For those of you who have stayed with me through the past few months and past few blog posts know that I am in transition. The cross pollination concept struck a chord not just with me but with a number of you as well. But a few of you have let me know that you want a bit more of the meat of my changes (no pun intended!). Changing a mindset of cause/treatment from a soft tissue explanation (muscle, fascia) to a neurologically driven one is a bit slow, but most things are for me. So I came up with a mental example that I hope may make things a bit clearer.
Cervical traction is a staple of myofascial release, as well as a vast number of other modalities. I am going to ask you, after reading through this post, to close your eyes and imagine yourself performing cervical traction with a patient. When you gently (or not so gently) wrap your hands around the back of the patient’s head/neck and take up the slack into traction, what is it that you are engaging? A first thought might be that you are engaging the spine and the ligaments that comprise the entire spinal region, taking up the slack and providing a stretch to this complex. If you follow the craniosacral therapy paradigm, you may feel that you are engaging the dural tube and freeing dural tube restrictions. You may believe that you are stretching tightness in the muscles and/or fascia of the cervical region. There are so many models of explanation, right?
Now step back and imagine your hand placement. Are you engaging the skull/spine directly with a firmer grip or holding ever so loosely, engaging more of the skin and superficial tissue? This can create quite a difference in what you feel, as well as what your patient feels. Try it next time; take hold of the skin of the back of the neck/head and allow it to glide upward toward the top of the head. Take up this stretch until the gentle resistance is felt. Are you still engaging the spine? Quite possibly, but you are engaging it at a much lighter level. Are you still stretching the muscle/fascia/dural system? Maybe, though it is more of a conceptual construct that a truism. Stretching the skin and cutaneous skin receptors? You betcha! All we can be certain of when we touch a patient is that we are engaging the skin/skin receptors. All else is speculation. I know there will be doubters of this statement, but think about it for a moment. What else can you be certain that you are touching, other than what you are directly engaging?
The superficial layers of the skin are richly innervated with both cutaneous and deeper nerves, as well as a multitude of receptors. As a main sensing organ of the brain, the skin is in very close communication with, and could be considered an extension of, the brain. As such, looking into the capabilities of the nervous system as mediators of change can pay important benefits to us as therapists. I am not an expert on the nervous system. For more in-depth discussions of this I would send you to other sources. But I am a curious observer of treatment and change, and can report that since using this novel method of thought and treatment my therapeutic outcomes have improved.
At times, transitioning to different methods of thought and action can be painful and difficult, as old and beloved beliefs are hard to let go of. But when results improve, what could be stopping you? There may never be a perfect answer to the question of what is being engaged when we touch a patient, but just ask yourself, does what I am saying make sense? If you can logically rationalize any of the above explanations based on sound science, then go for it. But if you need to rely on pseudoscience or quantum physics-like explanations….find another way of thought.
For now,
Walt Fritz, PT
Foundations in Myofascial Release Seminars
Love the honesty. I remember when my son was in his 20’s and he knew everything, HA. I think our profession has been there for several years. Collaboration is the only way we can truly help our patients. We can spend a lifetime perfecting one technique so I want those who have done so with other techniques to be part of my patient’s recovery. So I take other classes and because I teach all the time and can’t get to many, I get treatment from these teachers so my body can learn and benefit.
Thanks, Taya. I share a similar belief that there are many great modalities, therapists, and teachers out there to avail ourselves of, it just takes the determination to do so.
Walt, Such openness to new ways of thinking are not always easy for any of us, but from a teacher it has to be even more courageous. Not because past ways of thinking were necessarily wrong but admitting that your reasoning may have been incorrect can be humbling.
Something I read recently refering to the dural tube during the first few weeks of life, implies that the skin is a distant portion of the brain. Not our historical view of the mind, but a possibility that opens new ways of thinking outside the box.
Keep us posted as this could be very interesting. A theory with some possibility of fact is worth investigating
Thanks, Dan. A teacher should be just as open to learn and change. What makes this difficult to see is the investment many teachers have in their brand and products prevents overt change. My two cents inserted there!
Etymologically, the skin and brain both form from the ectoderm, so you are right on target with what you said. If one can touch the brain, so to speak, in such an easy manner as interacting with the skin, do we need more complicated (and far-fetched) explanations?
Walt,
It’s hard to know exactly where to begin with this. I’ll start here . . .
“But if you need to rely on pseudoscience or quantum physics-like explanations….find another way of thought.”
What makes you think Quantum Physics IS pseudoscience?
As I was and have been an Energy Medicine Practitioner before being an MFR therapist I spent all of my therapeutic time doing what you have called here, pseudoscience. When after a treatment session a woman was relieved of Poly Cystic Ovary Syndrome she didn’t bother to tell me that I was engaged in pseudoscience.
But that’s not my main question here . . . What I’m wondering is after you call MFR precepts into question, what exactly is the alternative theory that you are offering up? I’m not clear on what you are really saying here. Can you clarify?
“What makes you think Quantum Physics IS pseudoscience?”
I don’t.
John, You misinterpreted what I said. I am not equating quantum physics with pseudoscience. I am simply saying that if you need to rely on either pseudoscience OR quantum physics to explain what you do, then find another model of explanation.
As for quantum physics providing an explanation for what is done with our hands, there you have a lot of convincing to do. So many in our field have used vague aspects of quantum phsycs to explain phenomenon that cannot be explained via traditional science. These explanations are so far-fetch that no one without a PhD in physics could explain how off-base these explanations are. Many people assume that if traditional science cannot explain things, then quantum physics MUST be able to.
The theory I am asking others to consider is one of a more basic concept of neuroscience. It is not “alternative”, but accepted science. If pressure is placed on a nerve, the body goes into a protective mode. Reduce the tension, and the threat is discontinued and things return to normal. Isn’t that a simple way of looking at what we do? When an accepted manner of explaining what I do is available, why use one that is not accepted?
We do many things with our hands that produces fantastic results. We often then explain the results based on what we were taught as the explanatory model. I passed on half-truths and down right absurdities for many years, until I stood back and evaluated what I was saying.
Walt,
I’m all for keeping open to different ways of looking at what we do. But I do wonder why you call quantum physics pseudoscience. As I was an energy medicine practitioner for some years before learning MFR I spent most of my time doing something that others might call pseudoscience. Yet, the work many people do in this area has shown to provide significant and wonderful results.
There are many factors that go into healing work, intention not the least of them. That so called pseudoscience you mention has shown itself to be more science that pseudo and continues to do so more as time goes on.
The patient’s beliefs are always in play as well. When I did energy work and people had a good result they sometimes had a difficult time afterwards wondering how I could help them when I didn’t “DO anything” When I dod MFR I often mix in energy work and I find that people can accept it more easily when I’m pushing on their muscles. That makes more sense to them.
So, explain it as you will, there is more going on than many might be willing to accept. A lot of which is in that Quantum area.
A Scientific American article discussed the Cerebellum as working like the central processor in a computer. Therefore our touch gets processed for threat, comfort, guidance, compensation or avoidance.
I follow the principle found at Hebrews 5:14 ‘Through use ones perceptive powers are trained to distinguish both right and wrong.’
As per your request: when I engage the client with cervical traction I begin to distinguish the right feel from the wrong feel. I ask their cerebellum to respond to my cerebellum; if for example they crossed the right leg over the left or the left over the right would the improve the response. I chose that example because it affects the posture reflexes, the walking reflexes and the craniosacral reflexes. After I receive an answer by subtle changes in the feel, if I generically ask the client to cross their legs it will generally be in accordance with the answer I received by touch.
The more I study about fascia innervation and enervation and observe reflexes throughout the body with different motions, the more I consider myself a coach to the neuro-muscular-fascial system.
Most clients come to me in pain because they have continued to “limp” long after it is nessesary from some recent to long forgotten injury. When I am holding a position as taught by Taya I will often add the verbal guidance: You have been holding this position because of some injury that you may have forgotten and it is long ago healed and dose not need to be protected any longer. Not unusual in the couple of minutes involved for the client to relate something in their childhood .
I have asked myself the question again and again how does what we do work. I have taken years of classes with very scientific sounding explanations for why what we do works. They are satisfying on one level but on another level they seem utterly silly. The same physical techniques and pressures delivered by a person not in the correct “compassionate mindset” seem to fail completely. It is my belief that regardless of all the scientific slicing and dicing and explanations that make us feel intellectually satisfied what we are actually doing is loving the tissue and when you love the tissue with a compassionate love you are shown the way to effect change. Every mother does it with her baby. Simple. The science and the anatomy understanding definitely enhance our confidence and our ability to focus in more detail and to notice the results of our loving the tissue compassionately, so I am not advocating throwing away the quest for understanding of the science. The classes I have taken have enhanced the results and the experience immeasurably but with each class on the “science” it is revealed to me more clearly the “compassionate, patient, ego-less, love” that is truly doing all the work. Skin receptors, energy cysts, neurological chemical reactions, chakras, fascial membranes and the special magic of them, lymphatic fluids, stretch receptors etc etc. after all the classes I am not one scrap closer to knowing who is doing what – but I know with complete clarity that compassionate love is achieving miracles. Having said that I strongly recommend the classes, the focus, the wanting to know. Our “attention” to something so noble as wanting to understand in minute detail how to help people heal physically and emotionally is the highest expression of compassionate love.
Hi Margaret,
Thanks for your insights. I would agree with what you say, in part, except that I have found that if a technique truly “works”, it should do so without regard for the state of mind of the therapist. I think we also diverge in that I believe that knowing the science behind a modality can give one further insight into how to be more effective with that modality. To create an example, working the anterior portion of the enck, or treating the scalenes, as some therapists refer to this area, can give widespread improvement in neck and head pain/dysfunction. Knowing that the facial nerve has a branch that extends down into the upper neck, anterior to the sternocleidomastoid, and can be accessed here, allows one to potentially treat the entire distribution of this nerve, throughout the face. (see above drawing) Without A) knowledge of the anatomy of this nerve and B0 that intervening on one part of the nerve can and will potentially cause change in all parts of this nerve, one is treating blindly. One could certainly learn the far-reaching effects anecdotal, or through experience, which is great. But, if science can direct us to treat a specific area/nerve, why treat blindly?
Well-intentioned treatment is certainly desirable, but miracles are often just luck, and results are improved by knowledge.
I don’t think we diverge all that much. The technical knowledge is essential and the specificity key. My work has improved enormously with the anatomy training and the technical classes and with each one I take I wonder that I achieved anything at all prior to the latest class. You are right all the intent in the world without specificity leaves you well intentioned but blind. I guess sometimes the work is so incredible I am at a loss to explain what just happened and those moments are the ones I speak of and they can happen with any of the modalities and they leave you speechless and in awe of the client and the actual mechanism or spark or what separates a good session from a not so good even though the technical hand positions and pressure are the same. There is something more, something essential that is either there or it isn’t and as a receiver of body work that you know immediately as soon as you are touched.
I applaud you for your willingness to consider alternative paradigms. Even if something works, and works well, that does not necessarily mean that it is effective for the reasons that we assumed. So it is with Myofascial Release. Interaction with the fascia can take many forms, and each can be successful, even if they are addressing different parts of the system. We can release a Quadratus Lumborum by a slow myofascial stretch, but if it was part of a protective response to irritation around a kidney, a quick, gentle technique to the kidney can result in instantaneous change to the QL. There are also regulatory mechanism in the body that can be activated which seem to work by means of a local chemical change. The ground substance of the fascia is the environment of all of our tissues. Within the ground substance there are incredible networks which communicate to all the tissue systems and tissue layers. (Google Pischinger for some mind-blowing information regarding this matrix). If we approach the body as if we are interacting through a fluid intermediary, we can exert even light forces and have a higher influence. Intent is powerful; more powerful indeed, than exerting a great force, which elicits protective responses that need to be overcome.