Myofascial Release for Treatment of Voice and Dysphagia
I had the opportunity to attend the “Foundations of Myofascial Release in Neck, Voice and Swallowing” presented by Walt Fritz a few weeks ago in Rochester, NY. This 2-day, hands-on seminar dove into an approach to voice and swallowing treatment related to manual therapy that I had never thought to implement with my patients. This seminar piqued my interest as there is quite a bit of research on its usefulness with the voice population and a growing literature base on its use for treatment of dysphagia.
But honestly, what really sold me was Walt’s focus on person-directed care. You know that my number one goal for therapy is to make it functional, relevant, and person-centered. So I was immediately all in on this! Alright, are you ready to see if Myofascial Release (MFR) would be a good fit for your clinical practice? Keep reading to learn more!
What is Myofascial Release and where is its place in speech therapy?
MFR is a form of manual therapy that involves applying gentle and sustained pressure into the fascial tissue (connective tissue) to eliminate pain and improve range of motion. Classically used by physical therapists, this technique has been a buzzword over the past several years for speech pathologists. Why? Because it maintains quality literature in the voice world and has an emerging research base for swallowing therapy.
What does the research say about Myofascial Release?
Here is a very brief overview of some of the intriguing research articles supporting MFR as a treatment modality for dysphagia, dysarthria, and voice. If you would like to go more in-depth, please visit Walt’s website where he provides an extensive review.
1. Ateras, B., von Piekartz, H. (2017) introduced the concepts of neurodynamic testing and treatment for Parkinson’s patients with dysarthria. They found after use of neurodynamic principles, motor speech skills improved and subsequent speech therapy exercises could be carried out in a more intensive and effective manner.
2. Bordoni, B., Marelli, F., & Morabito, B. (2016) used MFR techniques on the tongue of post-whiplash injuries which “led to a disappearance of pain and the complete recovery of the normal functions of the tongue, such as swallowing and mouth opening.”
3. Burks, M., Bailey S., and Jefferson (2014) completed a case series for use of MFR to reduce dysphagia for head and neck cancer (HNC) patients.
4. Craig, Jk. Tomlinson, C. Stevens, K., Kotagal, K., Fornadley, J., Jacobson, B., Garrett, C.G., Francis, D.O. (2015) combined voice therapy and physical therapy which suggested MFR techniques may have a role in the treatment of Muscle Tension Dysphonia patients.
5. DePietro, J. D., Rubin, S., Stein, D. J., Golan, H., & Noordzij, J. P. (2018) looked at the use of laryngeal manipulation for dysphagia with muscle tension dysphonia and found an average of four sessions were required for patients to experience improvement in dysphagia symptoms.
6. Kang, C.H., Hentz, J.G., & Lott, D.G. (2016) found MFR for unloading laryngeal muscle tension to be an effective treatment for muscle tension dysphagia (laryngeal tension resulting in idiopathic functional dysphagia).
7. Krisciunas, G.P., Golan, H., Marinko, L.N., Pearson, W., Jalisi, S. and Langmore, S.E. (2016) completed a case series with five HNC patients during radiation treatment where patients reported lessened generalized neck and throat pain.
8. Marszalek, S., Niebudek-Bogusz, E., Woznicka, E., Malinska, J., Golusinski, W., & SliwinskaKowalska, M. (2012) found MFR improved functioning of the vocal tract in patients with occupational dysphonia.
9. Tomlinson C, Coon K, MacKenzie A, Archer K. (2013) researched PT’s use of MFR and an exercise program to improve patient outcomes related to pain and muscle tension dysphonia.
10. Roy, N., Nissen, S. L., Dromey, C., & Sapir, S. (2009) looked at articulatory changes associated with muscle tension dysphonia and the use of manual circumlaryngeal therapy for treatment.
How robust and diverse, right? And that is barely even scratching the surface of the literature out there! I loved the practicality of being able to use an approach with a wide variety of patients and diagnoses.
How is Myofascial Release person-centered?
Now that we discussed some research you’re probably thinking something like ‘manual therapy doesn’t seem like it could possibly be person-centered!’ I get it! I was doubtful at first too, but Walt’s philosophy and treatment style were unique. He emphasizes the necessity of verbal and/or non-verbal feedback from the patient in order for treatment to be successful. Person-directed interviewing and probe questions are integral to his seminar. This was humbling as often the therapist/patient dynamic is unbalanced. In fact, Walt teaches MFR techniques in a way that the patient actually has more control over the direction of treatment than the clinician! We were told to only treat areas that evoke familiar sensations or feelings for the patient and to let them have control of the pressure, length of a stretch, and areas treated through an open line of communication.
Putting it all together…
I, personally, was able to leave this course and apply the techniques I learned to several patients the very next day. I have found this to be a great skill to have in my treatment toolkit and would recommend this course to any SLP who frequently works with voice, HNC, or dysphagia patients. I left feeling prepared to implement Myofascial Release and also supported via an exclusive Facebook group and Youtube channel with video examples.
Are you itching for more info? Well, I can’t divulge all of Walt’s secrets! If you would like to take his seminar, you can check here to see if he is coming to a city near you. Or, listen to his Swallow Your Pride podcast episode where he covers the history of manual therapy, Myofascial Release, and discusses the research.
**I do not benefit financially from this article or review, I was just a big fan of this course!**
ABOUT THE AUTHOR
Katie Brown, MA, CCC-SLP,CBIS
Katie is the owner and founder of Neuro Speech Solutions. She is passionate about providing person-centered treatment to her clients in order to meet their life participation goals. Katie is dedicated to helping other SLPs provide functional therapy through affordable materials and education courses.
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