Objectives To assess the current state of scientific knowledge about myofascial release, a noninvasive manual treatment technique, and to identify the reliability of diagnostic tests for myofascial dysfunction and efficacy of the treatment.

Methods A literature search was undertaken, as well as exploring more widely for information concerning the subject, allowing an assessment of the rationale for the treatment and of the studies carried out.

Results Twenty-three items were identified in the literature search. No studies were found with which to determine reliability of the diagnostic method, but four randomised controlled studies of the treatment were identified. Two of the efficacy studies comprised several different modalities of treatment, so that no conclusions could be drawn. In one further study, the numbers were too small to allow safe conclusions; in the other, the myofascial release treatment was inferior to an isometric contract-relax technique. Overall, no good evidence of efficacy has been shown.

Conclusions We are unable to reach any conclusion on the diagnostic criteria and methods or on any efficacy of myofascial release. We recommend strongly that reliability studies be performed on diagnostic tests for myofascial dysfunction (tightness/looseness), so that efficacy studies can be performed on a more solid diagnostic foundation.