therapy has been shown to increase range of motion and decrease pain in overworked or damaged muscles, which is very useful for athletes who are in training.

“Athletes in general don’t want to miss that next training effort,” Pfannerstill says. “As a result, they want the tissue that’s been damaged to be normalized right away so they don’t have to miss any training or an event.”

Talking to Your Clients About Fascial Therapy

While adding fascial therapy to your resume can broaden your consumer reach, introducing a new modality into your current practice can be a little tricky. One great way to market fascial therapy is by educating your clients on how they’ll benefit—in terms they can easily understand.

Break down the definition

"A great analogy I like to use is I ask them if they have ever put on a T-shirt fresh out of the dryer,” says Jurch. “The shirt is usually a bit tight from the cleaning process, so they have to pull and stretch it so it feels more comfortable. I explain that your fascia is like the tight shirt and the techniques are designed to stretch it out and allow for them to feel better.”

Focus on how they’ll feel

Remember, too, that clients are going to generally care more about how they’ll feel after having a massage and less about the techniques used during the massage, so focus your message on the effect. “Phrases like ‘improved body position,’ ‘reduce pressure on painful structures’ and ‘improved mobility’ will allow you to attract people seeking these results, and then you can explain in more detail when you are in person,” Jurch says.

This same sentiment is echoed by Fritz. “Most clients care little of what you do. They care what you can do for them,” Fritz says. “I am exceedingly good at pain relief and this is how I market myself. I even named my practice the Pain Relief Center. People understand what goes on even before they come in for their first session.”

Be good and get out there

As with most anything you pursue, being good at what you do will always get people talking. Pfannerstill, for example, has a website he uses for promotion, but many of his clients come to him by referral. “

I’ve done well enough that the therapy speaks for itself,” he says. “I guess my bottom line recommendation is to be good. Be effective at what you do, and be able to treat a wide variety of people with a wide variety of tissue types.”

Community involvement

Another way to show clients your work is by being active in the community by volunteering your services at marathon events or races. Pfannerstill started out working races and events, and has encouraged his students to do the same.

“You can work one of these races and easily work on 10-15-20 people over the course of two or three hours,” he says, “and that would be that many more people who you’ve never met before and now have your card in their hands and touch in their brains.”

Understanding the Difference

Part of educating clients and potential clients about fascial therapy, too, is going to involve helping them understand how this modality is different from what they might traditionally think of as massage. For example, little, if any, lubrication is used with fascial work—with the exception of perhaps a very little cocoa butter, according to Pfannerstill. “I typically use cocoa butter or something that provides the correct amount of tissue drag,” he explains. “So, I’m actually grasping the tissue instead of gliding over the top of it.”

Additionally, you may find talking to your clients about how fascial therapy will feel helps in making them more comfortable with trying a new modality, as some consumers might have the idea that the technique is deep and painful—which, according to the experts we spoke with, isn’t true.

The experience certainly doesn’t have to be uncomfortable, explains Pfannerstill, though he quickly adds that for athletes looking to recover quickly, some discomfort might be involved. “It just depends on the amount of downward pressure that you use and how quickly you want to make the change,” he explains. “In other words, if I am more conservative in my pressure and in my drag, it may take me more sessions to reach the desired tissue consistency that I am looking for.”

So, for a client who is okay with a slower pace, more sessions might be needed to deal with the issue. When someone wants to be out of pain immediately, however, Pfannerstill says a bit of discomfort might result from being more aggressive with the tissue. “It’s about the intent of the work and the discussion you need to have
with your client as to how quickly you’d like to affect the change,” Pfannerstill adds.

Strong, open communication with your clients is something all three therapists believe is vital when doing fascial therapy, as well as keeping the clients active in the treatment process. Every new client should be greeted with a thorough evaluation. Fritz says he likes to be able to connect with the client’s pain and their needs to start the discussion about how the problem might be addressed.

“My conversation will address treatment as well as pain education” Fritz says. “Having a client play an active role in their recovery has been shown to be more effective than if they play a passive role.” Remember, though, that even with educational efforts, you might still find that some of your loyal clients are resistant to try something new, and that’s OK. “They may at first resist change of any kind, so don’t push,” Fritz says.

Continuing Education Opportunities

Setting yourself apart from the competition is key, and one good way to do that is by pursuing continuing education. “I would absolutely recommend that anybody who is interested in increasing the quality and specificity of their therapy would do well to investigate continuing education on fascial therapy,” says Pfannerstill.

Fritz suggests finding a program you are comfortable with, making sure the education you choose aligns with your own interests. Jurch, too, recommends really thinking about how you want to incorporate fascial therapy into your practice and then finding skilled practitioners to work with. “Research the different fascial techniques and see what would fit into your practice,” he says. “Invest the time and energy, and seek out skilled practitioners to learn from.”

Pursuing advanced training might change the way you look at massage therapy, too. “Because this technique takes a different approach than traditional massage, you must change your thought process as a therapist,” Jurch says. “The focus is the fascia, and you must be patient and wait for the tissue to change. You also need to be very focused and attentive in order to feel the barriers and restrictions to achieve the best results.”