I am having a physical therapist work on my elbows. They tend to flare up whenever I spend too much time on the computer. She has given me a special gadget I can use to rub my tendon that really seems to do the trick. I forgot to ask the last time I was in the clinic how and why this works so well. Can you offer any explanation?

It sounds like the therapist has instructed you in a technique called myofascial release therapy (MFRT). Applied by the therapist or by yourself, the idea behind this treatment approach is to apply a low load, long lasting stretch to the myofascial tissue (connective tissue that support and surround muscles and tendons).

There are different ways to apply myofascial therapy (directly, indirectly, using hands or the special tool you are using that was designed for this purpose). The desired result is to increase circulation, reduce sensitivity of nerves, and improve elasticity (flexibility and stretch) of the tissues.

The exact mechanism by which myofascial release therapy is effective isn’t entirely clear. Experts in this area of study believe the technique allows the tendon to heal and restore a more normal soft tissue structure without restrictions.

Reorganization of the collagen fibers that make up the connective tissue may be another way in which MFR lengthens the fascia and aids in healing. The prolonged, slow pressure applied to sensitive nerve tissue may help slow down pain signals.

You may be interested in the results of a recent study from researchers in Malaysia and India providing evidence to support the value of myofascial release therapy. In this study, 68 computer professionals with lateral epicondylitis were divided into two groups. Group 1 received 12 myofascial release therapy treatments over a period of four weeks. Group 2 (control group) received a sham ultrasound treatment to or elbow surgery.

Everyone in both groups was tested before treatment began and retested at the end of treatment (four weeks), and three months later as a follow-up. Pain, function, and disability were measured using a specific test called the Patient-Rated Tennis Elbow Evaluation Scale.

Test results showed a consistent and significant value of myofascial release (MFR) for this type of lateral epicondylitis. The MFR group had a 78.7 per cent reduction in symptoms while the control group had only a 6.8 per cent reduction. And that significant difference between the groups was still observed at the end of 12 weeks.

There were no adverse effects from either treatment but a few of the patients in the MFR group noted their pain increased the first week after the first treatment. Painful symptoms went away within a few days and there was no need for pain medications. The authors concluded that myofascial release (MFR) was much more effective than sham ultrasound therapy in decreasing pain and improving function in computer workers with lateral epicondylitis.