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Myofascial Release & Craniosacral Therapy |
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What is Fascia | Direct Myofascial Release | Indirect Myofascial Release | Craniosacral Therapy | Myofascial Release & CST |
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If you are wondering why the following article is similar to the Myofascial Release article wikipedia, it is because we created and authored the entry of "Myofascial Release" in Wikipedia on 13 August 2005.
Fascia is a seamless web of connective tissue that covers, connects, and holds the muscles, organs, and skeletal structures in our body. Fascia envelopes every structure in the body, each nerve, bone, muscle, organ pf the body is surrounded by fascia. Muscle and Fascia are united forming the myofascia system. Fascia forms an integrated web that unifies the body, connecting all body parts together. Fascia covers about half of the muscles attachment of the body, thus muscle tone has direct connection with the tightness of fascia.
Read the anatomy of Fascia on Gray's Anatomy. ... See pictures of fascia, fascia planes from anatomy lab . Fascia has been described in various ways, such as body stocking, Chinese finger trap, etc. Fascia is called the organ structure by Ida Rolf. Injuries, stress, trauma, and poor posture can cause restriction to fascia. Since fascia is an interconnected web, the restriction or tightness to fascia at a place, with time can spread to other places in the body like a pull in a sweater. Myofascial release is manual technique for stretching the fascia with the aim to balance the body. The goal of myofascial release is to free fascia restriction and restore its balance. In medical literature, the term myofascial was used by Janet Travell M.D. in the 1940s referring to musculoskeletal pain syndromes and trigger points. In 1976 Dr. Travell began using the term "Myofascial Trigger Point" and in 1983 published the famous reference "Myofascial Pain & Dysfunction: The Trigger Point Manual". Some practitioners use the term "Myofascial Therapy" or "Myofascial Trigger Point Therapy" referring to the treatment of trigger points, this is usually in medical-clinical sense. Read the definition & history of medical myofascial therapy. Here the term Myofascial Release refers to soft tissue manipulation techniques. It has been loosely used for different soft tissue manipulation work (connective tissue massage, soft tissue mobilisation, Rolfing, strain-counterstrain etc). There are two main schools of myofascial release: the direct and indirect method. Website:
The direct Myofascial Release method works directly on the restricted fascia, the practitioners use knuckle or elbow or other tools to to slowly sink into the fascia, the pressure is few kg of force, contact the restricted fascia, then put a tension or stretch the fascia. This is sometimes referred as deep tissue. (Read Art Riggs article on Deep Tissue Massage). Direct Myofascial Release seeks for changes in the myofascial structures by stretching, elongation of fascia or mobilising adhesive tissues. The misconception is that the direct method is violent and too painful, it is not essentially aggressive and painful, rather the practitioner slowly going through the layers of the fascia until the deep tissues are reached.
According to Dr. Ida Rolf, fascia is the organ of posture. Chemically it is composed of collagen, a unique substance that can be changed with addition of energy. In myofascial release, myofascia can be manipulated by adding energy. This energy is not metaphysical energy, but physical energy. By applying pressure, therapists add energy to the structure. Robert Ward suggested that the direct method came from the osteopathy school in the 1920s by William Naidner called Fascial Twist. Dr. Ida Rolf developed Structural Integration in the 1950s, a system of soft tissue manipulation and movement education that with the goal of balancing the body in gravitational field. She discovered that she could remarkably change the body posture and structure by manipulating the myofascial system. Rolfing® is the nickname that many clients and practitioners gave this work. (See the history of Dr. Ida Rolf) Since her death in 1979, various schools (from her students) arose which have adapted her original idea according their own flavours, lights and remembrance. Teachings of direct myofascial release was kept in the school and only available privately until recently (in the 1990s) where texts and courses are offered to general bodyworkers: Art Riggs, Michael Stanborough, Tom Myers, and others.
Michael Stanborough summarised the Direct Myofascial Release technique as:
As Dr. Rolf said "Put the tissue where it should be and then ask for movement". Watch Ida Rolf on Structural Integration.
Also See: Dr. Rolf on Structural Integration Dr. Rolf on Fascia
Links: The Guild for Structural Integration Tom Myers Anatomy Trains The Skeptic's Dictionary on Rolfing Somatic education, movement therapy & massage
Direct release tends to counter the area of dysfunction, e.g. a tight muscle is stretched. Indirect release starts the corrective method by exaggerating the dysfunction, the body is then allowed to express itself. As an analogy, when a drawer is stuck, direct technique would forcefully pull the drawer to open it. An indirect technique will push the drawer further in and gently trying to pull it without much force. The indirect method applies gentle stretch, the pressure is in few grams of force, the hands tend to go with the restricted fascia, hold the stretch, and allow the fascia to 'unwind' itself. The gentle traction applied to the restricted fascia will result in heat, increase blood flow in the area. The intention is to allow the body's inherent ability for self correction returns, thus restoring the optimum performance of the body. The indirect technique originated in osteopathy schools and also popular in physical therapy. German physiotherapist Elizabeth Dicke developed Connective Tissue Massage (Bindegewebbsmassage) in the 1920s with superficial stretching of the myofascia. According to Robert C. Ward, myofascial release originated from the concept by Andrew Taylor Still, the founder of Osteopathic medicine in the late 19th century. The concepts and techniques were subsequently developed by his successor including Dr. William Sutherland, and until 1980s they were popularised by osteopaths and physiotherapists. Robert Ward further suggested that the term "Myofascial Release" as a technique was coined in 1981 when it was used as a course title in Michigan State University. Initially Myofascial Release was popular among physical therapists in the US. John F. Barnes built on the indirect techniques in combination with CranioSacral therapy and made it to public in the 1980s by providing training to massage and other manual therapists. Barnes defined indirect MFR as a "whole body, hands-on approach for the evaluation and treatment of the human structure. Its focus is to optimize the function of the fascial system." Main techniques of indirect MFR include manual stretching, traction, skin rolling, deep gliding, holding, J-stroke, rocking, jostling, shaking and vibration, in addition it also used craniosacral therapy techniques (compression – static, listening to and following the craniosacral rhythm, still point).
Carol Manheim summarised the indirect Myofascial Release principles:
The indirect myofascial release techniques according to John Barnes are as follows:
Links: Articles on Myofascial Release John Upledger and John F. Barnes
Why Myofascial Release Works?
In myofascial release treatment, therapists can feel the "release" of tissue under the working hand. This is conventionally explained as the colloidal properties of fascia, which came from Ida Rolf's hypothesis. The mechanical properties of fascia is said to be thixotropic, adaptive under physical stress. Application of pressure is said able to change fascia from a more viscous "gel" into a more fluid "sol".
However research has shown that the ability to change from gel to sol only can occur under long-term mechanical stress. That means the exerted pressure should be in tons (thousands of kg) of force. Furthermore the thixotropic properties may be reversible when the applied pressure is taken out.
Robert Schleip (2003) provided another hypothesis based on scientific review. Biochemical studies have shown that fascia is richly populated in sensory mechanoreceptors. Fascia is the main sensory organ, with more receptors than other organs in the body. It is populated free nerve endings which responds to very light to strong touch. Fascia is also main organ for feeling our own bodies. For example people with lower back pain, the throracolumbar fascia do not have these mechanoreceptors. The intrafacial mechanoreceptors consist of 4 groups: (1) Golgi organs which are found mostly in myotendinous junction. (2) Large Pacini corpuscles, which respond to rapid changes in pressure, (4) Smaller & more longitudinal Ruffini organs which do not adapt quickly to pressure. (4) Interstitial myofascial receptors.
Schelip postulated that myofascial manipulation involves a stimulation of intrafacial mechanoreceptors. This stimulation leads to an input to the central nervous system, which then results in a changed tonus regulation of motor units associated with the tissue. The stimulation of Ruffini organs and the rich network of instertistial receptors can trigger the changes in autonomic nervous system.
The European Fascia Group (Schleip et al., 2006) recently showed that fascia behaves like a sponge, when fascia is stretched there are longitudinal relaxation changes in the collagen fibers and the water is squeezed out. Within a few minutes the collagen fibers recover their original state, and water continues flooding into the tissue to an even higher percentage than before, substantially increasing the elastic stiffness. Fascia seems to adapt with very complex and dynamic water changes to mechanical stimuli, to the degree that the matrix reacts in smooth-muscle-like contraction and relaxation responses of the whole tissue. So when we stretch the fascia, the tissue response we experience may be due to the sponge effect of fascia, like squeezing and refilling effects in the semi-liquid ground substance.
Listen to an interview with Robert Schelip http://www.insidesi.com/category/robert-schliep/ Or Robert Schleip Talking about Fascia Congress http://www.youtube.com/watch?v=y01_bpLMpqU
CranioSacral Therapy (CST) is a gentle, hands-on method of evaluating and enhancing the functioning of a physiological body system called the craniosacral system. Craniosacral system is an environment where the brain & spinal cord function, is contained within a tough membrance (the Dura Mater) and comprised of cerebrospinal fluid that surrounds and protects the brain and spinal cord. An imbalance to the system can causes sensory, motor & neological dysfunction. Therapists tune into the craniosacral rhythm (which can be felt at different sites around the body) and evaluate the skull for symmetry of the cranial bones and the flow of the cerebral spinal fluid. Using a soft touch generally no greater than 5 grams of force, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system.
The origins of CranioSacral Therapy come from Cranial Osteopathy. A common belief in anatomy and medical schoois that the cranial bones fuse by the end of adolescence. In the early 1900s William Sutherland believed that the adult cranium (the skull bones encasing the brain) doesn’t fuse, that there is a slight movement in the structure. His observation: "Bevelled, like the gills of a fish, indicating articular mobility for a respiratory mechanism” This movement was influenced by the rhythmic flow of cerebrospinal fluid (the nourishing and protective fluid that circulates through the spinal canal and brain) and could become blocked. He developed subtle techniques using very gentle manipulative pressure to encourage the release of stresses and strains in the cranium and throughout the body. The teaching of Cranial Osteopathy was kept in closed door in the osteopathic schools until late 1970s. Osteopath Dr John Upledger took it further in 1975 by developing the therapy into what we now know as CranioSacral therapy. Dr Upledger pioneered research in CranioSacral therapy at Michigan State University and made it to public by publishing his book in 1983 and provide training for general public and various practitioners. This caused upset by many traditional osteopaths who was anxious that the techniques being misused by therapists that were not properly trained. Trivia: In one scene from the movie X-Men: The Last Stand, Professor Charles Xavier (Patrick Stewart) is shown to give craniosacral therapy to the Dark Phoenix or Jean (Famke Janssen).
The book that spilled the bean. John Upledger on CranioSacral Therapy
CranioSacral & Myofascial Release John F. Barnes combines indirect myofascial release and craniosacral therapy. John Barnes said that clients who received myofascial release treatments made progress to a point and they will reach a plateau or regressed back to their original conditions., because only part of the fascial system is treated. Clients who only received craniosacral therapy experienced reliefs, and dysfunctions will recur. Focussing only on part of the fascial or craniosacral system will only resolve temporary problems. Craniosacral system is embedded in a much larger fascial system. If one only focuses on the craniosacral system of the clients, when they have fascial restriction, muscle spasm, or osseus restriction, then these restrictions will pull on the dural sleeves of the craniosacral system back to dysfunction. Combining the cranial rhythm with fascial tissue mobility, a trained therapist will be able to relate restrictions to the effects on the cranial system.
Website Hugh Milne Visionary Craniosacral
Articles: Learn about Cranial System from Real Bodywork CranioSacral therapy & Scientific Research Part I & Part II by John Upledger Craniosacral therapy - Myth or Science?
CranioSacral Articles in Massage Today Articles by John Upledger (compiled by Massage Nerd)
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