Type "myofascial therapy" into a search engine and you will find myofunctional therapy practices — this one included — mixed into the results, which means some of the people who click through are looking for something we do not do. The reverse happens too: a dentist mentions "myofunctional therapy" for jaw pain, and the patient books a myofascial release session at a physical therapy clinic, because the two words sounded like the same thing.
They are not. One is an exercise program that retrains how your tongue, lips, and jaw behave all day. The other is a hands-on technique that treats tight muscle and connective tissue. Here is what each one actually is, who does it, where they overlap, and how to figure out which one you were referred for.
The Short Answer
Orofacial myofunctional therapy is active and long-term. A trained clinician evaluates how your tongue rests, how you breathe, how you swallow, and what oral habits you have, then teaches a sequence of exercises you practice daily for several months to replace those patterns. Nothing is done to you; the change comes from what you learn to do differently.
Myofascial therapy — most often called myofascial release — is passive and in-the-moment. A practitioner uses their hands (or sometimes tools) to apply slow, sustained pressure or stretch to muscles and the fascia around them, aiming to reduce tightness, tenderness, and pain in that tissue. The work happens on the table.
The prefix is the only thing they share. Myo- simply means muscle, and it shows up in a lot of names — myofunctional, myofascial, myotherapy, myofascial pain syndrome — that describe very different things.
What Myofunctional Therapy Is
ASHA's clinical guidance on orofacial myofunctional disorders defines them as "movement patterns that involve oral and orofacial musculature, which result in incorrect positioning of the tongue at rest and during swallowing, breathing, and speech production." The treatment targets listed on the same page read like a checklist of what a program works toward: establish a clear nasal airway, a closed-mouth resting posture, lip seal, lingual-palatal seal (the tongue resting against the roof of the mouth), an open nasal pathway during sleep, improved speech sound placement, elimination of prolonged nonnutritive sucking, and a modified swallow for saliva, liquids, and solids.
In practice, those targets are the reasons people are referred:
- Tongue thrust — the tongue pushing forward against or between the teeth when swallowing or at rest
- Chronic mouth breathing — an open-mouth posture that persists after the original nasal blockage is treated
- Thumb, finger, and pacifier habits — and the bite changes that follow prolonged ones
- Tongue tie — retraining before and after a release procedure
- Orthodontic stability — protecting an orthodontic result when the tongue's resting position is the force working against it
- TMJ discomfort and sleep-disordered breathing — as one component of a team plan
The tools are exercises, not hands. Our guide to myofunctional therapy exercises walks through what the nasal breathing, tongue posture, lip seal, swallowing, and jaw work actually look like and how a program is sequenced. If you want the full explainer first, start with what myofunctional therapy is.
What Myofascial Therapy Is
Fascia, in the Cleveland Clinic's plain-language description, "is the band of thin, fibrous connective tissue that wraps around and supports every structure in your body." When muscle and its fascia become tight, inflamed, or knotted, the result can be myofascial pain syndrome, which the Cleveland Clinic defines as "a chronic condition that arises from inflammation in your muscles and fascia," marked by trigger points — "small bumps, nodules or knots in your muscle that causes pain when touched and sometimes when they're not touched."
Myofascial release is one of the manual techniques used to treat that tissue. A 2015 systematic review of randomized controlled trials in the Journal of Bodywork and Movement Therapies (Ajimsha et al.) describes it as "a form of manual therapy that involves the application of a low load, long duration stretch to the myofascial complex, intended to restore optimal length, decrease pain, and improve function." The same review concluded that the literature on its effectiveness "was mixed in both quality and results," while calling the direction of recent studies "encouraging" — an honest summary that the technique has real support but not a settled evidence base.
Myofascial work is not specific to the face. It is used on backs, necks, shoulders, hips, and feet. When it is applied to the jaw, it targets the masseter, temporalis, and pterygoid muscles that do the chewing and clenching, sometimes including gloved intraoral work on the inside of the cheek.
Who Provides Each
This is where the confusion usually gets resolved, because the two are delivered by different professions.
Myofunctional therapy is provided by clinicians with specific certification in orofacial myology layered on top of an existing license. ASHA states that "orofacial myofunctional interventions are conducted by appropriately trained speech-language pathologists (SLPs) as part of a collaborative team," and that "SLPs who serve this population should be specifically educated and appropriately trained to do so." Registered dental hygienists and dentists also pursue orofacial myology certification. What all of them have in common is that they are teaching you a program, not treating tissue by hand.
Myofascial release is provided by hands-on practitioners. The Cleveland Clinic lists physical therapists among the specialists who treat myofascial pain syndrome and, for release work specifically, suggests looking for "a massage therapist with experience in stretching and working out trigger points through myofascial release therapy." Chiropractors, osteopathic physicians, and some dentists with additional training also perform it.
At Bloom, Laura Friedman holds the CCC-SLP and QOM credentials and provides orofacial myofunctional therapy. We do not provide myofascial release, massage, or any other manual soft-tissue treatment. When a patient needs that, we say so and coordinate with the physical therapist or other provider who does. Our TMJ disorder page describes that team approach.
Side by Side
- What it is. Myofunctional: exercise-based retraining of tongue, lip, jaw, and breathing patterns. Myofascial: hands-on stretch and pressure applied to muscle and fascia.
- Active or passive. Myofunctional: active — you do the work, daily, at home. Myofascial: passive — the practitioner does the work in the session.
- Main goal. Myofunctional: change a habit or pattern permanently. Myofascial: reduce tightness, tenderness, and pain in tissue.
- Typical provider. Myofunctional: an SLP, dental hygienist, or dentist certified in orofacial myology. Myofascial: a physical therapist, massage therapist, chiropractor, or osteopathic physician.
- Body region. Myofunctional: mouth, face, and airway only. Myofascial: any region — the jaw is one application among many.
- Typical duration. Myofunctional: a program of months with weekly or biweekly visits. Myofascial: a session or a short series, repeated as symptoms return.
- Common referral sources. Myofunctional: orthodontists, dentists, ENTs, sleep specialists, pediatricians. Myofascial: dentists, physicians, pain specialists, or self-referral.
Where They Overlap: The Jaw
The one place the two fields genuinely meet is temporomandibular disorder — TMD, the group of conditions most people call TMJ.
The National Institute of Dental and Craniofacial Research describes TMDs as "a group of more than 30 conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement," affecting "about 5% of adults in the U.S." and occurring "twice as common in women than in men." NIDCR sorts them into disorders of the joint itself, disorders of the chewing muscles, and TMD-associated headaches — and that sorting is the key to the comparison.
When the problem lives in the muscle tissue, manual therapy has direct support. NIDCR notes that "research suggests that manual therapy, a type of physical therapy in which a therapist uses their hands to stretch the soft tissues and muscles around the joint, can help improve function and relieve pain." That is myofascial territory: tight, tender masseter and temporalis muscles that respond to being worked on.
When the problem is why those muscles keep tightening, the question changes. A tongue that rests low in the mouth instead of against the palate, an open-mouth breathing pattern, a forward swallow, daytime clenching, gum chewing, and nail biting all load the jaw thousands of times a day. Manual therapy releases the tissue; if the pattern that tightened it is untouched, the tightness returns. Myofunctional therapy is the part of the plan that addresses the pattern.
Both approaches sit comfortably inside NIDCR's overall guidance: "Because evidence for many TMD treatments is limited, experts recommend conservative treatments and avoiding treatments that permanently change the jaw joints, teeth, or bite, or involve surgery." Neither one is invasive, and neither one changes the joint or the bite.
Which One Were You Referred For?
Go back to the wording and the referrer.
It was probably myofunctional if: the referral came from an orthodontist, dentist, ENT, sleep physician, or pediatrician; the concern was tongue posture, tongue thrust, mouth breathing, an open bite, a thumb or pacifier habit, a tongue tie, snoring, or orthodontic relapse; or the word "exercises" or "retraining" came up. Our myofunctional therapy overview and our comparison of myofunctional therapy vs. speech therapy cover the rest of what that program involves.
It was probably myofascial if: the referral came from a physical therapist, pain specialist, or chiropractor; the concern was described as tight muscles, knots, trigger points, or muscle pain; or the plan involved massage, stretching, dry needling, or trigger point injections. That is a manual-therapy provider, not a speech-language pathologist.
It could be both if: you have jaw pain, clicking, headaches, or facial muscle fatigue and the evaluating provider mentioned both tight muscles and habits like clenching, mouth breathing, or a low tongue posture. In that case the two are not competing — one treats the tissue and the other treats what keeps loading it.
If you are unsure, ask the referring office one question: "Is this something a practitioner does to me with their hands, or a program of exercises I do myself?" The answer sorts it every time.
Two Practical Notes
Coverage. Physical therapy, including manual therapy for TMD, is often a covered medical benefit when there is a diagnosis. Massage-based myofascial work frequently is not. Myofunctional therapy is covered inconsistently — sometimes reimbursed under speech-language pathology codes when tied to a swallowing or speech diagnosis, often paid out of pocket. Our myofunctional therapy cost and insurance guide explains how to check your plan.
Sequencing. When both are on a plan for jaw pain, patients often find the hands-on work makes the exercises more comfortable early on, and the exercises make the hands-on relief last. Neither has to finish before the other starts, but each provider should know the other is involved.
Frequently Asked Questions
What is the difference between myofunctional therapy and myofascial therapy?
Myofunctional therapy is an exercise-based program that retrains the resting posture and function of the tongue, lips, and jaw over several months. Myofascial therapy, usually called myofascial release, is hands-on manual treatment that applies sustained pressure or stretch to muscle and fascia to reduce tightness and pain. One is active and changes patterns; the other is passive and treats tissue.
Is myofascial release the same as myofunctional therapy?
No. They share the prefix myo-, meaning muscle, and both can be part of a jaw-pain plan, which is why they get mixed up. Myofascial release is done to you by a physical therapist, massage therapist, or similar provider. Myofunctional therapy is a program you do under the guidance of a clinician certified in orofacial myology.
Which one do I need for TMJ pain?
Start with a dentist or physician diagnosing what kind of TMD you have. Tight, tender chewing muscles point toward manual therapy. A low tongue posture, mouth breathing, clenching, and other daily habits point toward myofunctional therapy. Many patients have both on the plan.
Can you do myofunctional therapy and myofascial release at the same time?
Yes. For jaw and facial pain that is a common arrangement — release makes the exercises more comfortable, and the exercises change the patterns so the tightness is less likely to return. Different professionals provide each, so coordination means each knowing the other is on the plan.
Does a speech therapist do myofascial release?
Not typically. A speech-language pathologist's orofacial work is myofunctional — exercise-based retraining. Bloom provides orofacial myofunctional therapy and does not provide myofascial release or massage.
Not Sure Which One You Need?
If a provider mentioned "myo-something" for your jaw, your tongue posture, or your child's mouth breathing and you are still not sure which service that was, schedule a free consultation with Laura Friedman — CCC-SLP and Qualified Orofacial Myologist — in person in Dallas or online nationwide. If what you need is hands-on tissue work rather than retraining, you will hear that directly, along with who to see for it.