Barrett L. Dorko, P.T.

          There is an article about "squeezies" in my local paper today. Squeezies are the small, round, polyurethane devises that you've seen pop up on your supervisor's desk the past few years. They are supposed to provide an outlet for stress by virtue of their resilience. No matter how much you squash them in your fist, they return for more, always beginning and ending your interaction with an identical shape.

          As it happens, I carry one of these in my suitcase. I show it to my classes, using it as an example of typical bodily response to outside force. I don't know about you, but my impression of the human body is that it is typically as resilient as a squeezie.

          I know that not everyone would agree with me. Over the past decade a virtual army of therapists have been convinced that connective tissue is stretched when they employ force with their hands. It is interesting to me that descriptions of this technique emphasize "following" the "release" of the "fascial planes."

          While following the patient's motion is something that I have advocated for many years, I never assumed that the movement was being produced by the fascia. It is inert, contains no contractile fibers or efferent support. It doesn't move any more readily than our clothing. I short, fascia doesn't form us, it conforms to us. Its shape and thickness is dependent upon its responsibilities of support, containment and chemical filtering in any particular location. These qualities vary wildly so that while it can be said that connective tissue is continuous, it is by no means homogenous. Mechanical forces might be translated through portions of it, but that force would be dispersed and absorbed rapidly as it traveled to the hardest connective tissues immediately adjacent to those that differ in their density and flexibility.

          Any softening or increased range of motion within the body that follows the kind of pressure I can exert with my hands cannot be said to be due to connective tissue changes. It is incapable of changing in response to my pressure in so rapid or radical a fashion. Period.

          Descriptions of so-called "myofascial release" (MFR) commonly contain a repudiation of the Newtonian physics we use to describe the effects of force and mechanical stress. I've read that this is because Newton's equations are so old, assuming, I guess, that this makes them somehow worth less. In fact, they have proven reliable (with the exception of movement at incredible speed or in the presence of immense gravitation) countless times in the past three hundred years. In the world I live in each day, Newtonian physics work just fine. This cannot be said of Captain Kirk perhaps, or it seems, any number of MFR practitioners.

          Finally, I'd like to return to the squeezies I read about today. In the paper they are described as "a remedy for anger." They are the punching bag of the 90's. We're supposed to redirect our instinctive attack behavior in this harmless and socially acceptable way. Sounds a little unsatisfying to me, but that's just my opinion.

          But it makes me wonder about some of the heavy pressure often employed in manual care. While there is little evidence that the condition it is thought to alter (myofascial restriction) actually exists or that we could change it manually if it did, there might be some satisfaction gained simply by virtue of the effort employed. Since the patient is (unlike a squeezie) animated, I would suppose that their simultaneous efforts to avoid the possible pain from such technique might actually help them as well. When it "works" I presume it is for reasons other than the MFR theorists propose.

          The term "release" has become equated with a dubious theory and an unwarranted technique. It is incredibly popular, I know.

          But not with me.