Facts & Fallacies of Myo-Fascial Release ...
is written to demonstrate the Harmony of Muscle and Fascia, as well as the differences.
This is a Response I made to Doreen in an article posted at IgnitePhysio on Myofascial Release and its proposed properties:
Hello Doreen. Here are some comments on Fascia:
I totally agree that sensory inputs and biochemical actions from fascia are probably vast and diverse, contributing greatly to unique information processed by the CNS [central nervous system] & brain. And yes, they were greatly under-reported for way too long. In order to have effective myofascial release techniques, we need precise structural analysis and postural evaluation.
Below are some quotes from the article and my responses:
RE: “…dynamically adaptable and an important tissue in cell regulation….”
Agreed there. Fascia, for example, has an amazing ability to stay soft with slow penetration from an outside force or object, yet instantly harden with fast penetration by outside for. Fascia is also amazingly flexible (i.e., bend-able) and resilient without losing integrity.
RE: “…Because of this, a pull on one corner of the connective tissue framework exerts a pull throughout the structure…”
Here, I would agree that a component of a tensegrity unit can affect other components, even at a distance. I call those “structurally transmitted forces (or strains if pathological).” EXAMPLE, an over-shortened abdominal wall will pull the rib cage down, flatten the lumbar spine, cause kyphosis of the thorax, lever the cervical spine forward, causing forward neck & head posture. Then, the neck muscles, anterior & posterior, have to increase tension to A.) hold the head up against gravity and B.) stabilize against the downward force of the AB muscles on the upper front line of the torso. (Structural homeostasis as one muscle or muscle group contracting causes an opposing group to generate opposing force.)
I also agree the heavy innervation of fascia can contribute greatly to neurologically transmitted effects to near & distant parts of the body. Proper myofascial release should track these as precisely and accurately as possible.
However, this does not occur via the fascia system alone. It occurs via the integrated synergy of the musculo-fascial system, both muscle cells and fascia working together in a harmonious way.
RE: the “Sweater Analogy” & Illustration:
This is a bit like the old myth of a “butterfly flapping its wings and starting a hurricane on the other side of the Earth …”
Even the author of that phrase himself says it is theoretical and not a “real” phenomena. Too many things happen to prevent the forces of the butterfly wings from traveling too far without resistance slowing it down. Simple friction from the atmosphere gets in the way, not to mention countervailing forces such as wind.
And, while I have very high regard for people like Deane Juhan and his written work in his excellent book, Job’s Body, that is one detail I think is not exactly correct or even useful. And nearly ALL the fascia people rely on this visualization of the sweater pull. It’s a nice idea.
For one thing, it ignores the fact that in many cases, two adjacent structures of fascia are pulling in opposite directions and can literally "cancel each other out." That’s because most fascial structures are casings of muscles, and it is those integrated casings — muscle cells contained within fascial tubes — traveling through the body.
But in many cases, for example, the hamstrings pulling down on the back of the pelvis, therefore causing the back muscles to pull up on the back of the pelvis. So because of structural homeostasis, the back is pulling in the opposite direction from the hamstrings.
RE: Anatomy Trains: Myofascial Meridians and “myofascial continuities” …
I like Tom’s book, Anatomy Trains, a lot. It is very well done, interesting, very well illustrated, and there is a lot of good information in it.
However, some of his fascial “anatomy trains” I find very UN-useful for effective myofascial release strategies. For Example, MOST of the people I work with, using Tom’s terminology, are shortened up on the FRONT line from the pubic bone UP to the base of the neck. But they are shortened up on the BACK line from the upper, posterior ridge of the pelvic rim down the posterior portion of the legs to past the knees.
That combination of the upper front line and lower back line is what the VAST majority of Clients I see (as well as therapists who were students in my training programs) present with. That produced, BTW, a posterior tilted or at best a neutral pelvis. (True anterior tilt with excess lordosis is exceedingly rare.)
[OR, it is in MY practice and many of the therapists I know. ~DSL]
This means MOST of my structural work revolves around assisting the Client in Relaxing & Lengthening the abdominal wall (part of Tom's front line) and the hip extensors (part of Tom’s back line), which together posteriorly tilt the pelvis. If I was following strictly with the Anatomy Trains model, I’d be doing the abdominal wall and hip FLEXORS (both on the front line), or hip Extensors and posterior low-back muscles (both on back line).
But I find either of those contra-indicated in most cases in the early stages of therapy. (There are, of course, exceptions, but my example is the majority of people I and most of the therapists I’ve ever worked with see, including physical therapists.)
Now, I’m not saying working with the entire front line or entire back line is never warranted in some or even many cases. It depends a lot on what patient or client population you see much of.
All I’m saying is the most common postural misalignment in many patient populations is what I’ve described above.
Going back to Deane Juhan’s book, Job’s Body …
Yet Deane also reports, in the very same book, why fascia — BY ITSELF, meaning, without the pull of the actin/myosin units within the muscle cells — cannot be a primary source of postural distortion or imbalance. He describes how under anesthesia, people with significant postural distortion will lose those distortions while under anesthesia, yet when they return to consciousness, so do the postural imbalances return.
Therefore, since anesthesia works by inhibiting MOTOR nerves (as well as sensory), and the motor nerves act on muscle fibers and NOT fascia (fascia being primarily sensory), then it is primarily neuro-MUSCULAR forces, transmitted through the fascia, producing postural distortions, not neuro-fascial forces.
[And neuro-muscular is primarily motor, while neuro-fascial is primarily sensory.]
(I’ll get back to the sweater thing in a moment.)
It might well be true that neuro-fascial signals and SMALL degrees of forces send signals to the CNS (central nervous system) triggering neuro-muscular reactions & responses. But alleged and significant “fascial contractions” are difficult, if not impossible, to demonstrate [except at the microscopic level]. And many people have tried.
And, as referenced in your footnote regarding Robert Schleip’s work and contractile fibers, if you read other of his research, he says he worked with people under anesthesia, attempting to change their fascia with manual therapy. He admits the structure of fascia can-NOT be changed with anywhere near normal forces. He said the point at which fascia actually changes structure is just before it reaches the breaking point, and you are NOT going to achieve that with therapeutic levels of manual pressure or stretching.
RE: Contractile fibers in fascia?
And, Schleip (among others) reported on the discovery of “contractile fibers” within the fascia. Well, turns out in further research these stray contractile fibers are VERY few in number, they usually only show up after an injury to an area, and they are smooth muscle fibers, which do not generate [anywhere] near the pulling power of skeletal muscle fibers. ...
And they are NOT under conscious [efferent] control.
According to the research I’ve read, the contractile fibers Schleip speaks of are theorized to develop in order to hold damaged tissue together to facilitate tissue healing. But generate significant structural forces within the muscle or throughout the whole body? Not very likely.
This means that while fascia is extremely bend-able, [flex-ible] and resilient, it is NOT stretch-able or LENGTH-able, nor is it contractile in any way like [or to the degree] the actin-myosin units are.
(Physics and biomechanics use the term “stiffness” to refer to resistance to permanent deformation when bent or stretched. The technical use of the term “stiff” versus the layperson use of the term can get [very] confusing.)
What IS remarkable about fascia is how bend-able, twistable and resilient it is (NOT “stiff” in layperson terms), yet its very high resistance to extensibility (changing of length without permanent distortion and therefore technically speaking is “stiff”) is what allows it to transmit the actin-myosin generated forces through the facial sheaths, which become the tendons, which become the periosteum, by which they deliver the muscular force to the bones.
(I think that ability is just remarkable that fascia can be & do that, by-the-way. Being a firm believer in the division of labor as a culturally evolutionary force in humankind, I find it quite interesting that some people fervently need to add more properties to the biological division of labor of fascia beyond what it already does. Asking it to do things muscles already do FAR more [effecticiently] (effectively & efficiently) is unnecessary and counter-productive from a health care point-of-view.)
Now, if fascia was NOT highly resistant to stretch, huge amounts of muscular force would be lost by way of force dispersion when muscles contract and the fascia “stretch,” which it does not do much of, for very good reasons.
Research over many years, available in many physiology textbooks, puts the maximum stretch-ability of fascia-related components at a maximum of 4 to 7 %, depending on who you read. (I did see 10% somewhere once, but only once.) This probably contributes to the “shock-absorber” effect of musculo-fascial units.
Yet muscle fibers can change length up to 150%. THAT is a lot of length-ability. But it does NOT come from any elasticity in the muscle cells, but in the ability of the very “stiff” actin and myosin units to “ratchet across” and slide past each other.
What makes a bone or joint move from internal forces is the synergistic effect of the deeper Musculo-AND-Fascial units whose individual, unique properties, working together, generate contractile force (actin-myosin cells) and deliver that force to the bones (via fascial sheaths, tendons, periosteum), as a harmonious, cooperative unit. No duplication of function necessary, that I can see.
They work in harmony with each other, contributing their unique and very different properties.
RE: “… Other characteristics of myofascial pain include pain that is dull, aching, and often deep. …”
As long as we remember the word “myofascia” is interpreted as muscle AND fascia working together (NOT just the fascia located around the muscles), then yes. But as Tom Myers acknowledges very early in his book, too many people think of myofascia as JUST the fascia. Of course, Tom occasionally gives the impression he too focuses on JUST the fascia, which might be a contradiction or misunderstanding, but he at least openly acknowledges the need for, in practice & function if not scientific study, treating muscle and fascia as integrated, synergistic units, not discreet, independent actors in the landscape of the body.
Talking about fascia independently is great for examining its unique characteristics and properties, but not so good when discussing how fascia actually works as a member of a highly integrated & synergistic system, the Pycho-Neuro-Musculo-Fascial-Skeletal system.
RE: “… I could feel a definite connection of a shortened fascial line.”
Now, my question is, HOW does one feel the difference between the muscle and the fascia in the tissue? How does one observe a “shortening of the fascial line” independently of the muscle fibers encased within the fascial sheaths?
They are so intimately interwoven with each other, how can you observe or feel, let alone treat them, as independent entities? After 30 years of practicing hands-on therapy and stretching therapy, I’ve not developed that level of sensitivity to feel or see a difference between muscle fibers and their casings [fascia] in any practical way. (When speaking of myofascia, fascia is the casing or sheaths of the muscle fibers.)
This is, in part, where the sweater analogy breaks down, UNLESS you include the muscle cells in the model.
The hardness we feel in these tissues is in my view generated [primarily] by actin-myosin cells shortening, increasing internal [hydro-static — water] pressure within each cell. Being water filled, the increased hydrostatic pressure within the cell presses outward against the fascial sheaths, in turn creating the hardness of the tissue.
It is not one or the other, but BOTH muscle and fascia working together producing that hardened feel of the tissue. If fascia were truly extensible (stretchable) it would disperse that hydrostatic pressure, dramatically decreasing the ability of the muscle to deliver force to the tendon and bone.
And HOW does a fascial line “shorten” without the actin-myosin action of muscle fibers? The pro-fascia advocates are correct in pointing out many things fascia does that previously went unnoticed. HOWEVER, they have bent over backward trying to prove that fascia can, in and of itself, “shorten” or “contract” sufficiently to cause significant postural distortion.
Any “contraction” of fascia, apart from its synergistic actions with muscle fiber, is probably due to dehydration, and to the slight hardening effect generated by the action of colloidal molecules that increase the density of the tissue when too much force is exerted too fast on said tissue.[Because colloidal molecules, due to their molecular structure, DO that without neurological input.]
But the hardening of colloidal molecules against outside forces is VERY different than the hardening of a contractile muscle cell. It’s like night and day.
There is also, possibly, the hypothesized piezo-electric effect that might have some hardening or “tensing” action on the fascia. Yet with next to no, or NO, motor innervation, and no significant presence of contractile fibers, there is, so far, no [significant scientific] evidence that fascia can “relax” or contract to any great degree on its own. [Maybe at the microscopic level, but not macroscopic.]
So, getting back to “…a pull on one corner of the connective tissue framework exerts a pull throughout the structure,…” Yes, but that is not from the structure being distorted through the fascial system BY ITSELF, but by the Synergistic Effect of musculo-fascial properties & forces acting together on bones & joints, sometimes in series and delivering forces several body segments away.
But the physiology of fascia, in and of itself, cannot deliver a STRUCTURAL pull at a distance without the muscular force being transmitted through the bones. But again, neurological transmissions are a whole other [aspect of the] story.
I’d like to discuss adhesions and scarring, but this has gotten long enough.
Bottom Line here is I have for many years been mystified as to why the amazing beauty of the system of Fascia & Muscle working together as a synergist, a harmonious whole is down-played by the pro-fascia advocates? For some reason, many of them have an attachment to the idea of fascia doing almost EVERYTHING and throwing out the magnificent Division of Labor — i.e., unique anatomical & physiological properties & functions — created by nature itself in muscles & fascia.
I think a lot of that is an emotional attachment to the ideas of the Founders, Ida Rolf, John Barnes, and others. In Ida’s case, she was in turn very influenced by Andrew Taylor Still and Alfred Korzybski, both great thinkers & innovators. But I think, once the unique properties of fascia were highlighted and brought to the forefront, the focus on fascia was over-emphasized at the expense of muscles. In her book, Ida Rolf Talks About Rolfing & Physical Reality, Ida is quoted as saying way back when that (approximate quote) “everyone is talking about muscles, and no one’s talking about fascia.”
Today, the situation is reversed.
Here’s an article I wrote that gets somewhat into the philosophical background of beliefs such as Ida’s on fascia:
What Ever Happened to the MYO in Myofascial Release?
Thanks for Reading,
David Scott Lynn (DSL*)
* DSL: Your Hi-Touch Uplink to the Inner-Net*
Inner-Net: Your Psycho-Neuro-Musulo-Fascial System