Myofascial Release: What It Actually Does—and What It Doesn't Do

Myofascial Release: What It Actually Does—and What It Doesn't Do

You may have already experienced myofascial release. The therapist slowly applies pressure to a tight area, waits, and then tells you that the tissue is “releasing.” You often get up feeling less pain. This sensation is real. What we’re questioning is the explanation you’re given for it. According to available studies, manual pressure cannot stretch tight fascia (seeour article on fascia), and there is no evidence that the tissue undergoes lasting changes. The relief is better explained by the nervous system’s response to touch, the context of the treatment, and the passage of time. It often doesn’t last long. Here’s the good news: understanding what’s really happening leads you to what helps the most—namely, moving, resuming your activities, and better understanding your pain. At Physioactif, we therefore do not market myofascial release as a treatment in and of itself. Here’s why, backed by studies.

What do people think myofascial release does?

It is often believed that myofascial release stretches and loosens fascia that has become too tight or “stuck,” thereby relieving pain and stiffness. Fascia is a layer of connective tissue—that is, supportive tissue composed mainly of collagen fibers. It surrounds muscles, organs, and nerves. According to this theory, the sheath tightens after an injury, poor posture, or stress. Prolonged, gentle pressure restores its flexibility.

There are several beliefs circulating around this idea:

• The hands can sense a specific restriction in the fascia;
• Sustained pressure permanently stretches or softens the fabric;
• The “release” that the therapist feels is the fascia giving way;
• The fascia retains adhesions or knots that need to be released.

These beliefs are intuitive, but they are not supported by research.

Can a therapist's hands really stretch the fascia?

A therapist's hands are unable to significantly stretch tight fascia, according to calculations and measurements taken on the thigh and foot.

How much force would it take?

In 2008, a team of researchers used a mathematical model to calculate the force required to deform the fascia with the hands. To compress the thigh fascia (fascia lata) by just 1%, a force equal to a weight of approximately 925 kg would be required. To slide it by 1%, approximately 460 kg would be needed. For the fascia under the foot (plantar fascia), the figures are approximately 852 kg and 424 kg¹. These forces far exceed those of manual therapy. The authors conclude that the release felt by the therapist cannot result from deformation of these tissues. They propose other possibilities: reflex reactions within the tissue, or softer tissues that deform. In their test, a pressure of approximately 10 kg compressed the superficial fascia of the nose by 9%¹.

Another study by the same group calculated how much tissue deforms under the hands. The skin deforms about 1.5 times more than the fascia, and fat deforms 2.5 to 3.5 times more². Therefore, what moves under the fingers is primarily the skin and fat.

The example of the iliotibial band

The iliotibial band is a wide band of fascia on the side of the thigh. It is a popular target for foam rolling and myofascial release. One study measured the band during three common stretches—performed on cadavers—and then during a hip contraction in 20 people. The average elongation of the band remained below 0.5%³. Another study stretched ten strips taken from cadavers until they ruptured. On average, they withstood a force equal to a weight of approximately 89 kg, elongating by about 9%⁴. According to the authors, stretches performed in a clinical setting likely remain within the elastic range: the band returns to its original shape when released, presumably without any permanent change⁴.

In living individuals, a stretching or foam rolling session did not alter the stiffness of the iliotibial band in the short term⁵.

What does the therapist feel when the tissue “gives way”?

The “release” that the therapist feels does not come from a tight fascia giving way: it could stem from softer tissues that deform, or from a reaction of the nervous system. Researchers in 2008 mentioned these two possibilities, without confirming them¹. According to a model proposed by researchers, the pressure from the hands triggers nervous system reactions⁶. A review reports that a complex 40-minute session reduced resting activity in the back muscles of people with chronic low back pain⁷.

There is another problem: hands are not a reliable measuring tool. A review analyzed the reliability of manual examination to locate trigger points—those small, tender “knots” that are said to be felt within the muscle. The authors conclude that physical examination cannot be recommended as a reliable test⁸. A more recent meta-analysis reaches the same conclusion: two examiners rarely agree on the presence of a trigger point⁹.

Adhesions and Knots

We often hear that fascia forms adhesions or knots that need to be released. The hands barely distort firm fascia¹; there is no evidence that they actually release anything. And studies on muscle knots show that palpation does not reliably identify them⁹. The tender area you feel does exist, but a tender area is not like glue that needs to be broken up.

What do studies on pain say?

In studies on pain, myofascial release has a small effect, often short-term, and the quality of the trials varies.

In 2018, a systematic review compiled trials on myofascial release for chronic muscle and joint pain. It included 8 trials. Only 3 had a low risk of bias, meaning they were methodologically sound¹⁰. For low back pain and fibromyalgia, the effect did not reach the smallest difference that patients can actually perceive. The only results that were large enough came from studies with a high risk of bias¹⁰. The authors conclude that the current evidence is insufficient to support this treatment for chronic pain¹⁰.

For chronic low back pain, two meta-analyses published in 2021 paint a similar picture. The first finds a small effect on pain and function, but no significant improvement in quality of life, balance, trunk mobility, or mental health. Its authors highlight the low quality and small number of studies¹¹. The second found a small reduction in disability, but no significant reduction in pain, quality of life, or range of motion¹². A 2023 review reports less pain and disability after a series of sessions, but no effect on pain from a single 5-minute technique. It cautions against generalizing these benefits, given the small number of studies⁷.

For plantar fasciitis, a large meta-analysis shows a reduction in pain in the short term with myofascial release, as with several other treatments. In the medium and long term, none of these treatments performed better than the control group, except for shock wave therapy¹³. For jaw pain, a 2026 review found a reduction in pain but rated the certainty of the results as low¹⁴.

Other researchers view the technique more favorably. A 2015 review cites a solid body of evidence and great potential. However, it acknowledges that studies vary in quality and results¹⁵. In the best-designed studies, the effect on pain remains small, often below the threshold that patients notice¹⁰. In one study, the reduction measured immediately after a session was short-lived¹⁶.

Why do we still feel better after a session?

The sense of well-being after a session is more likely due to the nervous system's response to touch, the context of the treatment, and the passage of time than to a change in the fascia.

A model proposed by researchers explains it this way: pressure from the hands triggers a series of nervous system responses in the tissues, the spinal cord, and the brain⁶. A 2025 review, which summarizes 62 studies, supports this view. Some neurological changes are supported by studies of moderate quality. The mechanical changes in tissues, however, are based on studies of the lowest quality. The authors add that it is not yet known why manual therapy helps¹⁷.

Techniques that move the joints slightly increase the pressure pain threshold—that is, the amount of force required to cause pain—immediately afterward. Their importance for patients remains unclear¹⁸. Regarding myofascial release for low back pain, a meta-analysis did not find this effect¹¹. In a study from the University of Sherbrooke, compared with a sham technique, a myofascial technique slightly altered the stiffness and thickness of the tissues in the lower back on one side only. Pain decreased immediately afterward and the following day. The authors describe a temporary reduction in pain¹⁶.

Context matters, too. The therapist, the patient, their relationship, the treatment approach, and the treatment setting all influence the outcome¹⁹. The effects of manual therapy are modest and depend on the patient, the therapist, and the setting²⁰. Finally, back pain often improves over time: an analysis of 118 trials shows the same pattern of improvement, regardless of whether treatment is active or not²¹.

None of this is “all in your head” in a negative sense. Your pain and relief are real. To understand how the nervous system regulates pain, read our article on the neuroscience of pain.

What about the foam roller?

Foam rolling provides short-term flexibility gains, but it is no more effective than stretching. It is often described as “self-administered myofascial release.” A meta-analysis of 26 trials involving healthy adults shows that a foam rolling session improves range of motion in the short term, compared to no exercise at all. And this analysis measures only the immediate effect²².

Another meta-analysis examined performance and recovery. Before exercise, the foam roller slightly improves flexibility. After exercise, it slightly reduces perceived muscle soreness. The authors describe these effects as rather weak and sometimes negligible²³. To increase range of motion, programs lasting more than 4 weeks are required²⁴.

If the roller feels good, use it as a comfortable way to move and warm up, not as a tool to reshape your tissues.

What helps the most when you're in pain?

When you're in pain, exercise, resuming activities, and gaining a better understanding of your pain are among the most well-supported approaches. For chronic low back pain, the American College of Physicians' guidelines list exercise as one of the first-line treatments, along with yoga, tai chi, and multidisciplinary rehabilitation²⁵. Massage is included only for acute or recent pain, with low-quality evidence²⁵. A series of articles published in *The Lancet* supports this view: patient education to promote self-management, resuming normal activities, and exercise²⁶.

Understanding one's pain also helps. A systematic review shows that education about the neuroscience of pain reduces pain and disability and improves mobility in people who have been in pain for a long time²⁷. Our guide on chronic pain covers this in detail.

Specifically, at Physioactif, we focus on three things:

• An exercise tailored to your needs, that progresses at your own pace. Our article on exercise progression explains how;
• a clear explanation of your pain, to reduce your fear of moving;
• a gradual return to the activities that matter to you.

Touch therapy still has its place. Manual therapy can relieve pain enough to allow you to move more freely. We use it as a short-term aid, never as the core of treatment. See our guide to manual therapy. If you’d like a plan tailored to your situation, our physical therapists can evaluate you at one of our five clinics.

What are some frequently asked questions about myofascial release?

Frequently asked questions about myofascial release focus on adhesions, the sensation of the tissue releasing, how long the effects last, foam rollers, and the role of touch.

Does myofascial release break up adhesions?

There is no evidence to support this. According to a mathematical model, a force equal to the weight of approximately 925 kg would be required to compress the thigh fascia by 1%¹. Palpation also does not reliably identify muscle knots⁹. The tender area does exist, but the relief is better explained by the nervous system’s response than by the fascia giving way.

I felt the fabric give way. What happened?

What you're feeling is real. Under pressure, the skin and fat shift more than the fascia². Pain relief likely stems instead from the nervous system’s responses to touch, according to a model proposed by researchers⁶.

How long does the effect last?

Not for long. In the best-designed studies, the effect remains small, and no lasting effect has been demonstrated for chronic pain¹⁰. In the Sherbrooke study, the reduction in pain was temporary¹⁶.

Is foam rolling better than stretching?

No. When it comes to range of motion, the foam roller isn't any better than stretching, and studies mainly measure the immediate effect²². To increase range of motion, you need programs lasting more than 4 weeks²⁴.

Why doesn't Physioactif offer myofascial release as a treatment?

Because the data are insufficient to justify this treatment for chronic pain¹⁰. For low back pain, the guidelines instead recommend exercise²⁵, education, and a return to normal activities²⁶. We prefer to invest your time in what helps the most.

Is touch actually good for anything?

Yes, in the short term. Touch can relieve pain for a while. According to a model proposed by researchers, it works through the nervous system⁶. It is exercise and a return to normal activities that make the difference in the long term.

Where can I read more about fascia?

In English, Paul Ingraham, author of the website PainScience.com, provides a good summary of the research on fascia²⁸. He also explains why fascia does not “melt” under pressure²⁹.

References

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Our physical therapists defined the research strategy, plan, and clinical content of this article. An AI tool assisted with the literature review and text editing to ensure consistency in content and writing style.