Aftercare Instructions
After Your Hydrofascia Release™ Procedure
A clear, step-by-step guide for the days and weeks following your ultrasound-guided hydrodissection at The Fascia Institute and Treatment Center®.
Most Important Rules
Avoid ice. Heat is encouraged.
Ice tightens fascia and slows the glide we just restored. Heat does the opposite — it relaxes tissue, improves circulation, and helps the newly separated layers stay separated. Use a warm shower, heating pad, or warm compress as often as it feels good.
About Your Procedure
What Hydrofascia Release™ Does
Hydrofascia Release™ is an ultrasound-guided procedure in which a small volume of fluid is injected precisely between fascial layers, around entrapped nerves, or within thickened myofascial planes to mechanically separate adhesions and restore glide between tissues that have been stuck together — often for years.
The solution used in your procedure is selected based on your anatomy, your diagnosis, and the goal of the session. A common formulation includes lidocaine, bupivacaine, and a low dose of dexamethasone, but the recipe may vary. In other cases we use dextrose, saline, or platelet-rich plasma. Your provider will tell you which solution was used in your session.
Each component has a role: the local anesthetic delivers immediate relief and interrupts the pain cycle, the low-dose dexamethasone calms the local inflammation that has been maintaining the adhesion, and the fluid itself does the mechanical work of separating tissue planes that needed to move freely again.
Understanding the Discomfort
Expect pain and discomfort after the initial treatment. It should improve.
Many patients feel immediate relief during the procedure itself — the local anesthetic is at work and the tissue is moving in ways it hasn’t moved in years. When the anesthetic wears off a few hours later, soreness sets in. This is normal.
You have just had fluid forced between layers of tissue that were stuck together. The body responds the same way it would to any deep tissue work — with localized soreness, stiffness, sometimes bruising, and occasionally a feeling that the original pain has temporarily returned. This is the tissue adjusting to its new freedom of movement, not the procedure failing.
Discomfort typically peaks within the first one to three days and steadily improves over the following one to two weeks. By the time the soreness has resolved, you should feel a meaningful change in glide, range of motion, and pain quality in the treated area.
The goal of Hydrofascia Release™ is not just to break adhesions — it is to keep them from re-forming. The first two weeks of aftercare are what protect the result.
Section 1
Medications
Pain Relief — Use What Works for You
You do not need to avoid anti-inflammatory medications after Hydrofascia Release™. Tylenol (acetaminophen), ibuprofen, naproxen, meloxicam, and other NSAIDs are all acceptable for soreness if you need them. Use the option that works best for you, at the lowest effective dose, and for the shortest time you need it.
Continue any prescription medications, including baby aspirin, as you normally would unless we have told you otherwise.
If another physician prescribes a new medication, or you are uncertain whether something is appropriate alongside your treatment plan, send us a portal message before changing anything. Do not discontinue any medication you take for another health condition without checking with your prescribing physician.
Section 2
Wound Care, Heat & Ice
First 12–24 Hours
Keep each injection site clean, dry, and covered with a Band-Aid. You may shower at any time.
Avoid Ice
Ice tightens fascia and reduces the glide we just worked to restore. Skip the ice pack while you recover from this procedure.
Heat Is Encouraged
Warm showers, heating pads, and warm compresses help the fascial planes stay mobile. Use as often as it feels good.
Swelling & Bruising
Localized swelling and bruising at the injection sites can last up to two weeks. This is expected and resolves on its own.
Section 3
A Typical Recovery Timeline
Day 0 — The Day of Your Procedure
Often a window of immediate relief while the local anesthetic is active. Toward the end of the day, as the lidocaine and bupivacaine wear off, soreness or a deep aching sensation sets in.
Days 1–3 — Peak Soreness
This is usually the most uncomfortable stretch. The tissue is adjusting to its new mobility. Stiffness, aching, and bruising are normal. Heat, gentle movement, and an anti-inflammatory or Tylenol as needed are your tools here. Ice is not.
Days 3–7 — Steady Improvement
Soreness should be steadily improving. Begin gentle stretching and light movement. Many patients notice the original pain pattern feels different — sometimes better, sometimes shifted to a different area, which can mean a different layer of fascia is now revealing itself.
Weeks 1–2 — Resolution
Soreness from the procedure itself should be largely resolved. The new glide is settling in. This is when light massage, stretching, and physical therapy do their best work to preserve the result.
Weeks 2–6 — Reassessment
We will reassess at your follow-up to determine whether additional Hydrofascia Release™ sessions are warranted, or whether the area is ready to be reinforced with prolotherapy or PRP for longer-term durability.
If your soreness is still not improving after one week — or if it is getting worse instead of better — send us a portal message with an update and we will guide next steps.
The Science Behind the Procedure
Published research on ultrasound-guided hydrodissection.
The Hydrofascia Release™ protocol is built on a growing peer-reviewed literature describing how ultrasound-guided hydrodissection separates fascial adhesions, frees entrapped nerves, and restores tissue glide. A few of the references that have shaped our protocol:
Reference 1
Courseault J, Kessler E, Moran A, Labbe A.
Fascial Hydrodissection for Chronic Hamstring Injury.
Current Sports Medicine Reports. 2019;18(11):416–420. Describes the ultrasound-guided technique for separating fascial adhesions of the proximal hamstring complex — the foundational protocol that informs Hydrofascia Release™ at other anatomical sites.
Reference 2
Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD.
Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms.
Journal of Pain Research. 2020;13:1957–1968. Reviews the mechanical separation of fascial planes around peripheral nerves and the role of different solutions — including local anesthetic, saline, dextrose, and steroid blends.
Reference 3
Cass SP.
Ultrasound-Guided Nerve Hydrodissection: What Is It? A Review of the Literature.
Current Sports Medicine Reports. 2016;15(1):20–22. Foundational overview of the indications, technique, and expected recovery course for ultrasound-guided hydrodissection.
Reference 4
Stecco C, Stern R, Porzionato A, Macchi V, Masiero S, Stecco A, De Caro R.
Hyaluronan within Fascia in the Etiology of Myofascial Pain.
Surgical and Radiologic Anatomy. 2011;33(10):891–896. Explains how dehydrated, densified hyaluronic acid between fascial layers contributes to myofascial pain — and why restoring glide between those layers can resolve it.
Reference 5
Wu YT, Ho TY, Chou YC, Ke MJ, Li TY, Tsai CK, Chen LC.
Six-Month Efficacy of Perineural Dextrose for Carpal Tunnel Syndrome.
Mayo Clinic Proceedings. 2017;92(8):1179–1189. Randomized controlled trial demonstrating durable benefit of ultrasound-guided perineural hydrodissection for nerve entrapment — a key clinical validation for the broader Hydrofascia Release™ technique.
Section 4
Managing Discomfort
Oral Pain Relief
If you are sore within a few hours of the injection, take whichever over-the-counter pain reliever works best for you. Tylenol 1000 mg every 8 hours, or an NSAID such as ibuprofen or naproxen at standard dosing, are both reasonable options.
Use the lowest effective dose for the shortest time you need it. Follow the label, and contact us if your soreness is not improving by the end of the first week.
Heat for Comfort and Glide
A warm shower, heating pad, or warm compress applied to the treated area for 15 to 20 minutes at a time helps with soreness and supports the new fascial glide. Use as often as it feels good.
Section 5
When to Contact Us
Send a Portal Message If You Notice
— Drainage from the injection site
— Bleeding that does not stop with light pressure
— Fever after the procedure
— New numbness, tingling, or weakness in the treated area
— Pain that is worsening rather than improving after one week
If You Feel Severely Unwell
Do not hesitate to go to urgent care or the emergency room. Reach out to us afterward so we can coordinate follow-up care.
Section 6
Bodywork & Physical Therapy
The right bodywork in the days and weeks after Hydrofascia Release™ preserves and extends the result. The wrong bodywork can undo it. The general principle: keep the newly separated tissue moving, but do not aggressively re-traumatize it.
Helpful
Light massage of the treated area, gentle stretching, range-of-motion work, and structured physical therapy. Heat before stretching can enhance the benefit.
Limit
Dry needling and cupping of the treated area for at least two weeks. Both can create new adhesions or micro-trauma in tissue that has just been freed.
If your physical therapist or massage therapist asks what you can and cannot do, share this page with them. The two-week window is the part that matters most.
Section 7
Activity & Exercise
Light movement, walking, and gentle range-of-motion work are encouraged in the first few days — motion is what keeps the freshly separated fascial layers from sticking back together. Hold off on heavy lifting, sprinting, or aggressive sport-specific training of the treated area until your provider clears you. We will guide return to full activity at each follow-up.
A Note on the Journey
Tissue that has been stuck for years does not stay free on its own. Movement is what keeps it that way.
Commit to the heat, the gentle stretching, the walking, the physical therapy. Each habit in the first two weeks compounds into the durable result we are aiming for.
— The Fascia Institute and Treatment Center®
Questions Between Visits
Send us a message through the patient portal and our clinical team will reply during business hours. For urgent concerns outside of business hours, please call our office or seek in-person care.