Myofascial Release; The Great Conversation

[nari]

hey Diane...you just stole my phrase about the Blob....

Nari

[Luke Rickards]

Dave,

As my mom has said "If everyone jumps off a bridge, does that make it right?" More plainly if you can convience alot of people (weather it be through skewed research or just via case studies) that a hypothesis is correct does that mean it is correct?

Firstly, are you suggesting that the entire international neuroscience community has jumped off the bridge and Barnes is standing at the top waving? Secondly, as Barrett points out, science is not a belief system, therefore it does not attempt to convince. BTW, did you listen to your mom?

Emotion can be related to or a least grouped with stress. Think of how many people grind their teeth at night or tighten up their shoulders because of stress. This prolonged posture or abuse to the TMJ causes physical pain and malfunction. Yes you can argue that this emotion isn't stored in the body, however then explain why is it that although the stress/emotion has been removed ... and yet another stressor/emotion comes by and your body reacts the same exact way?

You have never heard of the subconscious!?


Walt,

"A clinical encounter can be an empty experiential slate upon which both patients and practitioners may paint a picture of clinical success, even when the method is ineffective. Most maladies improve without treatment, placebo effects and regression to the mean may lead to improvements not directly caused by the treatment, and subjective validation may lead to imagined improvements where none exists". If we are to post citations and trust research, do we pick and choose which parts of the research to believe? These "trusted" researchers just invalidated all that we work for, as " most maladies improve without treatment". I hope that we all do not feel this is true, as we see the opposite in our treatment room every day.

Is there any evidence that it is not true? You've never had an ache that just went away, or an injury that healed on its own? Ask everyone you know if they've had such an experience - sounds like you'll be surprised. No, I'm not reading selectively - I stand by that statement and am fully cognizant of the magnitude of non-specific effects in my clinic. I don't find this thought a threat.


Regarding the answering of questions, I'd like to see the following ones answered -
From Jon:
1. If the patient pushes back but doesn't say anything in particular or anything at all, isn't it necessarily the therapist that interprets what that means and thus what happens next is the therapist's intent?
2. The patients you help improve. So at a minimum, some element of your therapeutic interaction is helping. Much of the improvement can likely be explained, plausibly, by our current understanding of pain physiology. Here's the part you can help me with. Why should I abandon these reasons and adopt a theory that seems to defy neurophysiology and may lead me to do more than is necessary and increase the risk of unintended consequences?

From me:
1. It clearly states in Barnes' book that evidence exists demonstrating that emotions, memories and trauma are stored in the fascia. Are we going to see these papers or not?
2. And a new one: It seems that in MFR the fascia has assumed most of the functions normally attributed to the brain and nervous system. What does John say about the brain? Is there any modern neuroscience in his work?

Thanks guys,
Luke

[nari]

Dave,

Quote:
'Most maladies improve without treatment'

Highly probable; take note of the word 'most'....we see the ones who don't improve spontaneously; and this may occur for any number of reasons that a psychologist or sociologist might have answers for.

One of the amazing assumptions made by therapists (and I include everyone who sits under the broad umbrella of 'therapy') is that what they actually DO in their Rx rooms is what actually gets the patient better.
This thinking tends to breed gurus and disciples who will protect their castle by any means at their disposal, including dodgy science. If one believes strongly enough, the line between science and mysticism, fact and fiction becomes blurry and interchangeable.
Philosophers sometimes seem to have a licence for merging possibilities with impossibilities; but scientists don't have that luxury. They have data and hypotheses which they attempt to prove or disprove (a la Einstein), but all are based on a few laws and zillions of theories, which emerge from an understanding of the natural world at the time. When other data surfaces, they review and revise their work.

I would suggest that the data used in spreading the word of MFR needs a very thorough dissection and perhaps some discarding in favour of new data...

Cheers

Nari

[Bas Asselbergs]

Thanks all, for a spirited thread!

Walt, out of many aspects on this thread, one line jumped out at me:
"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."

That is a lot of strength - How do you (or the theory of MFR) propose that gentle, manual sustained stress can have any effect on this?

[Diane]

fascia has an average tensile strength of 1980 lbs per su. inch. This could certainly hold a right hemipelvis in anterior rotation."

That is a lot of strength - How do you (or the theory of MFR) propose that gentle, manual sustained stress can have any effect on this?

Good point Bas!

hey Diane...you just stole my phrase about the Blob....

Sorry about having stole your line Nari, without crediting you for it. Everyone, that's Nari's line.

Dave and Walt, I forgot to mention David Butler's The Sensitive Nervous System. Mandatory reading. He doesn't tell people what techniques to use, he simply explains neurophysiology. He's a PT BTW.. I think we are here in one way or another at this site because of his book.

Another thing: science rules out other possibilities first before arriving at a conclusion. Ever heard of Occam's Razor? A scientific mind does the same thing, or "premature cognitive conclusions" become foisted upon the world and as memes, replicate for better or worse. Bearing that in mind, I'd like to see the promotors and teachers and conceptualizers of MFR rule out the nervous system as a factor in pain, movement dysfunction, sensory input through skin, improvement through treatment, first... before I'd consider accepting their thesis that fascia is somehow more important than being merely a bungee cord system that holds the body together with cellular "glue" (i.e. integrins) or that I can affect such a system directly, and not through the nervous system.

Dave, you're an OT! I thought OTs were all about the brain!

[bernard]

No Brain, No Pain! :lightbulb

[Diane]

Good one Bernard! :thumbs_up (You are cracking jokes/making puns in English. I'm impressed!)

[bernard]

I have very good teachers!!! :angel:

[Diane]

Luke, I just had a chance to read through your link on cranial, in a long ago post. Thanks so much for including it.

CONCLUSIONS
Over time, science-based disciplines expand their bases
of understanding and utility. Cranial osteopathy has not
done so. Its advocates still proffer: (1) the same biologically
untenable mechanism proposed by Sutherland 65
years ago, (2) no indication of diagnostic reliability, and
(3) no properly controlled research showing efficacy.
After many years, practitioners of cranial osteopathy, including
King and Lay, have provided little evidential
support for their many claims. These facts should lead to
an extensive revision of this chapter or to its removal
from the next edition of the Foundations for Osteopathic
Medicine.

If osteopathy is willing to prune back its fallacious memes in the light of current available research, so should PT be willing to prune back its fallacious memes too, and not assist them by passing them on for $.

[Dave Vollmers]

Diane -

I think I may have been a wee bit too tired when I posted and didn't get my point across. I'm not saying the fascial system is the nervous system anymore than you would say that the skin ligaments are. According to what I read in your abstract it appears that the skin ligaments mearly house or allow nerves to pass through and provide support much like any other part of the body that nerves travel through. The point I'm trying to make is that what you are terming as skin ligmaments sound the same as what John Barnes is defining as fascia.

Let me quote from John's book "Search for Excellance" where he describes what the fascia (connective tissue) is made of. "Connective tissue is composed of collagen, elastin and the polysaccharide gel complex, or ground substance....It's main componets [ground substance] are hyaluronic acid and proteoglycan." (this definition is referenced from Hall D. The aging of connective tissue exp. Gerontology. 1968; 3:77-89

If skin ligaments are made up of the same components than I think we have some common ground to talk with and this is were my post was trying to go.

In regards to

that fascia is the nervous system,

I want to quote another part of that same text "As described by Scott, the fascia serves a major purpose in that it permits the body to retain its normal shape and thus maintain the vital organs in their correct position" (referenced to: Scott J. Molecules that keep you in shape. New Scientist 1986; 111:49-53)

This shows my first comment that I am not saying that the fascia is the nervous system only that it houses it and allows if to take the paths that it takes.

Just a comment - I know it's petty and will only envoke a negative response - but I only say it to put the question out there, so please don't take offense for I don't plan on debating the topic of the importance of the brain but if

A body without a brain is just flesh and a cadaver.

than how do explain to a loved one that their clinically brain dead spouse/parent is being kept alive by machines. Or do you take the low road and just tell them that their loved on is just a cadaver. (I may regret this latter so please forgive me if it causes a backlash and I don't respond cause I'm not looking for a fight)

[bernard]

Dave,

I'll take no offense about the last sentence but without the external machinery, have these human beings some chance to live?
Have they a chance to say something or feel something we may recognize (a facial expression)?

It remains a dramatic situation where all actors have difficulties to move freely.

Is there a chance that a paralysed limb may be cured/treated by MFR?
Just take some minutes to think about this riddle?

[Diane]

Hi Dave,

Diane -

I think I may have been a wee bit too tired when I posted and didn't get my point across. I'm not saying the fascial system is the nervous system anymore than you would say that the skin ligaments are. According to what I read in your abstract it appears that the skin ligaments mearly house or allow nerves to pass through and provide support much like any other part of the body that nerves travel through. The point I'm trying to make is that what you are terming as skin ligmaments sound the same as what John Barnes is defining as fascia.

OK, point accepted.

Let me quote from John's book "Search for Excellance"

(well, ...ok... if we must go there.. )

..where he describes what the fascia (connective tissue) is made of. "Connective tissue is composed of collagen, elastin and the polysaccharide gel complex, or ground substance....It's main componets [ground substance] are hyaluronic acid and proteoglycan." (this definition is referenced from Hall D. The aging of connective tissue exp. Gerontology. 1968; 3:77-89

..I know.. (so your point is)...

If skin ligaments are made up of the same components than I think we have some common ground to talk with and this is were my post was trying to go.

OK, point accepted..

In regards to
Quote:
that fascia is the nervous system,
I want to quote another part of that same text "As described by Scott, the fascia serves a major purpose in that it permits the body to retain its normal shape and thus maintain the vital organs in their correct position" (referenced to: Scott J. Molecules that keep you in shape. New Scientist 1986; 111:49-53)

Hmmnn.. I'm getting lost a bit.. how did we end up here? I asserted that the nervous system is in charge of the behavior of mesoderm. Are you still trying to say that the mesoderm is in charge of the nervous system/motor behavior?

This shows my first comment that I am not saying that the fascia is the nervous system only that it houses it and allows if to take the paths that it takes.

Agree on this point.. to a point. Nerves can actually "plow" through mesoderm to get to where they want to go.

Bring it on Dave, bring it on. Keep trying to convince me that fascia is more important than the nervous system and dictates memories, emotions, their storage, that it can be manipulated from outside the skin layer somehow, even if this assertion requires a leap of faith as per Walt over into Oschman type pseudoscientific energy ideas.

As for people who are kept on life support and trying to convince their relatives that they are functionally not there anymore as human beings, I recommend a thorough reading and soaking up of Antonio Damasio, a neurologist who has treated and studied such patients for decades and has written several sensitive, groundbreaking books about consciousness and what exactly that means in human terms. There's a thread here about him. Use the wonderful search tool on this site that Bernard has provided us; just enter "Damasio" and click. Every thread containing any reference to him will instantly appear.

[Dave Vollmers]

Luke -

I'm not suggesting that the neuroscience commuinty has jumped off any bridge, I'm mearly taking your definition and posing the question back to you. We both agree that alot of research in inherently flawed but I think we can both agree that even with flawed research, if a clinician sees the prinicpals working in their practice than we utilize them. At this point aren't we than moving more towards a belief? Secondly isn't the purpose of research to either convince ourselves or others that a principal is sound and has merit, if not than what would be the purpose of research because if we aren't convincing ourselves or others than we are basing our practices on faith rather than fact. (just my own personal observations) BTW I did jump but I had a bungee cord around my ankles and it was a blast

In regards to the subconscious mind - yes I've heard of it and in fact I think it is where we need to tap into for true healing to take place. I'm not up in my research of the brain because I've spent my life with orthopedics (I'm not negating the importance of neuroscience it's just not were I spend my time reading research - probably for the same reason you don't read over the ballistic data of the new rifles that have come out from Winchester in the WSM class - it doesn't intrest you)

I want to make it clear that the only reason I'm here is that I think the disscussions on MFR have been tainted by Barrette and Walt because of their hisotry. I feel that all of you have a basis for understanding MFR and some of the questions are great but many of these questions can be turned around to each of our own practices and therefore spark some intelegent thoughts about what we "believe" works vs what the "facts" are. keep in mind, if you treat patients you must deal in a subjective world that forces the scientific model to change because when you deal with patients you will never have true objective data to work from.

just some thoughts for now but I do have to get to my patient and I would like to stop for now and continue with the rest of Luke's post latter.

Dave

[Barrett Dorko]

Dave says, "Keep in mind, if you treat patients you must deal in a subjective world that forces the scientific model to change because when you deal with patients you will never have true objective data to work from."

This isn't true unless the words subjective and objective mean something to you that has nothing to do with their common definition. It's obfuscation.

Walt and I have no "history" to speak of. We've never met and I've never read anything by him before a few days ago on this site. Which brings me to another question: With 50,000 students out there, why is it that only two have joined in on this conversation? Why not Barnes himself?

[nari]

Diane...I was only kidding!! re the blob bit....

Dave, you say you have spent your life with orthopaedics and you suggest that the brain and CNS doesn't interest you...as though the two were totally separate. You can't really understand orthopaedic issues without knowing about the brain's role in this aspect and ALL aspects of dysfunction and pain.

It's like saying you study and are interested in evolution but don't consider Darwin relevant to the topic.....or you love cooking but don't own a stovetop or oven. A whole new world opens up once you appreciate the neurophysiology aspect; it makes the difference between being a technician and a professional thinker.

Do read about what the body is and the brain...Damasio, Ramachandran, Butler's Sensitive Nervous System, Moseley, Michael Shacklock...there are many who are trying to get therapists to think outside the Cartesian square. Don't get left behind in a murky world of fascia....


Nari