Understanding Fascia and the Benefits of Myofascial Release |

“The Force is what gives a Jedi his power. It’s an energy field created by all living things. It surrounds us and penetrates us. It binds the galaxy together.”

In the galaxy of your body, you are bound together, from every cell to every muscle to every bone to every organ to every nerve by something called fascia. Since everything within you is connected to everything else, that means that your low back pain could be stemming from a restriction in a nearby “planet” like your hip flexors or glutes, or an even more distant satellite like your foot. This continuity has a huge impact on your experience of pain and your ability to perform at your best — whether you are an elite athlete, a weekend warrior, or a just a human being who wants to feel good enough to live the way you want to live.

If you’ve landed on this article you’ve probably heard a buzz about fascia. Perhaps you’re seeking more about the science of fascia or want to know more about the benefits of myofascial massage. Whether your goal is to improve performance or you’re simply seeking some self-care tips, this article will deepen your knowledge and provide a clear understanding of fascia, why it matters, and why properly executed myofascial release is critical to your health and longevity. Scientific research on fascia is expanding weekly, and we will continue to update the information in this article as our collective understanding of fascia grows.   

Exploring Fascia – Find What Interests You
Click on the links below to be escorted directly to the section that most suits your needs.

What is Fascia?

Biotensegrity

Fascia Defined

The Must-Know Categories of Fascia

What is Myofascia and is it different than Fascia?

What is Fascia Made of?

What are “Fascial Seams”?

What is Self Myofascial Release (SMFR) and How Does it Work?

The Benefits of Self Myofascial Release

Can Self Myofascial Release Reduce Pain?

Can Self Myofascial Release Improve Performance?

Can Self Myofascial Release Improve Mental Health?

What is the Best Way to do Self Myofascial Release?

What are the best Self Myofascial Release Tools?

Now, It’s Time to Get Started

References

What is Fascia?

Fascia has long been misunderstood, and it is just now reaching its age of enlightenment . . . finally cracking the dermis into public consciousness and gaining the respect it deserves.  

Part of the reason that fascia has been so misunderstood is because it has no particular form. It shape-shifts around your body. It is sometimes firm and fibrous, sometimes goopy. At times it presents itself obviously (as with belly fat), while other times it is hidden, invested like membranous cloaks around the cells within your muscles.

It’s hard to aim the spotlight on a subject that constantly shapeshifts — not to mention how it’s known to “creep” (yes that’s an anatomical term) when it moves… it can’t exactly strut into the limelight on its own. But then, you wouldn’t be able to strut without it. Let’s begin with biotensegrity, a concept that must be understood in conjunction with fascia. 

Biotensegrity

The human body is not a mechanistic system of pulleys and levers. It’s what’s referred to as a biotensegrity structure. “An easy way to think about tensegrity is when push and pull have a win-win relationship with each other.”¹ Your bones form the compression bearing “struts” and the fascias maintain the tension, leaving your bones “floating” in the fascia.¹ In practical application, this means that tension gets distributed around the whole “system of the body.” How does this apply to you? Well, where you are feeling pain may not be the area that needs attention.

Fascia Defined

Fascia is both a tissue and a system… and it only just received an official definition within the last decade.

“Historically ignored, fascia has only recently found some well-deserved respect for its role in mobility and postural integrity. There is even a semi-annual Fascia Research Congress to discuss the stuff.”²

The Fascia Research Congress’s definition of fascia is rather technical:

For us non-scientists, here is a more succinct description of fascia from The Roll Model Method, “Fascia is the body’s living aqueous knitting fabric. This seam system is the body’s soft-tissue scaffolding that interconnects you to yourself.”³

Although these seams are continuous, the textures, tensions and purpose of fascia is not all the same. Here’s a quick breakdown of the different categories of fascia.

Jill Miller, co-founder of Tune Up Fitness and author of the book, The Roll Model, helped us understand this concept in a 7/3/2018 post on Instagram:

Fascia: Liquid? Solid? Interstitium? The fascial zones where movement occurs are a true marvel of transitional nature. Here you have abundant fluids, migrant cells, sensory nerve endings, resident cells, pre-lymphatic vessels and plenty of dynamically stabilizing collagen fibers. Their zones exist all over our body and permit differential movement. They are a biological estuary and need to be respected as such. Dr. Neil Theise recently named it the ”Interstitium” and it made headline news worldwide.

For you brave souls open to seeing a cadaver’s fascia up close and personal, you will revel in Gil Headley’s Fuzz Speech video, and will be forever convinced why movement is medicine!

What is Myofascia and is it different than Fascia?

“Myofascia refers to the familiar-named muscle structures along with their associated interpenetrating fascias. For example, your biceps is a myofascial structure, as is your gastrocnemius (calf muscle). There is no muscle that does not have fascia winding its way throughout every layer of its cells and fascicles and surrounding its whole structure. Therefore, while we are in the habit of talking about muscles, the terms myofascia and muscle can be used interchangeably.”³

In other words, myofascia is not “different” than fascia. It is a subset of fascia. Myofascia is a term to distinguish the fascia that is a part of every muscle of your body. Fascia can exist without being a part of a muscle…but a muscle cannot and does not exist without its “myofascia.”

Myofascia = Myo (muscle fiber) + Fascia (the fascial wrappings holding the muscle fibers together to form a muscle)

Muscle fibers are the drivers of mobility and contraction, but they could not function without their fascial partners. The fascia organizes, lubricates and transfers energy for those muscle fibers.²

Myofascia naturally includes the fascia that is cloaking and connecting all muscle fibers together, it “twines around every cell, cell bundle, and group of cell bundles.”³ If you really want to geek out one day you can learn all of the sub-categories of myofascia called endomysium, perimysium and epimysium. We go over these layers in our Tune Up Fitness trainings.

Likely the reason “myofascial” gets so much attention, is because seekers of fascial therapies are often doing so related to muscular performance – to improve strength, improve flexibility and improve motor control. But what you must know is that ALL FASCIAS ARE CONNECTED.

Even though we tend to want to separate and categorize in order to better understand the body, fascia doesn’t really work like that.

As David Lesondak explains “The most important thing to keep foremost in mind, at all times, is that the fascial net is one continuous structure throughout the body . . . as far as the body is concerned, the fascia is all one – one complex, holistic, self-regulating organ.”¹

When you engage in your rolling practice, take a moment to think about these glistening membranous tissues within you, and let them inform your motion. Indeed, in this zone, the phrase “motion is lotion” is a perfect label. 

Indulge in subtle movements and focus on a slow, deliberate touch. Feel how this percolates locally and globally into your whole body sense.

What is Fascia Made of?

Excellent question, here’s where things get really interesting. It is basically both a liquid and a solid. Also known as a colloid.

Fascia is a colloid. Gels and emulsions are colloids. A colloid is a substance that contains particles of a solid material suspended in a liquid. Essentially, a colloid is both fiber and fluid.¹

Meanwhile, the components of fascia are cells and the extracellular matrix (ECM). 

The ECM is both a fiber and a fluid. The ECM fibers are composed of collagen and elastin, and they provide support and structure (the scaffolding) for everything in the body. Collagen, which is the primary protein in ECM, has tremendous tensile strength, which means it can be stretched without breaking. Elastin is an aptly named fiber, as it is very elastic, so it adds additional resiliency to fascia. The ECM is gelatinous soup that fills in all the empty spots in our “inner space.” It’s composed of water and peptides such as hyaluronan, and it’s in this goop where chemical exchanges happen between blood, lymph and tissue cells. This substance is also critical for slide and glide of tissues.¹

What are “Fascial Seams”?

While everything is connected to everything in the body, there are certain currents or ribbons of tissue, along which tension and energy are transferred, enabling movement and providing stability. Jill refers to these as “microstitches that compose your weave.”  

*Fascial Continuities from Anatomy Trains

These myofascial continuities describe “interlinked series of these connected tracts of sinew and muscle.”⁵ These continuities are discussed in depth in Anatomy Trains by Thomas Myers, but here is a very brief introduction to seven of the major ones: 

• Superficial Back Line – connects entire posterior surface of the body from the bottom of the foot to the top of the head.”⁵
• Superficial Front Line – connects the entire anterior surface of the body from the top of the feet to the side of the skull.⁵
  
• Lateral Line – connects each side of the body from the mid-point of the foot, up the outside of the ankle, the outside of the leg and thigh, along the trunk, under the shoulder, and along the side of the neck to the ear.⁵
• Spiral Line – loops around the body in a spiral, connecting the one side of the upper body to the opposite side of the lower body, on both the anterior and posterior side of the body.⁵
• Arm Lines – these lines run from the rib cage and spine through the shoulder and hand.⁵
• Functional Lines – these lines extend the Arm Lines to the truck and opposite side pelvis and leg.⁵
• Deep Front Line – this comprises the body’s myofascial core.⁵

Thomas Myers and Jill Miller have partnered together to provide a self-directed embodied experience of these trains, using the Roll Model Balls. Look for their live events and video collaboration in the summer of 2020! Register here to stay informed.

What is Self Myofascial Release (SMFR) and How Does it Work?

Although the concept of “myofascial release” (MFR) is widely used by the scientist hoping to stake a flag in new anatomical turf, the PT trying to alleviate chronic pain for a patient, or the body-builder aspiring toward a decimal more motor control (and so many more), new research challenges the popularized concept of this term.  

“Myofascial release is a term who’s origin emanates from the founder of Osteopathy A.T. Still and his early students. The “release” work uses a therapist’s palpation skills to engage the fascial stretch barrier of a client with appropriate sustained pressure or a variety of manual mobilizations. Conversely, release can be achieved by shifting fascial tissues away from a restriction. In SMFR, an individual performs this tool assisted application in a self-guided manner.”⁶

Myofascial release can be done as a form of hands-on therapy, as well as a form of self-care. John F. Barnes is a physical therapist who has been using myofascial release and training practitioners since the 70s. He describes this modality as follows:

Myofascial Release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the Myofascial connective tissue restrictions to eliminate pain and restore motion. This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly will allow a viscoelastic medium (fascia) to elongate.

For the purposes of this article, when we refer to “myofascial release” we will be primarily be talking about self-myofascial release (SMFR).

As stated above, we believe it is important to note that the term myofascial “release” (MFR) has recently been proven to be not completely accurate. As you read above, fascia runs throughout your entire body; your nervous system, your vascular system, ALL of your systems sit within it. In a new study that asked whether tissue thickness changed while using a foam roller, it did not find morphological changes in the fascia itself with this particular foam roller application.⁷ But while the researchers did not find changes in the actual fascial thickness, range of motion (ROM) greatly increased. They also noted that the likely cause of the extra mobility could be from the altered input into the nervous system via sensory receptors in skin, fascia and myofascia, and through changes in fluid dynamics. So, while the term SMFR may not be physiologically accurate, the concept of the practice is vitally important. Further research will eventually explain the exact mechanisms.

MFR is also used to manipulate scars and the adhesions associated with them. The scar tissue can alter mechanics far away from the site of surgery or injury even after the body’s fascia has repaired itself. The scar represents an agglomerate of solidified fluids and fibers that acts as a new more stable tissue where those same tissues were once breached.¹

The Benefits of Self Myofascial Release

Do you want to move with power and grace? Experience less pain and more peace? Are you looking for faster muscle recovery?  

Self myofascial release (SMFR) has been proven to facilitate all of these things. SMFR has many of the same benefits as manual myofascial release, with the added benefit that they can be done on your own terms, at your own convenience, and for free! Also, for people who are touch-adverse, SMFR provides a way to get the extensive benefits of MFR as well.⁶ Let’s explore these benefits more fully.

Can Self Myofascial Release Reduce Pain?

Self myofascial release can reduce pain in the body via several different avenues. It’s an effective remedy for both acute pain and chronic pain. Here are a few key elements: 

• Release Trigger Points: Pain can be caused by trigger points, which are “a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taught band.”⁸ These trigger points can cause pain, tenderness, motor dysfunction and autonomic phenomena in the trigger point itself and in a referred area.⁸ These areas of hypersensitivity can be addressed with SMFR.

• “Pain caused by myofascial trigger points (TrPs) may present as an acute, recurrent, or chronic pain syndrome. In the presence of sufficiently severe perpetuating factors, an acute syndrome persists to become a chronic myofascial pain syndrome.”⁹ When unresolved, trigger points can persist and cause secondary and satellite trigger points, leading to widespread and chronic pain. Addressing trigger points and other perpetuating factors such as postural patterns and joint dysfunctions can help address chronic myofascial pain.⁹

• Enlighten Your Homunculus: Your body is mapped to a portion of your brain called the sensory motor strip which provides a representation of how much cortical real estate (brain sensation function) each body part receives (the neurological term for this is Homunculus). These “body maps” are consistently updated by changes in bodily sensation and action. When information is not clearly relayed from the body to this area of the brain, there can be “blurry” areas in the “body map” that can play a role in pain, tension and sub-optimal movement. SMFR may be able to provide sensory input that may assist in the accurate refinement of these “body maps”, especially when combined with movement, breathwork, and posture exercises.²¹
• Improve Proprioception: Proprioception is “Your body’s sense of itself. Your inner GPS system. The ability to sense the position, location, orientation, and movement of your body and it’s parts.”³ As mentioned above, improved proprioception can help decrease pain by improving the cortical map. By stimulating various sensory nerve endings in the fascia, SMFR serves as an avenue for improving proprioception and identifying areas that are misused, abused, or confused. In Yoga Tune Up®, we call these “body blind spots.” By identifying and exploring these body blind spots, your perception of pain can be diminished.  

• “One biological fact of utmost importance is that there is a mutually inhibiting relationship between pain (nociception) and proprioception (body sense).³ The more proprioceptively aware you become, the higher your ability to manage pain.

Can Self Myofascial Release Improve Performance?

It would almost be quicker to list how MFR DOESN’T improve performance! But, just to really drive home the point that YOU SHOULD BE DOING SELF MYOFASCIAL RELEASE, we will give you all the juicy details. Here is a sampling of what SMFR can do for you: improve movement coordination, improve joint range of motion and mobility, increase torque, decrease muscle fatigue and soreness, reduce arterial stiffness, improve vascular endothelial function, decrease lymphedema, improve slide and glide of tissues and fluid dynamics.⁶ (additional references within)

So SMFR is a vital tool that should be used by athletes to enhance their performance, as well as by weekend warriors who don’t want to groan loudly when they try to stand up from their chairs after their first Monday morning conference call.

• Pre-covery and Recovery – SMFR is a key component to both preparing the body for efficient movement and for helping the body recover afterwards. Two studies done by Dr. Robyn Capobianco showed that rolling the gastrocnemius on a soft rubber Yoga Tune Up® ball was able to offset a stretch-induced force deficit, while also increasing torque, range of motion, and force production. These results were demonstrated by both college and middle-aged adults. The results for middle-aged adults were extremely interesting, as their ankle dorsiflexion (the lack of which often drives slip and falls) increased by almost 25%!¹³, ¹⁴

• Improved slide and glide – Our layers of tissues are meant to slide and glide across each other, enabling effortless, graceful movement and free-flow of life-giving fluids throughout the body. However, when we hold our body in a static position for several hours a day, several days a week, fascial changes start to occur. The layers of tissues start to adhere to each other, and fascia starts to become dense and fibrotic. Fascial restrictions can lead to: restrictions in the flow of lymph and blood. Remember – 90% of fluids are reservoired in the fascia!  

• Muscles that are unable to fully contract or stretch, leading to imbalances throughout the body and restrictions in proper joint mechanics.³

• Nerve compression, resulting in “tunnel syndromes” where the nerve gets compressed within the fascia, causing inflammation and sensitization inside the nerve itself.¹⁵

• Chronic pain conditions like fibromyalgia. SMFR can help people suffering from chronic pain by reducing stiffness, fatigue, wide-spread pain intensity and ROM.¹⁶

Elite athletes have teams of therapists who work with them to keep their tissues functioning optimally and to balance out the effects of intense training. However, for the executive who loves to hit up the links every weekend, or the retiree who lives to obliterate the competition on the pickleball court, or the bank teller who recently started Crossfit – SMFR can help these every-day athletes keep their fascia healthy, hydrated and pain-free.

Can Self Myofascial Release Improve Mental Health?

Just like everything is connected to everything via fascia in the body, the mind and the body are also inextricably linked. The mind and the body are two sides of the same coin. This fact is recognized in the biopsychosocial model of pain. This model states that there can be biological and biochemical contributors to pain (e.g. a broken leg), as well as psychosocial contributors to pain (e.g. depression, anxiety, loneliness, stress, etc.). All of these inputs are processed by the nervous system, which decides if all incoming signals should result in an outgoing pain signal. Pain is an experience in the body, and it often presents itself even when there is not physical tissue damage, and sometimes there IS tissue damage, but NO pain!

SMFR can help down-regulate the “biology” portion of the pain experience, as described above.

But, perhaps even more importantly, it also positively affects the psychosocial component.

Self myofascial release/SMFR is a ticket to physiological relaxation, increased parasympathetic activity, and improved embodiment. This ties in to the discussion about proprioception above. But it also opens up another conversation into another subtle category of sensing our body’s implicit feelings called interoception. Interoception is our body’s physiological sense of itself, the many nerve endings that comprise this aspect of body sense are also embedded in our body’s fascia, but our brain processes the majority of these signals in its emotional processing centers.¹⁰ By stimulating all of those various nerve receptors while doing SMFR, your brain is getting a much clearer map of your body.  

SMFR can also facilitate an improved awareness and emotional connection with the inner Self. When the human organism experiences trauma (which can include falls, car accidents, surgeries, and other more complex forms of trauma), and the trauma or “threat” is not processed successfully, the energy mobilized by the body to deal with the threat can get trapped in the body, causing constrictions and a host of other symptoms such as panic attacks, anxiety, difficulty sleeping, chronic fatigue, headaches, digestion challenges, neck and back problems, depression, forgetfulness, inability to deal with stress, etc.¹¹

Interoception can help humans be present and aware of the sensations, emotions, and feelings flowing through the body. Building this capacity to be present with what is happening in our “inner space” can help the body process the stuck energy mobilized by trauma.¹² When practicing SMFR, give yourself permission to BE in your experience – to be curious, open, patient, to go s l o w. Notice how the pain experience changes with different thoughts, different movements, and different and novel experiences. Be open to witnessing your rage of emotions. Be a companion to the pain instead of fearing and resisting it.   

*This content is not intended to be a substitute for professional medical and psychological advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any condition.  

What is the Best Way to do Self Myofascial Release? 

You might also ask, is there a wrong way and a right way? Well, the short answer – Yes! When exploring your tissues with self-massage tools, do so with curiosity, awareness, patience and gentleness. Your goal with SMFR is to soothe your tissues, to encourage them to return to a restful tone – relaxed and balanced, yet ready for action. It doesn’t have to hurt to work!  

You don’t have to grind down your soft-tissues to get them to lengthen, soften, or loosen. In fact, the more you bully your soft tissues, the more you arouse their innate defense mechanism. They brace in response to threat, via the muscle spindle response. Guess what else braces? Other nearby muscles who rally to protect the tissue under attack.

The more you push, the more they push back. So when you’re rolling yourself like you’re ironing your birthday suit, your fascial tissues will likely swell and inflame full of defensive cytokines and make you feel even more swollen & stuck than before. Often as you roll, or stick or whatever, the “ouch” that you feel is your nervous system kicking into high gear and telling you that you’re pushing too hard, and to please back off. Are you listening? Or BALLdozing through it? — Jill Miller

In the Roll Model® Method, we use 9 primary techniques for optimal SMFR, they include: 

1. Sustained Compression: Allow the Therapy Ball to rest without movement as you apply consistent pressure to one area
2. Stripping: Slide a ball (or pair) from one end of a muscle area to the other, combing through both the superficial and deep fascial layers going back and forth (from origin to insertion)
3. Cross Fiber: Move, slide, or drag the Therapy Ball across the “grain”of a muscle to mobilize multiple layers of fascia
4. Skin Roll/Shear: Use a Therapy Ball to gently pinch your skin as you traction and shift your superficial fascia over the deep fascia
5. Contract/Relax: Dock the Therapy Ball on a spot, stiffen the muscle where the ball is placed and hold for seven to 10 seconds, then relax
6. Pin & Stretch: Pin a Therapy Ball anywhere along a muscle and move a joint that is above or below while keeping the ball locked in place
7. Pin/Spin &Mobilize: Put the Therapy Ball on a target within muscle, twist it into that spot, then move a neighboring appendage away from that spot keeping the ball pinned
8. Plow: Move the ball(s) like a squeegee to gather as much of the loose fascia as possible and move it as a mass in one direction
9. Stack: Place one Therapy Ball underneath the area you want to address and place another ball on the opposite side of that area then apply pressure to both sides simultaneously

Watch our video playlist of these self myofascial techniques and download our Roll Model SMFR Techniques Poster for a handy reference of each technique. 

As mentioned, the human body is a biotensegrity structure, so stress and strain gets transferred across the system. Consequently, when doing SMFR, it’s important to investigate the “peripheries” of where you are feeling pain. If your upper back hurts, explore your neck and pecs. If your knee hurts, roll out your calves and feet. This relates back to the Fascial Seams previously discussed. 

Often, “the loser complains,” meaning that the muscles that are getting stretched (eccentrically lengthened) are the ones sending nociceptive signals to the brain, but it’s really the muscles that are hypertonic/contracted that need to be addressed. So, explore uptown, downtown, and around the town to see what is really going on throughout the whole neighborhood! Remember, with fascia, everything is an interconnected system. As you go through this process, you’ll likely discover silently suffering areas of chronic tension, a.k.a “body blind spots.”  

Use the Roll Model therapy balls to root out these blind spots, and administer the techniques above to fluff, stimulate and traction these tissues; in the process you’ll empower your self-care skills and become one of your very own healthcare providers.

What are the best Self Myofascial Release Tools?

The goal is to treat your tissues with the respect they deserve – i.e., treat your tissues well and they will serve you well in return. Given that, should you batter them into submission with the edge of a kettlebell? Plow the pain out of your IT band with a hard foam roller? Find an edge of a window sill and get into the stabbing pain by your shoulder blade?

Fortunately Science has provided an answer! In a study conducted in Korea by Yushin Kim et al, researchers discovered that therapeutic tools providing gentle pressure are superior to those providing firm pressure. In the study, the researchers used a soft inflatable rubber ball to massage the posterior neck muscles. The soft rubber ball resulted in reduced muscle tension and discomfort as well as increased neck extension ROM and decreased tissue thickness.¹⁷ Another study showed that a softer tool increased mechanical stress transfer to the targeted tissue, which is the avenue by which massage has so many beneficial effects.²⁰

Harder tools create a threat response – causing muscles to brace against the intrusion, inflammation to increase, and increasing stress hormones like adrenaline and cortisol. Using a harder massage tool can also increase the risk of injury. In a May 2019 case report, a woman injured the tibial division of her sciatic nerve by massaging her glutes with a lacrosse ball.¹⁸

Like Likes Like – the human body reacts best to being touched by something similar in texture, density, and hardness to itself. “Your soft tissue likes a soft tool.”³

One of the reasons we developed the Roll Model Therapy Ball products is because they have an inner density that maintains integrity but are surrounded by a soft, pliable and grippy outer layer. This grip helps grab multiple layers of fascia, enabling you to perform all of the key techniques that effectively stimulate mechanoreceptors without creating muscle bracing or damaging soft tissue.   

Now, It’s Time to Get Started…

Thanks for sticking with us on this epic journey through the gorgeous galaxy that is your human body. You now know what you are really made of and how to take care of your fascia and myofascia. The body is meticulously woven together, cell-to-cell, to perfectly adapt to how you use it. However, sometimes those adaptations, based on how we use (or misuse) our body, can begin to cause pain or restrict mobility.  

With the knowledge of fascia and your new self myofascial release skills you can slowly remodel your tissues to facilitate a better flow of body and mind. Couple that with the proper soft tissue tools, time, patience, and curiosity, and you have the power to decrease pain, improve performance and mental health, and elevate awareness of your inner space. You now know what tools to use, and how to use them. If you’d like an even deeper study, consider taking a Tune Up Fitness Training and see Jill Miller’s new book Body by Breath. May the Force be with you! 

Download your free copy of Understanding Fascia and the Benefits of Myofascial Release PDF

References

1. Lesondak D. Fascia: What It Is and Why It Matters. Edinburgh: Handspring Publishing; 2017.
2. TBiel A. Trail Guide to Movement: Building the Body in Motion. Boulder, CO: Books of Discovery; 2019.
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4. Benias PC, Wells RG, Sackey-Aboagye B, et al. Structure and Distribution of an Unrecognized Interstitium in Human Tissues. Scientific Reports. 2018;8(1). doi:10.1038/s41598-018-23062-6
5. Myers TW. Anatomy Trains. Edinburgh: Churchill Livingstone/Elsevier; 2009.
6. Fascia, Function and Medical Application, edited by David Lesondak, Jill Miller et al, Taylor and Francis ahead of Publishing.
7. Yoshimura A, Inami T, Schleip R, Mineta S, Shudo K, Hirose N. Effects of Self-myofascial Release Using a Foam Roller on Range of Motion and Morphological Changes in Muscle. Journal of Strength and Conditioning Research. 2019:1. doi:10.1519/jsc.0000000000003196
8. Travell JG, Simons DG, Simons LS. Myofascial Pain and Dysfunction: the Trigger Point Manual: Vol. 1:Upper Half of Body. Baltimore: Williams & Wilkins.; 1999.
9. Travell JG, Simons DG, Simons LS. Myofascial Pain and Dysfunction: the Trigger Point Manual: Vol. 2:The Lower Extremities. Baltimore: Williams & Wilkins; 1999.
10. A.D. (Bud) Craig. How Do You Feel? An Interoceptive Moment with your Neurobiological Self
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12. Blackstone J. Trauma and the Unbound Body: the Healing Power of Fundamental Consciousness. Boulder, CO: Sounds True; 2018.
13.  Capobianco RA, Almuklass AM, Enoka RM. February 2018. Manipulation of sensory input can improve stretching outcomes. Eur J Sport Sci. 18(1):83-91. doi: 10.1080/17461391.2017.1394370. 
14. Capobianco RA, Mazzo MM, Enoka RM. February 2019. Self-massage prior to stretching improves flexibility in young and middle-aged adults. J Sports Sci. 4:1-8. doi: 10.1080/02640414.2019.1576253.
15. Jacobs D. Dermo Neuro Modulating: Manual Treatment for Peripheral Nerves and Especially Cutaneous Nerves. Victoria, British Columbia: Tellwell; 2016.
16. Ceca D, Elvira L, Guzmán JF, et al. Jul-Aug 2017. Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized control trial. J Sports Med Phys Fitness 57(7-8):993-1002. 
17. Kim Y, Hong Y, Park HS. 2019. A soft massage tool is advantageous for compressing deep soft tissue with low muscle tension: Therapeutic evidence for self-myofascial release.
18. Cho JY, Moon H, Park S, Lee BJ, Park D. Isolated injury to the tibial division of sciatic nerve after self-massage of the gluteal muscle with massage ball. Medicine. 2019;98(19). doi:10.1097/md.0000000000015488
19. Pearson N, Prosko S, Sullivan M. Yoga and Science in Pain Care: Treating the Person in Pain. London: Singing Dragon; 2019.
20. Blyum L, Driscoll M. Mechanical Stress transfer – the fundamental physical basis of all manual therapy techniques. Journal of Bodywork and Movement Therapies. 2012;16(4):520. doi:10.1016/j.jbmt.2012.01.006
21. Medina J, Coslett HB. From maps to form to space: Touch and the body schema. Neuropsychologia. 2010;48(3):645-654. doi:10.1016/j.neuropsychologia.2009.08.017