If there were one map of the body for all to follow, a map that showed all areas of injury, trauma, and pain, along with the necessary route to take to eliminate those issues, life would be simple.
I received a new GPS this past Christmas. My old GPS had become unreliable due to a few quirks and I did not have full trust in my iPhone’s GPS, given a few wrong turns along the way. While my new GPS offers me nearly a nearly foolproof ability to find my way around while traveling, it lacks in some key areas. I learned this a few years back, while traveling to teach one of my Foundations in Myofascial Release Seminars. My hotel was not terribly far from the seminar venue, but each morning and night, I followed the female mechanical voice on my GPS, dutifully turning when she told me to turn. Prior to this, I had always carried a map while traveling and studied it beforehand, as well as before venturing off on a new destination. While near the end of my trip, my old GPS began exhibiting one of its quirks and forced me to find my own way. After spending nearly 4 days in that city I realized that I had no idea how to get to where I wished to go, even though the distance was small. I had previously relied on some internal ability to see a place on an internal map in my mind. I did find my way to my destination eventually, but it was a very good lesson to me.
In order for us to benefit from a map, we need to decide on our route preferences. What factors go into deciding which road to take? When one initially programs a GPS, it will query you to see if you wish to prioritize shortest distance, shortest time, avoiding highways, etc. However, I think most of us forget about these variables each time we plunk in our destination and follow the voice. If we are reading an old-fashioned paper map, we have choice that is more overt; highway or country road, scenic route or “just get there”. If we are curious, we may choose a route that takes us past places of interest.
Choosing a map to follow in the body is no different. Many maps are offered, from the ones we learned in school, which tended to be more simplistic, the maps offered through continuing education, and the ones offered by our own experience. I learned a map of the body and followed this map for many years. That map stated that the body behaved in very specific ways. This method was influenced by the theory that fascia was the “great unknown” when it came to unresolved pain. The mysteries of the fascia were there for anyone to perceive, if you only chose to follow the teacher who taught this work. Sounds a bit mysterious, does it not? My introduction to myofascial release was explained in a manner that made sense, at least from my very superficial level of understanding, as well as cherry picking the available evidence to suit my needs. It really lacked any plausibility from a scientific perspective, but I skipped over any lingering questions I might have, as what I learned to do with my hands was incredibly effective. Occasionally my instincts caused me to question my teachers, but the all-important “results” quickly put any doubts to rest! I know now that much of what I learned was either outdated or wrong. In essence, I became a good listening and follower, but not a good questioner. I began applying the principles with my patients and quickly began to notice things that seemed more important to me that did to my teacher, and things my teacher thought were important mattered less to me. Sounds like maturation, correct? What was apparent to me was that dysfunctional tissue (non-specific tissue), presented with a characteristic density that was easily palpable. At first I attempted (rather successfully, I thought) to equate this density to “fascial restriction”, as that was what I was taught. However, over time, the “Feel” became the most important element. Fast-forward a decade or two. A few years back I began to expose myself to a neuroscience approach to pain; one that used basic neurology to explain the changes we feel with bodywork. I at first rejected this as skeptical nonsense; how could the results I saw with MFR be wrong? The results were not wrong, just the explanation. The transition from an old-school mentality of myofascial release to embracing these newer concepts was not difficult, as under my hands I still felt what I had felt in the past. Only now, I had much more plausible explanations to use.
The maps that I now use are based on simple anatomy and mostly neuroanatomy. It is not sexy stuff, like other explanations of body work and MFR, and doesn’t try to bridge any chasms between body work and parts of the process that we, as body workers, have no business addressing. I am a huge fan of the Visible Body app. While it can be purchased in modules, the Visible Body Atlas is a comprehensive guide to the body and will be the map we use.
For those of you with an enlightened sense of feel, learning this new form of myofascial release work will come easily. The most difficult part may be asking yourself to put aside your beliefs on how best to make changes in the body. Over the past 20 years, I have lightened my touch considerably and enlightened my mind even more. I do not work to any level of uncomfortable depth and never elicit pain.
There are those who feel that the term “myofascial release” is so scientifically incorrect and unrealistic that it should be abandoned. While I believe we are influencing much more than just the fascia, and that fascia is not the magic tissue it has been made out to be, I do feel there is logic in sticking with it, if nothing more than the name recognition value. Ultimately, I will not try to convince you of anything; your process may be as long and tortuous as mine was. In the end, I hope that you simply come away with a better ability to help someone in pain. That is where we start.
The new myofascial release differs little when it comes to what we do with our hands. But it differs wildly with what we do with our minds. Enjoy!
Walt Fritz, PT
Well said Walt, I know the results I get are real and at the same I am aware that the explanation about why is limited. I am always interested in exploring more deeply why what I do works, and with that knowledge how I can improve my work and results. Thank you.
I know the work gets me great results with my clients. And that’s all the proof I need.
Very interesting comparison of the GPS and the body map. Every person’s body could be viewed as a different map. A therapist’s ability to listen, follow and question are what can make a session go well or not so well. It also depends on the client’s ability to do the same. There is definitely a back and forth in the process.
So many maps! Our training teaches us to read maps in certain ways, but our experiences show us that there are other ways to read the map. You are spot-on when you say “A therapist’s ability to listen, follow and question are what can make a session go well or not so well”.
It is true that MFR as it was proposed was based upon theories that have been more elaborately exposed through relevant research, the whole story is far from fully fleshed out. After only a decade and a half we have at our disposal much new and very exciting research.
As much as neuroanatomy presents a “plausible” story. I still don’t think it is as big as it is made out to be by those who want to believe it is the magic bullet.
Neuroanatomy is certainly a valuable and vital part of the function of the body. But to assume it is preeminent in how everything works, just doesn’t sit well with me at all. As an acupuncturist, I experience the body from that meridian perspective. While the MAJOR meridians run along paths populated by nerves, meridians of different sized and connections run everywhere in the body. The usual connection that non -acupuncturists make in assuming that neural relationship to acupuncture points is definitely misleading and incredibly simplistic. Frequently I find misinformation and simply wrong understanding that derives erroneous conclusions that seem to fit a neuroanatomy explanation.
Even though I do not YET have the “scientific proof” to support my sense of MF work, I believe in time the actual value of the fascial system and its profound function will be determined. The non-conventional means for accessing this incredible tissue will also gain much more credence in time. In so doing the relationship between the nervous system and the connective tissue will be more deeply and correctly understood.
The Fascial system ties the whole body together and we have to look at it from that stand point. It is the major system that facilitates communication between all of the other systems. It is just a matter of time before we all get in with “Scientific Proof/Validation.” When we are able to discuss the body from that perspective we will truly be talking about the whole body as a functional unit.
Bamboo,
I wouldn’t doubt that you wish to look beyond neuroanatomy, being an acupuncturist. The two conflict on even the most basic levels, but that is for others to fight over.
You said “The Fascial system ties the whole body together and we have to look at it from that stand point. It is the major system that facilitates communication between all of the other systems.” Just because the fascia is present throughout the body implies no “tieing in” of anything. That is falling for the same old lines that we were both taught but have very little credence. Substitute the word “Nervous” for the word “Fascial” in the first sentence that I quoted and I believe you have the truth.
Cheers,
Walt
I am not disagreeing that the nervous system plays a vital role in the story. The understanding of the FASCIAL SYSTEM as a system is so limited and to put all of our explanatory eggs into the nervous basket, will ultimately cause a nervous breakdown. WE don’t know everything there is to know about fascial tissue or how all of the parts work together. When there is a determined effort to see how the whole works together, then the fascial system will gain much more prominence in the story.
WE really don’t understand the communicative function of the fascial tissue, we don’t understand how anything can happen without the control of the brain. We keep speaking of the mind as equal and the same as the brain and it isn’t. This is important, because explanations get very sloppy on this point and all points there after. There are so many intuitive red flags that fly when I hear people embrace the neuroanatomy as the be all and primary mover of the system.
As a practitioner, I want to find answers, find the roots of problems and which ever route that takes so be it. Acupuncture is not at odds with neuroanatomy. It is western medicine that is at odd with chinese medicine and all othe traditional medicine systems. Western medicine is reductionist and Chinese medicine is relational…so the vantage pt is different. In China there are collaborative efforts between practitioners (even though there is a hierarchy.) The lack of willingness for sincere exploration into the concepts of Chinese medicine by western researchers leaves a lot to desired. Until they are willing to really explore the concepts on the terms of a relational science they will always fail to grasp the depth and value of the medicine.
When people talk about the meridians in Acupuncture in terms of the 14 regular meridians they are generalizing about something that is way more complex and pervasive than those 14 meridians would suggest. The meridians go everywhere int the body in several layers. They connect different organs and energetics in a way the nervous system as we understand it cannot match. They connect everything to everything else in the body, literally. This one of the reasons distal treatments work so well. Perceiving the body within the framework of Newtonian physics also puts limit on the expansiveness that research can go to find more answers. Neuroanatomy also doesn’t address the notion of the holographic reality of the body.
Our teacher may have gotten wrong in terms of the explanation in relationship to the neural interactions within the fascial tissue, but he was on to something. We have to remember he started talking about MFR way before any of the current research was done. We used to call the fascial tissue layers, and we know it is a web. We and he didn’t have the knowledge we have now. And I still think the neuroanatomical explanation lacks vital bit and pieces to make it completely plausible. How he described what was happening is NO different than the scientists who put forth the idea that the cell was a bag of water with a nucleus. How far we have come from that time.
Right now, neuroanatomy sounds real good. It seems plausible. But it isn’t the whole story. So my point is to urge a bit more caution in jumping on the neurotrain. MFR affects the whole body when we use it, why aren’t we looking for holistic and integrated explanation rather than jumping on the first available one dimensional train?
One of the great implausibilites of fascia and the fascial system is the notion of fascia stretching and tensegrity. WE know it doesn’t “stretch” (like muscle), but we can put it into a tenstion that runs through the whole body very easily. That we can elicit a change from the foot to the head with minimal tension or compression seems unbelievable. What happens with the tissue? What happens with the tensegritous model (I think this concept still holds true in neuroanatomy.) Certainly we stimulate sensory nerve endings and I would bet a lot more than that. WE don’t have the data, knowledge or research to answer these questions. It is not ok to take one system at face value as the overall explanation. We need research into the embryological development of the fascial system so we can follow the development and growth of the body from the stand pt of fascia in relation to all of the other parts of the body. Then we will probably be able to see how things really connect through this system. We might even see the over lap in areas we had no clue about.
Bamboo,
Your theories are based on fasica’s eventual role of prominence as the key player “When there is a determined effort to see how the whole works together, then the fascial system will gain much more prominence in the story.” On what evidence do you base this comment?
It’s amazing what the body tells us when we listen. I tell my clients to listen to their bodies more.
Very well said! I’ve noticed an evolution in what I’m tracking in the body as I’m giving an Ashiatsu session. Many things over the years that I’ve read and learned seriously influence the intent of the work I do. I love seeing the same issue or tissue in a different light, so the change in point of view overtime is amazing. Even if I’m using the same stroke/technique as always, the idea behind it has grown and aims the work towards a different destination. Neat neat. In a way you are learning from yourself through this growth, too!
To follow the analogy of this article, even though I begin a hands-on massage with an idea of the body part “map” in my mind, I follow sensations of touch and intuition to know how and what pressure to apply and to know when to stop and move on to the next area.
The main block presented to me occurs when the client erects a barrier to healing.
Maybe she isn’t quite ready yet to release the problem that has been affecting her muscles and tissues.
Maybe her doubts about her ability to cope need dealing with.
In these instances it is necessary to work on the reasons she has for wanting to prevent the healing.
And once they have been resolved then the path can be followed more effectively.
Interesting article Walt, I have enjoyed reading it and the comments that have followed. I too appreciate the fundamental connection between the body and the nervous system (both the central and autonomic nervous systems). I believe that the body and mind (unconscious and conscious) are one and are most effectively treated in this way.
The fascial system is a continuum, which as Bamboo says ties the body together, however it does not function in isolation. Nothing in our whole being functions on its own, it is all interconnected so when one thing is out of balance the whole system needs considering.
From my experience as a neuro physio and holistic therapist, so far, it is never about one thing. It is never just one tissue that is in distress or out of balance or one aspect of the brain that is not working as efficiently as it could be. I agree with Walt and do not believe creating further pain is helpful, causing an irritated nervous system more pain usually serves to increase the irritation and the body responds to this.
I remember years ago attending a myofascial release course and having an interesting discussion with the tutor following a demonstration of a neck release technique. I told him that I always re-educate the body in movement following myofascial release as movements are habitual so even if soft tissue length and alignment have been changed it doesn’t mean the movement pattern or the way someone moves will change and remain so and was interested to hear his opinion on this. He told me he was gradually beginning to see the importance of this and had started working with some local neuro physios. At this point in time I always treated body and brain together and didn’t include the mind so much. This was because I didn’t have the knowledge, skills and understanding to effectively incorporate a greater consideration and treatment of the mind. Even though I knew what I as missing I didn’t appreciate how crucial it was!
I agree with Dave that when a person has a barrier to healing this can be worked with if they are ready to do so. I have found this barrier is usually within the conscious or unconscious mind. As a therapist my job is to facilitate healing and rehabilitation according to what the persons body and mind are telling me.
To me it is about listening with my hands to what their body is telling me, observing how they move, considering how efficient their brain is in selecting a movement or how quickly it can react to a postural disturbance (like a light push from one side when standing still) and listening to what their mind is telling me. During the listening I am treating and change direction based on what I am feeling, hearing and seeing.
I am not saying this way of working with myofascial release, and other treatment modalities is the only way it just works for me and there is some evidence behind it. With everything I do I am learning and adapting and having fun along the way!
Best wishes
Ann
Ann, Movement education/re-education can be a vital part of this work, agreed. The interconnectedness of our body is facilitated in shape-holding via the fascia, but fascia as the magnificent communicator has been, in my opinion, grossly overstated. Many of the people teaching myofascial release today rely on scientific “glitterature” instead of scientific literature to push their agenda, using flashy bits of information and new knowledge that has little bearing on the real body. No doubt, we are connected but is fascia the key or just a supporting actor?