Myofascial Release; The Great Conversation

[Diane]

Hello,
Just a note to explain that I've moved the conversation into the general discussion forum, territory that may be considered a wee bit more neutral, perhaps... apologies for any sense of dislocation that may be experienced by any participants. Please continue.
(Any other changes you'd like to see to the thread title Walt?)
Diane

[nari]

Hi Walt,

As someone who has had no contact with MFR other than secondhand reports, I am curious about:

jon's post, above: How can you explain this anomaly at Sedona?

After googling MFR I came across:

.."specific manual techniques of holding the tissue for 90-120 seconds allowing for a mechanical and biochemical reaction to begin. Full release of the restriction may take 5 minutes or longer."

(from the austinbodyworks site)
This sounds like a form of neuromodulation, but why the emphasis on the fascia? What about the CNS?

A page referring to Dr Melissa Nelson in the body-dynamics site describes unwinding workshops, love workshops, osseous integration...and so on.
What are you unwinding? Where does a love workshop fit in? How do you integrate bones?

How does this fit with the ethics / professionalism of physical therapy as I understand it is practised in the USA?

Nari

[Luke Rickards]

Hi there Walt,

I understand that Upledger is becoming quite well known for his use of Dolphin Energy during seminars. Does he teach that in the Advanced SomatoEmotional Release classes?

As to “us guys” assigning properties to the connective tissue that it simple does not possess, here are a few references from peer reviewed journals that you may have missed along the way:

None of those references offer the slightest bit of evidence that the fascia behaves in the way suggested. The 3 outcome studies appear very low in internal validity, and one of them was using direct, Rolphing-type MF treatment.

The Schleip reference is relevant to the comment above, however, it clearly states that this is a hypothesis. Can a few smooth muscle cells pull the entire hemipelvis into anterior rotation, for example?: that will be the question to answer. From Barnes book, "Recent evidence and my experience have demonstrated that embedded in our structure, particularly the fascial system, lie memories of past events or trauma." Can you please post this evidence? - I'd like to read it.

Cheers,
Luke

[Walt Fritz]

So many questions...why don't you just take the seminar?

I'll try to respond to questions in the reverse order that they came. I'm not a scientist, nor do I have a background in research, as many of you seem to have, and I respect this fully. Not wanting to quite stoop to a certain level, I must ask you who are taking shots at me and MFR to expect the same.

Luke,

"I understand that Upledger is becoming quite well known for his use of Dolphin Energy during seminars. Does he teach that in the Advanced SomatoEmotional Release classes?"
I don't know if he does, I've never taken this level with him. Is that how you can dismiss a professional, by tagging this on? Upledger's work has a huge amount of research behind it, check it out. As for Schlelp's work stating that fascial plasticity is only a hypothesis, I'm not sure whether you actually read the two papers he wrote on this. If I'm not mistaken, a hypothesis is stated at the beginning of any work, but Schlelp goes on to explain that fascia is indeed capable of the changes that we in MFR claim. As to "a few smooth muscle cells pull the entire hemipelvis into anterior rotation", no, I doubt that a few muscle cells could do this, but the enormous strength of fascia can.
Reference - Katake, K. the strength for tension and bursting of human fascae, J. Kyoto Pref. Med. Univ., 69: 484-488, 1961. old research, but it shows that fascia has an average tensile strength of 1980 lbs per su. inch. This could certainly hold a right hemipelvis in anterior rotation. And, Schlelp's articles, as well as the Mark Barnes journal reference mentioned previously, show that fascia can be altered through the proper application of forces. As for the Barnes quote from his book, I do not have that reference, but I will try to obtain it.

Nari,
As to Dr Nelson, I do not know her work so I cannot comment on her love workshops. This is not one of John's classes either. Osseous integration, as taught through John Barnes MFR, is applying MFR principles to the osseous structures. In the example of the right forward pelvis, the ilia would be taken to their barriers in the desired direction and held there through subsequent releases, to take the fascial restriction out of the system, returning the pelvis to a more neutral alignment. Superficial fascia would be addressed as well as deeper layers, including those within the sacroiliac region. What is being unwinded, or unwound? Not sure from Dr. Nelson's perspective, but in MFR Unwinding can be something as simple as following the three dimensional nature of the fascia through its course, barrier uopn barrie,, which is often not the original linear direction that was begun.

Jon,
I wasn't in the treatment room, but it sounds like a common experience of tissue memory. The therapist never forces the barrier, they just maintain sustained gentle pressures at the barrier unless the patient asks you to stop which is always their option.

To the patient when tissue memory arises, it can feel like enormous pressure, etc, since it is reproducing a past experience. As the sensation of the past subsides, the tissue releases, prior pain or symptoms lessens, and range of motion increases. No harm is done and the patient improves even though years of traditional therapy have not helped.

However, I dont think it is prudent to continue to discuss this patient's blog.

Barrett, have you asked this woman for her permission to post her blog on all the many sites that you have? It may be legal to do so, but it may be a serious ethical violation without her persmission. It is one thing for one to visit her blog. Her purpose was to help other patients by sharing her experience.

But for you to put this out to the world or other sites and then distort it as you have is quite another.

Your distortion is immense. You never mention that she was suffering with pain for years, slowly becoming more and more disabled to the point where she had to use a scooter to get around the food store. You then failed to mention that after her sessions she was relatively pain free, could walk again and was profusely grateful to all the MFR therapists that had helped her. She didnt ask what neural theory we used. She asked for help and she got it.

Barrett,
There seems to be a bit of confusion here when you stated that MFR is having increasing difficulty getting CEU credits around the country. Are you referring to John's MFR classes specifically? If so, you are mstaken, as John has never been denied CEU credits and his classes continue to draw large numbers no matter what state he is in and the desire for more has brought on new seminars. I applaud your success, in therapy as well as in your seminars, but please speak truthfully when speaking about MFR.

First you stated: "You’d probably be better off not telling me how to behave", then later: "This thing about recovered memories seems to have you confused" and "obviously you’ve not read “The Memory War” as I suggested." Lets make a deal: I'll not tell you how to behave, if you stop with the condescending attitude toward me.

"When they treat it as if it is the authentic origin of the patient’s problem and go on to encourage its fuller expression (this includes profound emotive responses) they are at best beyond the depth of their knowledge and training and at worst acting in a fashion proven unethical over a decade ago."
Barrett, you are making a huge and incorrect assumption that we treat anything that the patient says, in terms of a past memory, as authentic in origin. It is only authentic in that the patient spoke it at that moment, no more. What their impressions are as to the authenticiy of it beyond the moment is for them to determine. If, believing that it was something from the past and helps them to heal, they have that right. We, as John Barnes MFR trained therapists, make no determination to any effect as you have so frequently and incorrectly stated.

I must ask you, how can you judge so much of a work and of a person without actually attending one of his seminars? Isn't the scientific mind one that explores all avenues before coming to a conclusion? I know for a fact that John Barnes attended one of your seminars many years back, in order to see what you and your work is all about. In order to spread the word against his work the way you have for years, don't you think you owe it to your students and your loyal followers to at least see what it is that you have benn criticizing for all these years? In your first post to me on 12/29, you stated: "I don't think it's appropriate to chose one or two aspects of your practice for discussion and refuse to discuss others". Well? Stop making assumptions on something you seem to know very little about.

By saying that Carol Davis made statements publically in 2003, I assume you are referring to the MFR chat line which you got kicked off of for making outrageous statements under a false name? You held onto this quote of her's for this long?

Bernard,
Of course the brain has a function in all of this. It interprests the person's pre-existing condition and alters its view when changes are made. but there would have been nothing new to interpret, in this study or any patient expample that I know of, if changes were not made to the physical body, via MFR or any other modality.


Diane,
In response to your questions about the neural componant of this work, think of a nerve (or muscle, blood vessel, organ, etc.) as a garden hose. If you step on the hose the water is slowed or shut down. MFR takes the pressure off of the hose to allow everything to return to its normal flow.

I am enjoying your questions, especially when the asker is open to the answers.
Walt

[Diane]

Bernard,
Of course the brain has a function in all of this. It interprests the person's pre-existing condition and alters its view when changes are made.

So... Walt, are you saying that you make the changes from the outside of someone else's body, and then that person's brain decides to change its view or its interpretation of that body?

but there would have been nothing new to interpret, in this study or any patient expample that I know of, if changes were not made to the physical body, via MFR or any other modality.

So... Walt, are you saying that you make the changes from the outside of someone else's body, and then that person's brain decides to change its view or its interpretation of that body? Retroactively?

Diane,
In response to your questions about the neural componant of this work, think of a nerve (or muscle, blood vessel, organ, etc.) as a garden hose. If you step on the hose the water is slowed or shut down. MFR takes the pressure off of the hose to allow everything to return to its normal flow.

How does MFR take the "pressure off the hose"? What is the mechanism? Are your hands able to somehow go through all those slippery layers and directly unload things that are subcutaneous without breaking skin?

One last time: So... Walt, are you saying that you make the changes from the outside of someone else's body, and then that person's brain decides to change its view or its interpretation of that body? Retroactively? After the "fascia" is "adjusted"?

[nari]

Walt, Dr Nelson's site includes John Barnes' name, so he and his work is implicated in her work, albeit through a different interpretation.

OK, I still do not know what is releasing from what, exactly, but maybe that will becomes clearer as time goes on.

Can you explain the 'barrier'? and what causes barriers and multiple barriers?
If it exists, then there must be a physiological reason for it to do so. Are we talking internal / external causes? or origins?

You're going to have to answer quite a few questions, I think...

Nari

[bernard]

Hi All,

Ian Stevens sent me this (was unable to post because a browser problem = safari)

Bernard I could not send this for some reason (strange safari browser)


http://www.nature.com/neuro/journal/...ull/nn896.html

http://en.wikipedia.org/wiki/Insular_cortex

I was thinking of the peripheral explanations for therapies and as a
Physical therapist I should really 'believe' that this is the main
explanation for the effect of the interventions .
If there is no sensible explanation for the fact that many interventions
cause change in either perception or sensation and in some cases movement
patterns the best way to explain this is to believe in something. This
something is a theory . I believe most of the theories in manual therapy are
wrong --heretical i know! .....However as Melzack suggests theories drive
beliefs and ultimately what we do and how we act towards each other.
The above articles are based on scientific methodology but point towards the
complexity of the interaction between body and brain.
As things in the western biomedical paradigm are so dualistic it is my
opinion that in order to offer treatments that differ from the dominant
biomechanically driven solutions people make things up to suit notions that
are plausible at the time- or at least sound like they are. This is the
basis of all the tissue based solutions . There's an A-Z of them ?
Currently we have 'new neuroscience' (such as the papers above) which in my
opinion seem to offer rational approaches and make sense of so much that
we try to offer .
This in my humble opinion is the golden age . Instead of drifting into turf
wars we could be embracing this new found knowledge in an attempt to bring
people together !This sounds a bit religious but all of the issues that are
amenable to our intervention are open to 'procebo' .... I do believe touch
is a good thing !
''I would think that the whole point of having a mamalian brain is to be
able to adapt and to be able to learn, and that means being highly sensitive
to signals and information from the context . In this sense , part of the
reason for placebo's negative image, for the ways in which biomedicine
dismisses the physcian -patient relationship and power of narrative ,is that
most people are bad neurobiologists and think if i can't explain the
phenomenon by a rigid , lock and key algorithm ,then its nothing but
mystical hokum''(Placebo Effect an interdisciplinary exploration Anne
Harrington -ed p235)
I think we would be better off discussing somatic markers than fascial
releases and also look at factors that promote fascial tightness or more
likely 'locked in' cns motor patterns . The fact that many of these issues
respond to simply sitting still and either meditating or visualisation may
provide some clues as the dominant mechanism ?

Confession -- I have no vested interest whatsoever in any technique or
approach . I don't run a successful practice ,sell books or market anything!
I am interested in sharing ideas and think that the internet , open
discussions a bit of movement , music, wine and getting out in the fresh
air usually sorts most things out in the long term !

Happy New Year to you !

ian

[Diane]

Good links Ian, and great post.
Happy NY to you too!

[PTPete]

Deja Vu. However, this discussion motivated me to hunt around a little for the "deep model" of MFR, if it exists. I'm not finding much real science for it, but there are some interesting theories, namely the writing by Robert Schleip. I found an additional abstract that adds a little evidence, but PubMed didn't offer me much.

Med Hypotheses. 2006;66(1):66-71. Epub 2005 Oct 4. Related Articles, Links


Passive muscle stiffness may be influenced by active contractility of intramuscular connective tissue.

Schleip R, Naylor IL, Ursu D, Melzer W, Zorn A, Wilke HJ, Lehmann-Horn F, Klingler W.

Department of Applied Physiology, Ulm University, Albert-Einstein-Allee 11, 89069 Ulm, Germany.

The article introduces the hypothesis that intramuscular connective tissue, in particular the fascial layer known as the perimysium, may be capable of active contraction and consequently influence passive muscle stiffness, especially in tonic muscles. Passive muscle stiffness is also referred to as passive elasticity, passive muscular compliance, passive extensibility, resting tension, or passive muscle tone. Evidence for the hypothesis is based on five indications: (1) tonic muscles contain more perimysium and are therefore stiffer than phasic muscles; (2) the specific collagen arrangement of the perimysium is designed to fit a load-bearing function; (3) morphological considerations as well as histological observations in our laboratory suggest that the perimysium is characterized by a high density of myofibroblasts, a class of fibroblasts with smooth muscle-like contractile kinetics; (4) in vitro contraction tests with fascia have demonstrated that fascia, due to the presence of myofibroblasts, is able to actively contract, and that the resulting contraction forces may be strong enough to influence musculoskeletal dynamics; (5) the pronounced increase of the perimysium in muscle immobilization and in the surgical treatment of distraction osteogenesis indicates that perimysial stiffness adapts to mechanical stimulation and hence influences passive muscle stiffness. In conclusion, the perimysium seems capable of response to mechanostimulation with a myofibroblast facilitated active tissue contraction, thereby adapting passive muscle stiffness to increased tensional demands, especially in tonic musculature. If verified, this new concept may lead to novel pharmaceutical or mechanical approaches to complement existing treatments of pathologies which are accompanied by an increase or decrease of passive muscle stiffness (e.g., muscle fibroses such as torticollis, peri-partum pelvic pain due to pelvic instability, and many others). Methods for testing this new concept are suggested, including histological examinations and specific in vitro contraction tests.

PMID: 16209907 [PubMed - in process]

Walt thank you for the discussion, if you have more answers or information I'd love to see it.

Barrett, you continue to make my PT school education irrelevant. Thanks, I think.

[bernard]

Hi Pete and Welcome,

This paper was already cited and the full text is available =>
http://www.somasimple.com/forums/showthread.php?t=1157

[Luke Rickards]

Hi Walt,

Having a master's in osteopathic manual medicine, I am quite well acquainted with the research for and against all craniosacral concepts. There is not much to be impressed with in Upledger's work, or much of the CS/OCF theory. You may want to read the file attached.

I have read both of the Schleip articles mentioned here very closely. Can I suggest you do the same, but paying particular attention to all of the "may"s and "if"s in both, as well as clear recommendations by Schleip that his hypothesis needs to be tested before conclusions can be drawn. One possible hurdle is that much of this research has been done on animal tissue. Many of the readers here will be aware of the story of Strain/Counterstrain Technique, which was born from conclusions about the human gamma efferent system based on research of cat muscle that turned out to be almost totally invalid. (For some strange reason S/CS theory is still taught at university)

I found this statement by Schleip interesting -

We suggest that treatment with super-slow manual deep tissue techniques..may be helpful in this and similar conditions. Such techniques are commonly practiced by osteopaths and by practitioners of the Rolfing method of deep tissue manipulation

Nothing about emotional or traumatic memory expression there.

I don't think anyone here doubts the tensile strength of connective tissue.

I look forward to reading evidence of the memory and trauma storage capabilities of fascia.

Thanks,
Luke

[Jon Newman]

From the blog:

If you have ever considered going for an intensive, but didn’t want to venture into those waters without more information, join me on my journey. I may not share everything, but I will share everything that I am comfortable sharing.

Regardless that Dottie feels comfortable about what she wrote, enough to post it on the World Wide Web, this is a critical discussion about PT, not Dottie. I've seen plenty of people like Dottie (similar presentation) and have obtained similar results without subjecting them to personally embarrassing situations or pinning them to a plinth table. Is pinning someone to a plinth table your version of gentle sustained pressure? What part of that is consistent with "We do not force"?

In my literature searches on memory, fascia doesn't seem to be a big player. Like others (and I'm sure neurologists would be quite keen also) I'm quite interested to hear more about this or do I have to pay to go to a course to hear about it because it is proprietary information?

[Diane]

Walt, you might enjoy reading this thread, or perhaps not..
In either case I want to direct your attention to this point, from the twelfth post down, discussing a type of thinking the author of HareBrain TortoiseMind calls "D-mode" thinking:

"13. D-mode works well when tackling problems which can be treated as an assemblage of nameable parts.

It is in the nature of language to segment and analyse. The world seen through language is one that is perforated, capable of being gently pulled apart into concepts that seem...self-evidently 'real' or 'natural', and which can be analysed in terms of the relationships between these concepts. Much of traditional science works so well precisely because the world of which it treats is this kind of world. But when the mid turns its attention to situations that are ecological or 'systemic', too intricate to be decomposed in this way without serious misrepresentation, the limitations of d-mode's linguistic, analytical approach are quickly reached. Any situation that is organic rather than mechanical is likely to be of this sort. The new 'sciences' of chaos and complexity are in part a response to the realisation that d-mode is in principle unequal to the task of explaining systems as complicated as the weather, or the behaviour of animals in the natural world. Along with the rise of these new sciences must come a re-evaluation of the slower ways of knowing; of intuition as an essential complement to reason.

... or body systems, particularly some favored anatomical system that is really at too deep a level to be got at directly. Mental shortcuts get taken, and mental paths get worn deeper. Meanwhile the jungle gets denser off-path and never explored.

Really, what we are dealing with here in this conversation is not good guy/ bad guy stuff. We are dealing with memes (thought viruses), and the ability they have to take advantage of and set up housekeeping in minds that are prone to "premature cognitive committments" (which may start out as a path, but eventually become a superhighway). Memes then replicate, often out of control, infecting all who come near them. I think the general opinion of John Barnes in this group is that he is a bit of a typhoid Mary that way. He seems not to suffer from his own meme-fection but he passes it on and on through his followers.

What you have landed in, is a board with a bunch of eclectic people who have at least one thing in common, the desire to decrease mental camouflage and get at the real underlying scientific/biological/physical models underlying everything. Please forgive us, we get a bit impatient perhaps with D-mode thinking and premature cognitive committments. We are a deeper root system than that. A mind is like a forest. It's best if you know your way around inside your own.

The PT profession (any hands-on profession for that matter) may not think it needs people like us, may not want to entertain the sorts of questions we bring to bear on matters, may find our mentations tedious at best or irrelevant at worst.. however, like the big trees with no root systems, in some sort of strong wind, PT could blow right down and get sawed up for logs. If you want to explore, really explore what it is you do and better reasons than the ones you've so far offered up as explanations for why what you do seems to be effective, then stick around. If you are playing follow the leader, and are operating from a cult sensibility, then you really don't want to be here; we'll be fair but you'll begin to feel awfully set upon, and will experience cognitive dissonance (a good thing by the way.. it helps you find your own "undermind" where you can work out your own reasoning based on more reasonable input.) Learning.(links to learning originally provided by Jon the LinkMaster.)

[Walt Fritz]

Diane,

Thanks for the thoughtful reply. There seems to be two distinct directions that this interchange has taken. One, from you and many others, is an inquiry into the workings of Myofascial Release, seemingly made from a neutral and inquisitve base. Others have chosen to insert their biases. One of the primary requsts from readers centers around a scientific rationale for Myofascial Release that explains every and all aspect of the work, with an assumption that if it is not "provable", then it should be discarded. Proving that emotions lie stored in the body, not the brain, mis a slippery slope of emerging awareness and research, based on years of observation by many sources. I would direct you to James Oschman's book, "Energy Medicine in Therapeutics and Human Performance" for a much more thoughtful and substantiated treatise on these issues. No, I am not operating out of a cult mentality, no more than followers of anyone on this site is. I have seen wonderful things happen to patients over the years, patients who have not been helped by physical therapy, medication, and surgeries, as I'm sure you have as well via your work. If you are sharp enough, you can find an explanation within your literature to explain these results, but I feel that you will agree that all most of us in this esoteric therapy community rely on the results we achieve as important.

As to me sticking around and being up to the challenge of intellectual discourse, count me in. But, and here is the big but, must not we hold everyone to the same challenge. Barrett initially stated that he had been waiting for years to engage an MFR therapist in discussion and challenged me to hold open all parts of the MFR that I practice open to discussion. So I must turn the tables. Whel Barrett cites voluminous readings and references for "Simple Contact", I can find NO literature that supports, or even mentions Simple Contact> Shouldn't this be given equal scrutiny? I'm not trying to deflect any uncertainties about the foundations of what I practice, but, WHERE IS THE EVIDENCE? By the way, in the thread you directed me toward (yes, I did read it), further up the page you quote:

Claxton continues:

Quote:
Gendlin called this hazy shadow which they were attending to and allowing slowly to come to fruition, a felt sense, and it was quite different both from a string of thoughts and from the experience of a particular emotion or feeling. It seemed to be the inner ground out of which thoughts, images and feelings would emerge if they were given time and unpremeditated attention.

How about this? Does this not sound like ideomotor movement?

Simple contact must be good stuff, if that is what you are referring to. This sounds like the exact description of the unwinding state in Myofascial Release! Would this state, that you quoted and describe, be able to be explained by hard research? Doubtful. We both operate from an ill-defined space, and this is where growth occurs. Reasearch emerges from original thought. It is within this mindset that MFR can operate. Surely, it can simply be physical application of techniques, much like any other type of work. But when you connect with the person on the table, in the way you reference, that is when the beauty of our work, yours and mine, come through. Let us both continue the work that we do, accept when there is not an acceptable explanation for it, and keep helping people.

I'm not shutting off any and all questions, not in the least. But, let us set the same standards for all on this site.

[Barrett Dorko]

Walt,

Would you like some documentation regarding the denial of CEUs for PTs?

You say, “Your distortion is immense.” How so? The sum total of what I’ve done is to publish the link a total of two times. Anybody who wants to read it is free to do so and Dottie states she wants this. There they will find exactly what anybody else finds and they are free to interpret it as we all are. I see no distortion of any sort.

I never posted anything on the MFR Chat. Occasionally a member would find something I’d written elsewhere and copy it to the list. Other members would then vilify me and wonder aloud who had done what to me in order to turn me into such an awful person. This went on for four years. I have never, never used a false name on the Internet and my personal rule is to not say anything to anybody I wouldn’t say in their presence.

You say, “We, as John Barnes MFR trained therapists, make no determination to any effect (of recovered memory) as you have so frequently and incorrectly stated.”

Can you explain then why his book is full of one story after another about this?

More later.