A common aftermath of body work in general can be redness and itching of the skin. I have seen this especially evident in the trunk and ribcage area and can sometimes be rather pronounced. I was taught that this was a reaction to histamine released from the cells, creating an itching sensation. What have you been taught? Also, why does it seem more evident in the trunk vs other parts of the body?
I have a few good theories that I will share, but I invite your feedback.
Walt Fritz, PT
John Barnes teaches that it is a vasomotor response and can indicate that the person needs additional treatment in that area.
While observing a vasomotor response can be an important part of Myofascial Release, I does little to describe the mechanism.
Medicine.net defines a vasomotor as “Vasomotor: Relating to the nerves and muscles that cause the blood vessels to constrict or dilate”, while encyclopedia.com defines it as “denoting a region in the medulla of the brain (the vasomotor center) that regulates blood pressure by controlling reflex alterations in the heart rate and the diameter of the blood vessels, in response to stimuli from receptors in the circulatory system or from other parts of the brain”.
We have been taught that the fascia is responsible for this reaction, which may be the case. Another view is provided by Diane Sherwood, a physiotherapist from Saskatchewan, Canada and contributor on SomaSimple.com. In a correspondence regarding the itching that often accompanies bodywork, Diane states:
“autonomics are only sympathetic. The sympathetics control vasoconstriction and sweat glands – the vasculature to sweat glands, the sympathetics can dilate. However, the reverse has to happen too, and skin has six sizes of vasculature and no parasympathetic innervation (except in the lips..) in humans. So, the sensory nerves handle vasodilatatin. Each size vessel is controlled by a different neuropeptide, secreted by afferent neurons. Its complex, especially when you start thinking about the vascular plexuses inside nerves themselves, called vasa nervorum. Nerves do not have any lymph drainage, so the nerves rely on vascular drainage only. If the plexus is stalled in some part of the nerve for some reason, drainage won’t happen, the neurons can get irritated, and the substances they release won’t flow away from the neurons like they should, instead they’ll back up and irritate the neurons, like pee in a diaper giving a baby diaper rash. That’s how I look at it, at least… cranky neurons will give rise to sensations that may not be being caused from outside the nerve, but from inside its own tunnel. The skin will react though.
There is another piece, and that piece is that skin cells themselves can signal, are sensitive to neurotransmitters, have transient receptors for this and that, can signal to a limited extent. Why? because skin, nerves and brain are all made out of ectoderm. They are always checking in on each other. The sensory nerves can bother the autonomics and the autonomics can bother the sensory neurons. Reacting to signals from each other. More sensitive to each other than to signals from mesoderm.”
When asked if she had an idea as to why the area of the trunk/ribcage seems especially susceptible to this phenomenon, she states:
“If the sensitivity of cutaneous nerves (which carry all the epicritic and exteroceptive neurons) is a factor, then the ribcage would be a likely place for such sensitivity because of how long and how vulnerable the lateral cutaneous nerves of the trunk are. Check them out in Netter or something, trace their path. They have to branch at extreme angles and have to navigate ribs and three sets of respiratory rib muscle to surface. It’s a perilous journey for them to get to their skin targets. Depending where they surface they also have to get through serratus and lat.”
The influence of the autonomic nervous system seems to play a crucial role in the vasomotor response. When we lay our hands on people we are working from a set of assumptions that were taught and that we often take at face value. Is the fascia a crucial part of this process, or just a body part under the control of higher centers?
There is an article by Robert Schleip, a German Rolfer and fascia researcher, that talks specifically about the role of mechanoreceptors and how they are affected with fascial manipulation. The vasomotor response is mentioned within this rather short article, though not in the exact context of the present topic.
Schleip has managed, through his research, to move fascial work beyond the pure mechanistic model and has blended more current research of neurology to form a more complete description on the mechanisms to describe myofascial release.
You can read Schleip’s article at: http://www.fasciaresearch.com/InnervationExcerpt.pdf
In another of Schleip’s articles, “Fascial plasticity – a new neurobiological explanation:
Part 1” (http://bodyworkcpd.co.uk/articles/Schleip/schleip2003.pdf), he talks about the enteric brain, that is, the enteric nervous system (ENS), contained within the abdomen. The ENS contains over 100 million neurons and seems to work largely independent of the cortical brain. Many of the snesory neurons of the ENS are mechanoreceptors which, when activated, can trigger neuroendocrine changes. This includes a change in production of histamine.
These changes in skin color and, occasionally, itching, seem to occur largely in the trunk, including the chest wall and abdomen. Stimulation of the mechanoreceptors in the ENS just may be responsible.