The Intersect Between Fascial Tissue and Pelvic Health: MFR Therapy for POP


Several years ago, I learned about myofascial release therapy (MFR) while participating in a local business meeting that included clinicians from multiple fields of practice. While the meeting had nothing to do with my personal healthcare, conversations that occurred included info share by a therapist who specializes in treating women’s pelvic floor dysfunction with MFR. My curiosity led to me to explore more deeply to better understand the treatment, but also to share it with APOPS following. To say I was shocked at the difference in my capacity to contract my pc muscle post internal MFR treatment the first time around is an understatement. I was equally shocked this time at how many internal sore spots existed in my vaginal canal. Much gets lost in translation when describing MFR; you simply have to experience it to better understand the sensations that occur upon release of bunched up fascial tissue.

MFR can be a valuable tool for treating women’s pelvic health. Whether exploring as a non-surgical treatment, to maintain post-surgical ballast, or to level issues with the complex combination of a hypertonic pelvic floor and POP, this is a treatment worth educating yourself about. Following is a series of questions answered by Sarah Trunk PT, DPT.

What is the theory behind the John F. Barnes approach to Myofascial Release?
Sarah: This approach takes into account the fact that our body is surrounded by and made up of fascia (our connective tissue whick is similar to a 3-dimensional webbing). This structure is full of collagen and weaves in and out of our whole body, head to toe to provide support to our body. Trauma, surgical scars and inflammation can cause our fascia to tighten down and solidify, placing up to 2,000 pounds of pressure per square inch on sensitive structures. That’s 1 metric ton of pressure! Myofascial release gently releases the pressures this system exerts on our bodies, including our joints and organs, can be life changing in improving our function.

How does the John F. Barnes approach differ from other types of MFR?
Sarah: John F. Barnes has been teaching this method for more than 40 years. His method has continued to be characterized by gentle hands-on soft tissue release with prolonged holding times of several minutes. Since that time, other approaches also deemed ‘myofascial release’ have arisen which often use a more aggressive pressure over a shorter time frame. Any massage therapist or physical therapist could tell you they practice ‘myofascial release’ which can be confusing as they are typically referring to many other styles of soft tissue mobilization. After practicing Physical Therapy for many years in various settings, I almost exclusively practice the John F. Barnes Approach due to its gentle nature with much more effective and long-lasting results.

Explain MFR treatments for the pelvis:
Sarah: Your practitioner will meet with you to take a thorough health history then begin an exam both externally and internally. It’s important to assess and work both internally and externally to gently restore proper alignment to the pelvis, coccyx, tailbone and to decompress any areas of tension along the organs of the pelvis. 

How can MFR be helpful as a non-surgical POP treatment?
Sarah: As I mentioned above, tightness in our fascial system can exert up to 2,000 lbs per square inch of pressure on various tissues and organs. These forces can push and/or pull the pelvic organs out of place. Gently releasing tight tissues throughout the lower abdomen, pelvis and even the thighs can help the organs return to their natural resting place and take the ‘squeeze’ of pressure off of them. For example, I’ve worked with several patients where I am able to feel the bladder ascending back where it belongs as we perform the gentle myofascial release work, hugely helpful with their urinary incontinence symptoms!

Are there any types of POP or degrees of POP severity in which MFR would be contraindicated?
Sarah: Mild forms of POP are more easily treated than severe prolapses which have progressed quite significantly. I would recommend talking with your physician about this, especially with moderate to severe cases. In any instance, this type of therapy is extremely gentle and the risks are quite low.

How many MFR treatments or how soon after an MFR treatment will I experience symptom relief?
Sarah: Most patients will notice some sort of change in their body in 3 sessions. Every person is different however; some may experience relief in a few sessions while with others it may take months. The severity of your symptoms and how much strength you have in your pelvic floor muscles will also be important factors in this. I would recommend asking this question of your therapist after the first session once they have evaluated your condition and can give you a more exact idea. It’s a great idea to work with a John Barnes’ myofascial release therapist that’s also a physical therapist, as they will be able to address strengthening with you as well.

Can MFR help with both POP pain and pressure?
Sarah: Yes certainly; the extreme amount of pressure exerted by the fascial system on nerves, organs and other structures in the pelvis can cause significant feelings of pain and pressure in our bodies. Gently releasing this ‘vice grip’ of the fascial system can provide significant relief.

Is MFR beneficial for women for long term maintenance post POP surgery?
Sarah: In recovering from surgery, it’s important to first regain the strength of your pelvic floor and abdominals. Following this, myofascial release can be especially helpful as well to gently balance the pelvis and the contents within. You will want to get your physician’s OK to start physical therapy and/or MFR after surgery, often 6-8 weeks following. Long term after surgery, it’s important for you to know your body and what feels normal to you. Physical therapy and myofascial release can be wonderful tools to utilize as needed to keep you functioning optimally as the years go on.

For more information or to find a John F. Barnes therapist that practices Women’s Health/Internal Pelvic work, please go to

Information and services provided by:
Sarah Trunk PT, DPT
Balance Within Physical Therapy