One article on PainSci cites Meltzer 2010: Does Fascia Matter?
PainSci commentary on Meltzer 2010: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
I would never normally be interested in this paper. In fact, I would never have chosen to read it myself, because I don’t think it’s good enough science. I am spending some time on it only as a gesture of good faith to a critic, who supplied the paper as an example of basic fascia science that matters. It may not have been a good choice for that purpose.
This is a test tube study showing that naked cells handled stress better (fewer signs of harm) if they were treated with, believe it or not, “simulated” myofascial release (MFR). A meaningful, accurate simulation of manual therapy on naked cells is an amusing notion, and it’s clear that what happened to those cells differs dramatically from what would happen in a real living body.
Even if true and reproducible, this data would mainly support the rationale for MFR specifically for post-exercise soreness — something of a dead end for the clinical relevance of MFR, because exercise-induced soreness has little to do with the main claims of MFR, which primarily concern correcting postural asymmetries, eliminating alleged restrictions, and treating chronic pain.
Post-exercise soreness is comparatively trivial, and patients don’t seek therapy for it (it’s usually over before they can get to an appointment). There’s a lot of research showing that exercise-induced soreness is basically invincible anyway. For this property of fascia to be clinically relevant, it would have to imply that MFR might be able to treat chronic pain from other causes … not the transient annoyance of soreness after a game of soccer.
This isn’t a rejection of all possible clinical relevance of the data. My point is that there are so many problems that its relevance is watered down to quite a thin sauce — way too thin.
I do concede that the paper shows some evidence that fibroblasts have interesting and perhaps positive responses to mechanical forces. That is inherently interesting, and probably worth investigating further, but it’s a mighty reach to postulate any clinical relevance to what most therapists do, most of the time, with patient’s fascia.
“Reach” is what the authors do, in spades. They claim to have no conflicts of interest, and they probably don’t, technically. Nevertheless, I suspect their egos are deeply invested in the notion that “fascia is important,” because they seem to be seeking evidence to support their pre-conceptions — typical of research funded by The National Center for Complementary and Alternative Medicine, and a hallmark of junk science.
It’s quite likely that if less biased researchers did this experiment, they would not be able to reproduce these results.
~ Paul Ingraham
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
In this study we modeled repetitive motion strain (RMS) and myofascial release (MFR) in vitro to investigate possible cellular and molecular mechanisms to potentially explain the immediate clinical outcomes associated with RMS and MFR.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.
- Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial. Bandak 2022 Ann Rheum Dis.
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
- A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Yousef 2013 Anaesthesia.
- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.