Differences between myofascial release, massage and craniosacral therapy

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Written By Diene Oliveira Cruz

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Myofascial release and massage therapy are often confused due to their apparent similarities. However, there are key differences between the two that can significantly impact their effectiveness for different individuals.

Key differences below:

Myofascial Release

  • Focuses on releasing fascial restrictions through gentle, sustained pressure into the myofascial connective tissue.
  • Uses very light force and developers have claimed to release restrictions within the body’s fascial system with as little as 5-10 grams of pressure.
  • Aims to realign and rehydrate fascia to eliminate pain and restore motion. Can be globally applied or focused on restricted areas.
  • May utilize passive stretching and feedback from the client’s body to guide technique.
  • Sometimes integrated with massage but considered a distinct therapy.


  • Encompasses many techniques (effleurage, petrissage, friction, etc) that manipulate the superficial and deep layers of muscle and other soft tissues.
  • Often employs lubricant and rythmic techniques to knead, glide, rub tissues.
  • Aims to relax soft tissues, enhance circulation, increase range of motion, and reduce pain.
  • Pressure and speed is moderated based on client feedback.
  • Primarily works on individual muscles rather than fascia between muscles.

Craniosacral Therapy

  • Gentle, hands-on approach that releases restrictions in craniosacral system to improve central nervous system function.
  • Works on cranium, spine, sacrum and fascia using very light touch, 5-10 grams of pressure.
  • Aims to enhance circulation of cerebrospinal fluid and balance parasympathetic nervous system.
  • Practitioners evaluate rhythmic craniosacral motion and restrictions through palpation.
  • Addresses whole body rather than localized areas.

While therapies may overlap, the primary goal, philosophical approach, evaluation methods, and techniques differ substantially. Further research is needed on their comparative effectiveness.

In this article, we will explore the concepts of myofascial release and massage, their similarities and differences, and how to determine which may be best suited for you.

What is Myofascial Release?

Myofascial release is a technique focused on treating muscle and connective tissue, specifically the fascia. Fascia is a web-like matrix of connective tissue that binds and supports muscles and muscle groups throughout the body.

This continuous network is referred to as the myofascial system. Both massage and myofascial release techniques involve the use of hands or instruments to manipulate muscle and connective tissue, aiming to improve circulation, stimulate nerve fibers, relieve pain, and restore coordination in the affected areas.

Myofascial Release is a set of techniques (manual or instrumental) used to treat the tissues surrounding the muscle. It is inserted in several contexts of the physical therapist’s clinical practice.

More specifically, the main benefits of the myofascial release technique are:

  • Relieve myofascial tensions;
  • Treat chronic muscle pain;
  • Improved Range Of Motion;
  • Improve Flexibility;
  • Adapt to the distribution of muscle mass;
  • Improve blood circulation;
  • Improve tissue respiration;
  • Promote progressive changes on the physical and emotional levels;
  • Increase body awareness;

The muscle fascia is one of the tissues most benefited by the myofascial release technique.

Fascia is a type of fibrous connective tissue that branches throughout the body continuously, wrapping structures and forming a sheath under the skin.

These connective tissues maintain and connect all body structures by interrelating them, creating a three-dimensional web distributed in every tissue, from muscle groups to bones and even organs.

CranioSacral Therapy


Craniosacral Therapy is a gentle manual therapy dedicated to the diagnosis and treatment of the Craniosacral System through gentle and precise touches on the bones of the head, spine and sacrum, improving the functioning of the central nervous system and consequently, activating the self-healing capacity of the body, promoting deep relaxation and a sense of well-being at all levels: physical, emotional and mental.

Craniosacral Therapy is an evolution of Cranial Osteopathy. It is based on monitoring the subtle movement of the bones that make up the craniosacral system, releasing deep tensions, relieving pain and dysfunctions and improving the performance and health of the entire body.

The proper functioning of the craniosacral system influences all other physiological systems: nervous, digestive, circulatory, lymphatic, respiratory, hormonal and musculoskeletal. Using maneuvers that modify the circulation of CSF, TCS promotes an exchange of fluids in all body tissues, distributing the power of health and awakening the recovery processes. The work on the muscle fascia releases accumulated tensions and increases blood and lymphatic circulation, bringing flexibility nutrition, eliminating toxins and helping with the inflammatory processes that may be taking place, and resolving many uncomfortable symptoms such as chronic pain and localized disorders.

With appropriate manipulations of the vertebrae, the spine’s flexibility can be improved as the lubrication of the liquor reaches the places of compression and blockages, such as arthrosis, calcifications, herniated discs, and spinal problems.

CranioSacral Therapy acts on the balance of the Autonomous Nervous System, unloading the Sympathetic Nervous System if it is too activated and stimulating the Parasympathetic for relaxation in stress, insomnia, anxiety, and anxiety vice versa in cases of depression and chronic tiredness. Thus, it promotes deep relaxation and a sense of well-being, breathing becomes easy and free, and a state of suspension and peace of mind occurs, the same state of deep meditation that other methods can achieve.

The Therapy allows for greater observation of movements and internal rhythms and increases body awareness. With the release of system restrictions and blockages, old behavior patterns, wounds, and traumas can become conscious.


CranioSacral Therapy, Myofascial Release are all manual therapies used to improve overall health and well-being. These therapies work with different systems in the body and use varying techniques to release restrictions and enhance healing.

The CranioSacral system is made up of membranes that surround and protect the brain and spinal cord. CranioSacral Therapy is a gentle type of therapy that uses only five grams of pressure. This gentle pressure allows for the release of restrictions in the central nervous system and can alleviate pain within the brain and spinal cord.

The Myofascial system is a web of fascial tissues that run from the head down to the toes. When one area is injured, it can cause tight restrictions throughout the body due to the strong tensile forces of the fascia. Myofascial Release therapy accesses this system and works to alleviate restrictions and enhance the body’s natural healing ability.

CranioSacral Therapy and Myofascial Release: Key Differences

The main differences between the two are:

  1. Pressure: Craniosacral therapy uses a very gentle pressure of only five grams to release restrictions in the central nervous system, while myofascial release can involve deeper pressure to alleviate tight restrictions in the myofascial system.
  2. Focus: Craniosacral therapy focuses specifically on the membranes surrounding and protecting the brain and spinal cord, while myofascial release focuses on the web of fascial systems throughout the body.
  3. Approach: Craniosacral therapy is a very gentle and subtle approach that works to release restrictions and enhance the natural healing ability of the body, while myofascial release can be more intense and focused on manipulating the fascia to increase circulation, relieve pain, and improve flexibility.

Massage vs. Myofascial Release: Key Differences

  1. Purpose and Focus: Traditional massage is generally aimed at promoting relaxation and easing muscle tension. The therapist often works on the entire body, spending equal time on each area. Myofascial release, on the other hand, is more therapeutic and targeted, addressing specific areas of restriction or discomfort within the fascia.
  2. Environment and Duration: During a massage session, clients typically lie down in a dimly lit room, often partially undressed, with soothing music playing in the background. The sessions usually last about an hour. In contrast, myofascial release sessions are often shorter, ranging from a few minutes to 15 minutes. Clients remain fully clothed and may not necessarily lie down during the treatment.
  3. Techniques: While both methods involve hands-on manipulation of tissues, myofascial release focuses on working out kinks and restrictions within the fascia, while massage primarily addresses muscle tension.

Selecting the Right Therapist

The effectiveness of either technique largely depends on the skill and knowledge of the therapist.

When seeking myofascial release, it is important to find a practitioner who specializes in this technique and has a genuine interest in addressing your specific concerns. A good massage therapist may also incorporate myofascial release techniques into their practice, providing a more comprehensive treatment.

Overall, both myofascial release and craniosacral therapy are effective manual therapy techniques that can help address various issues in the body. The choice between them may depend on the specific needs and preferences of the patient, as well as the expertise of the practitioner.

diene oliveira cruz
Diene Oliveira Cruz
Physical Therapist | + posts

Physiotherapist, with specialization in Orthopedics and Traumatology by Santa Casa de São Paulo. Pain and Rehabilitation Specialist.

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