I just finished up a Foundations in Myofascial Release I Seminar in San Diego and I am waiting for a red-eye back to Rochester. I love shooting from the hip in my teachings, as I really enjoy meeting the individual needs of each therapist attending my seminars.  So having some new information allows a lot of off-script learning. In my last blog post I talked about experimenting with different pressures when applying cervical traction, inquiring to oneself what you actually affecting. I posed this question this past weekend, while the therapists were comparing the feel of a more solid traction that supposedly engages the spine, musculature, ligaments, and dual tube, with that of a traction that simply engaged the skin of the neck and occipital region. We also compared the typical TJM stretch, arm traction, and a few others. The results surprised me, as most of the therapists related that they felt more far-reaching effects with the much lighter skin stretch than the deeper engagement stretch. I like surprises such as this, as I am always open to learning.

We also began to explore treatment from a nervous system perspective. For all of you seasoned MFR therapists, think for a moment of performing an anterior cervical release, where you lift the sternocleidomastoid and drop in on the anterior transverse processes of the  cervical spine. You work your way down the neck, “releasing” everything in sight. How common is it for your patient to report sensation in the face, ear, eye, etc? I was taught this is due to the “fascial voice”, or that the fascia is continuous throughout and this is simply a far-reaching restriction. I bought this line for years. But pull out your Netter’s or other anatomy text. Note the wide distribution of the facial nerve. See that small tail that extends down into the anterior cervical region, the exact same region you are treating with the anterior cervical release. We are, in effect, grabbing hold of that distal end of the facial nerve and affecting all other part of that nerve. In reality, we are treating the entire facial nerve distribution via the distal tail. NeuroModulation. Sweet!

OK, I can hear what some of you are saying now; what does this matter, I get great results? Maybe it doesn’t matter and I do not deny you your results. But if you can key in on areas of distress, see what nerve is involved and look for places in the body where the nerve is accessible (often places where it comes close to the surface), you have found a medically and scientifically plausible rationale of treatment, congratulations!  It takes some work and some studying. I know I allowed myself to forget most of the neuroscience I learned in physical therapy school, but I am relearning it now.

Give it a try and see how the lighter nerve centered approach works for you.

For now,

Walt Fritz, PT

Author: Walt Fritz