ASA Ruling on Myofascial Release UK
Myofascial Release UK
The Natural Therapy Centre
12 Station Road
16 March 2011
Health and beauty
Number of complaints:
A leaflet, promoting training courses in a soft tissue therapy, was titled "INTEGRATED MYOFASCIAL THERAPY" and featured pictures of practitioners treating patients. Text below the pictures stated "Post graduate training programmes in MYOFASCIAL RELEASE Develop a unique and dynamic whole-body approach to healthcare. Enhance diagnostic and therapeutic skills. Learn advanced, traditional and modern fascial techniques". A logo at the bottom was accompanied by text which stated "Myofascial Release UK & Ireland".
Text inside the leaflet was headlined "Integrated Myofascial Therapy (iMFT) ... is a unique and dynamic whole-body, hands-on approach to healthcare. It offers valuable training in advanced, traditional and modern myofascial release (MFR) techniques that can be easily and effectively incorporated into existing practices. Fascia; a connective tissue, is a 3D living matrix that supports, protects and infuses every tissue and organ of the body. It responds dynamically to pressure created both internally and externally. With injury it loses its ability to respond to these forces and begins to bind down, creating a pull through its 3D planes (rather like a pull in a jumper). Due to this internal 'dragging' internal organs and vital structures become affected, creating pain and restricting movement and function. When slow, gentle pressure is applied to the body using fascial release techniques, this 3D living matrix responds in a natural and intuitive way by releasing and reorganising itself throughout the body. MFR treats the whole body; restoring balance and creating structural change that is both measurable and functional".
Text on a separate page stated "Myofascial Release can help: backache, sciatica and pelvic pain; sporting injuries; frozen shoulder; tight and tender muscles; fibromyalgia, CFS/ME; carpel tunnel; chronic pain and tension; headaches & TMJ disorder; injury and surgical scarring; tinnitus; scoliosis; unresolved emotional and physical issues; myofascial trigger point pain; and many others".
Text on a separate flyer within the leaflet stated "MFRUK workshops provide the skillful [sic] integration of fascial approaches that can effectively treat ... chronic fatigue and chronic pain syndrome ... RSI ... jaw pain".
1. The complainant challenged whether the ad's claim that MFR was effective in treating the conditions listed was misleading and could be substantiated.
2. The ASA challenged whether the ads reference to TMJ (temporomandibular joint) disorder, a serious medical condition, could discourage essential treatment.
1. Myofascial Release UK (MFR UK) said myofascia were the muscles and bands of the body which were also known as the connective tissue or soft tissue. They said fascia was a system-wide network that, when injured, transmitted that injury throughout the entire network which in turn created symptoms that seemed unrelated and were labelled as conditions by traditional healthcare. MFR UK said manual therapy was the governing term for all hands-on treatment of pain and dysfunction and MFR was one such therapy. They provided links to three Wikipedia articles which they said explained the forms of MFR, references, trigger points and origins of the therapy.
MFR UK said traditional healthcare needed research based evidence but, with myofascial pain, restrictions did not show up on regular scans or X-rays and symptoms did not follow a regular pattern. They said it was well documented that soft tissue and myofascial pain and restrictions had been discredited by traditional healthcare until recently. MFR UK said the research of fascia was now huge and provided links to the websites of two meetings of the International Fascial Research Congress. They also provided links to studies regarding the effect of MFR on chronic fatigue syndrome and fibromyalgia, a list of books about the myofascial system, pain and treatments, and links to the websites of several companies and organisations which provided MFR for specific conditions.
MFR UK said, now that the role of the fascial system was understood, it could be seen that carpal tunnel, frozen shoulder or scoliosis were not necessarily nerve, bone or muscle problems and instead such labelled symptoms could be caused by restrictions within the system-wide fascial network. They said this was why MFR had gained increased popularity in recent years and was an important part of manual therapy that could make a huge difference to the conditions referred to in the ad. They said science had now revealed the enormous role that the network played in health and MFR was therefore based on new and exciting evidence. They said MFR was taught as a component of a number of NHS, physiotherapy, college and university programmes, including on MSc and BSc courses. They provided links to the web pages of a number of such courses and believed that MFR's presence in them showed that it was effective.
MFR UK said, notwithstanding that, the statement "myofascial release can help" did not mean that MFR was a cure for any condition, symptom or ailment. They said the word "can" provided the meaning of probability and possibility, not definite cure and made clear that no guarantee was being made. They said numerous websites and marketing materials from thousands of allied healthcare professionals that were not capable of completely resolving problems, also used the words "can help".
2. MFR UK said they completely disagreed that the ad might entice people to try MFR before seeking medical attention. They reiterated that the leaflet was not for the general public and said every therapist was legally and professionally bound by their code of ethics to advise all patients and clients to seek medical attention for any and all aches and pains before commencing treatment.
The ASA considered that the claims "Myofascial Release can help: backache, sciatica and pelvic pain; sporting injuries; frozen shoulder; tight and tender muscles; fibromyalgia, CFS/ME; carpel tunnel; chronic pain and tension; headaches & TMJ disorder; injury and surgical scarring; tinnitus; scoliosis; unresolved emotional and physical issues; myofascial trigger point pain; and many others" and "MFRUK workshops provide the skillful [sic] integration of fascial approaches that can effectively treat ... chronic fatigue and chronic pain syndrome .. RSI ... jaw pain" would be interpreted by readers to mean that MFR could treat those conditions. We considered that those claims required a body of robust scientific evidence, such as clinical trials conducted on people, in order to substantiate them.
We noted the link to the study regarding the effect of MFR on chronic fatigue syndrome. We noted, however, that only the abstract from a conference paper on that study, and not the full study or results, was available at the link provided. Notwithstanding that, we understood from the abstract that the study had been conducted on 11 participants and we considered that a sample size of 11 was not large enough to support an absolute claim that MFR could treat chronic fatigue syndrome. We also understood that the study was not blinded or properly controlled.
We also noted the study regarding the effects of MFR on fibromyalgia. We noted that subjects in the intervention group received 20, 90-minute sessions of myofascial release massage from a specialist physiotherapist to the 18 painful sensitive points on the body described by the American College of Rheumatology, while subjects in the placebo group received 20, 30-minute sessions of sham magnotherapy to the lumbar and cervical areas. We therefore understood that the trial was only single-blinded and that the intervention group had received three times as much treatment time, pro rata, as the placebo group. Notwithstanding that, we did not consider that disconnected magnotherapy to two areas only was an appropriate method with which to control against an intervention group who were receiving wide-ranging, hands-on manual therapy.
We also noted the links to the Wikipedia articles and the web pages of the courses and the International Fascial Research Congress, but did not consider that they were suitable to support the efficacy claims in the ad.
Because we had not seen robust, scientific evidence that MFR could treat the conditions listed in the ad, we concluded that the ad was misleading.
On this point the ad breached CAP Code (Edition 12) rules 3.1, 3.7 (Misleading advertising) and 12.1 (Medicines, medical devices, health-related products and beauty products).
We considered that the reference to TMJ, alongside the references to the benefit and help provided by MFR, implied that MFR could treat TMJ. We therefore considered that the ad could discourage readers from seeking essential medical treatment for that condition, and concluded that on this point the ad breached the Code.
On this point the ad breached CAP Code (Edition 12) rule 12.2 (Medicines, medical devices, health-related products and beauty products).
The ad must not appear again in its current form.
Adjudication of the ASA Council (Non-broadcast)