The Myofascial Release Manual, 3d ed.

Manheim C. Thorofare, NJ 08086, Slack Inc, 2001, spiralbound, 304 pp, illus, ISBN: 1-55642-452-3, $45.

The third edition of this manual incorporates some major changes that are very useful. In this edition, the author answers questions that have come up in courses she has taught, and hand placements are skillfully illustrated for almost all muscles. The author uses text formatting to illustrate important points: names of muscles are capitalized for easy scanning; text containing vital information, precautions, contraindications, or important words is bolded; and key points are italicized.

The manual is divided into 5 sections. Section I is a basic introduction to myofascial release and covers history of the approach, the anatomy of fascia, basic concepts of myofascial release, basic steps of treatment, verbal and nonverbal communication with the patient, and indications and contraindications. Section II deals with the basic myofascial treatment techniques. For each muscle, written instructions on unilateral and bilateral gross stretch and focused stretch are included, along with excellent clinical commentaries.

Section III deals with advanced myofascial techniques. Trigger point release concepts are discussed, and advanced treatment techniques are illustrated. There is a very useful table indicating the patient's complaint, the common "medical diagnosis," and the trigger point location that is often the cause of the symptoms. Techniques related to diaphragmatic and pelvic floor releases are also included. A portion of this section covers skin and scar mobility, illustrating gross and focused skin rolling and scar release techniques. Strumming technique variations are illustrated for a variety of body areas. The author then progresses to combinations of releases that require more skill and the focus of the therapist.

Section IV is very short and touches on initial assessment. Section V is a review of a very complete postural examination from many angles and positions. There are 159 references related to myofascial pain and examination, evaluation, and management listed at the end of the manual. In the introduction, contributor Sam Kegerreis mentions the paucity of scientific literature on this subject and challenges practitioners to develop alternative, holistic methods of investigation. The author cites no specific studies that provide evidence that myofascial techniques are effective, and readers should be aware that there is currently little scientific evidence that the techniques described in this book are effective.

This manual provides the clinician excellent illustrations and detailed instruction on basic and advanced myofascial release techniques. This manual is not meant to be used as a substitute for a myofascial release course. It is, however, an excellent reference and refresher book for those who have taken such a course. The photographs are an excellent learning tool. My only suggestion to the author would be to expand her discussion of evaluation and include the postural evaluation.

Roslyn Sofer, PT, OCS
Touro College
Bayshore, NY

Ms Sofer is Assistant Professor in the School of Health Sciences, where she teaches classes on rehabilitation and therapeutic exercise, activities of daily living, adaptive equipment, and peripheral mobilization. She maintains a private practice in Rego Park, NY.