Myofascial release therapy is based on the idea that poor posture, physical injury, illness, and emotional stress can throw the body out of alignment and cause its intricate web of fascia to become taut and constricted. Because fascia link every organ and tissue in the body with every other part, the skillful and dexterous use of the hands is said to free up, or "release," disruptions in this fascial network. Pressure on the bones, muscles, joints, and nerves is relieved in the process, and balance is restored.

Like a "pull" in a sweater, the effects of tension and strain are thought to snowball over time. Abnormal pressures may tighten or bind the fascia to underlying tissues, causing "adhesions," or dabs of scar tissue that cling to muscle fibers. Even though these adhesions do not show up on x-rays or other scans, they can stiffen joints or contribute to painful motions, such as rotator cuff injuries. If they occur near a nerve, they may cause numbness, pain, and tingling, as with sciatica or carpal tunnel syndrome.

The gentle and sustained stretching of myofascial release is believed to free these adhesions and soften and lengthen the fascia. By freeing up fascia that may be impeding blood vessels or nerves, myofascial release is also said to enhance the body's innate restorative powers by improving circulation and nervous system transmission.

Some practitioners contend that the method also releases pent-up emotions that may be contributing to pain and stresses in the body. In a variation of the technique that therapist John Barnes calls "myofascial unwinding," moving various body parts through a range of postural positions is said to unleash, or unwind, repressed "memories" that the tissues have unconsciously come to "store." This leads to both physical and psychological healing.

Whereas muscles often respond to the firm strokes and thrusts of massage, fascia is thought to respond to a much milder touch. And unlike a typical chiropractic manipulation, which focuses on improving the motion and function of a particular joint, myofascial release works on a broader swath of muscles and connective tissue. The movements have been likened to kneading a piece of taffy--a gentle stretching that gradually softens, lengthens, and realigns the fascia.

The therapist will first ask about your complaints and closely inspect your posture as you sit, stand, walk, and lie still. The bones in your neck, chest, pelvis, back, or other areas will be felt and the skin stretched to feel for areas of tightness. Using the fingertips, knuckles, heel of the hand, or arm, the therapist then feels, or "palpates," deeper layers for any areas of bound-down fascia. When a restricted area is found, the tissues are stretched gently along the direction of the muscle fibers until a resistance to further stretch is felt.

The stretch may be held for one to two minutes, and sometimes for up to five minutes, before a softening, or "release," is felt. The release indicates that the muscle is relaxing, fascial adhesions are slowly breaking down, or the fascia has been realigned to its proper orientation. The process is then repeated until the tissues are fully elongated.

Physical therapist Carol Manheim, author of the Myofascial Release Manual, describes the process as "a nonverbal conversation between the therapist's hands and the patient's body. It should be very comfortable and relaxing." Because the fascia is an interconnected network, the therapist may work on many parts of your body, and not just those that hurt. To help you relax, you may be encouraged to breathe deeply or make sounds. If there is any discomfort, most people describe it as "good" or "healing."

Some people immediately feel better, even free of pain, and are able to move their joints more freely as soon as the session is over. Others feel some increased discomfort that night or the next day. Any soreness should subside within a day or two, however, and you should feel less pain and move more easily than you did before.

Sessions typically last 30 minutes to an hour and may be given one to three times a week depending on your condition. Costs per session range from about $50 to over $125 and may be covered in part by insurance as an adjunct to a chiropractic or physical therapy program prescribed by your doctor. A simple pulled muscle may respond completely after a session or two, whereas longstanding myofascial pain may require three months of regular treatment, coupled with a home program of exercise and stretches.

In fact, you should ask to be given exercises to do at home. Unlike stretching routines for specific sports, these exercises will be designed to lengthen the muscles and connective tissues in various directions. To relieve tightness in the pelvic region, for instance, you may lie with your hip resting on a small foam ball for several minutes. Exercises are tailored to your individual needs.

Myofascial release therapy has not been extensively studied but is gaining increasing notice among mainstream doctors. A 1999 study in the New England Journal of Medicine, for example, found that osteopathic spinal manipulation, including myofascial release, was as effective as standard therapies for the relief of lingering low back pain but had an added benefit: Those who received hands-on therapy required far fewer costly painkillers, muscle relaxants, and anti-inflammatory drugs, which could have potentially dangerous side effects.

In addition to back pain, myofascial release is used to treat a wide array of painful ailments affecting the muscles and connective tissues. These include fibromyalgia, rheumatoid arthritis, muscle spasms, whiplash injuries, and carpal tunnel syndrome. People with diabetes, who are at increased risk for painful plantar fasciitis and frozen shoulder, may also benefit. Elite runners, and Olympic athletes have used the technique for stress injuries (it has also been used in racehorses and their riders), as have weekend warriors with tennis or golfer's elbow, shin splints, or a bad sprain that is having trouble healing.

The therapy is used for many other conditions as well in people of all ages. Those with jaw pain, discomfort from the scars of surgery, headaches, and chronic fatigue syndrome may all benefit. In women, the technique is sometimes used for relief of pelvic pain, menstrual problems, incontinence, and even infertility. It is also offered to children with, among other conditions, birth trauma, head injuries, cerebral palsy, and scoliosis.