In this section, we begin to turn theoretical information into practical application - what technique to use, where to apply that technique, and in what order.
Sequencing
The order of things.
In a pressurized, fluid system -- a system of blocks and compressions throughout, generally one should work first from the biggest blocks in the system backwards to the least. In other words, start with the largest point or area of compression and accompanying pressure distortion. From there, attend to the more minor distortions. If rather we were to first release more minor areas of compression, we would likely be pushing changes in pressure directly into the bigger blocks in the system. This would have the effect of heightening pressure distortions at the most crucial and compressed junctions.
But what is a major blockage and what is more minor? That question is complicated considerably by gravity. Fluids moving upwards in the body and spine fight the force of gravity. Our base of support in the spine is the pelvis, and mechanically, a distortion there will effect everything above. But the pelvis and legs are also a fluid-pump, assisting the flow of all fluids upwards in the body and against the force of gravity. Because of this, fluid blockages in the lower lumbars and sacrum may very well have a heightened impact on everything above. A magnified impact. Hence a minor local blockage in the sacrum and lumbar may turn into a major blockage systemically. Thus our early attention there is well-placed and the spinal base of support requires prioritization in sequencing. However, to change the whole also requires attention to the whole. And that requires a heightened attention to the thoracic.
Several reasons apply:
a. Once a rib becomes fixated, a degree of immobility is also transferred to its vertebrae. A single vertebrae with a distorted movement pattern or lack of mobility also directly affects the mobility of the two adjoining vertebrae at it’s top and bottom joint articulations.
b. A fixated rib also transfers a degree of immobility to vertebrae(s) directly behind the rib. As well, the physical space between the two may become compressed.
c. A fixated rib may also exert a directional mechanical pressure/force upon it’s attached vertebrae, thereby creating a tendency for that vertebrae to shift and compress the Central Nervous System.
d. Patterning twists (rotation/counter-rotation) in the ribcage are more likely to become fixated and highly resistant to change due to a relative lack of space. Because of the necessity of changing the whole rather than a part, resolving distortion patterns in the human body necessarily requires resolving patterns through the troublesome thoracic. The immobile thoracic will hold lower and upper body twists. Often the thoracic is compensating to twists elsewhere, and without resolution of the compensations therein, the original twists will remain.
e. Ribs 1-5, which have a tendency to lodge and fixate, are located directly over the central aspects of the cardiovascular system. Release and decompression of the mid to upper thoracic will benefit the cardiovascular system within. Arguably the quickest route to affect systemic fluid pressure is through decompression of the cardiovascular system, spatially and neurologically.
The order of things.
In a pressurized, fluid system -- a system of blocks and compressions throughout, generally one should work first from the biggest blocks in the system backwards to the least. In other words, start with the largest point or area of compression and accompanying pressure distortion. From there, attend to the more minor distortions. If rather we were to first release more minor areas of compression, we would likely be pushing changes in pressure directly into the bigger blocks in the system. This would have the effect of heightening pressure distortions at the most crucial and compressed junctions.
But what is a major blockage and what is more minor? That question is complicated considerably by gravity. Fluids moving upwards in the body and spine fight the force of gravity. Our base of support in the spine is the pelvis, and mechanically, a distortion there will effect everything above. But the pelvis and legs are also a fluid-pump, assisting the flow of all fluids upwards in the body and against the force of gravity. Because of this, fluid blockages in the lower lumbars and sacrum may very well have a heightened impact on everything above. A magnified impact. Hence a minor local blockage in the sacrum and lumbar may turn into a major blockage systemically. Thus our early attention there is well-placed and the spinal base of support requires prioritization in sequencing. However, to change the whole also requires attention to the whole. And that requires a heightened attention to the thoracic.
Several reasons apply:
a. Once a rib becomes fixated, a degree of immobility is also transferred to its vertebrae. A single vertebrae with a distorted movement pattern or lack of mobility also directly affects the mobility of the two adjoining vertebrae at it’s top and bottom joint articulations.
b. A fixated rib also transfers a degree of immobility to vertebrae(s) directly behind the rib. As well, the physical space between the two may become compressed.
c. A fixated rib may also exert a directional mechanical pressure/force upon it’s attached vertebrae, thereby creating a tendency for that vertebrae to shift and compress the Central Nervous System.
d. Patterning twists (rotation/counter-rotation) in the ribcage are more likely to become fixated and highly resistant to change due to a relative lack of space. Because of the necessity of changing the whole rather than a part, resolving distortion patterns in the human body necessarily requires resolving patterns through the troublesome thoracic. The immobile thoracic will hold lower and upper body twists. Often the thoracic is compensating to twists elsewhere, and without resolution of the compensations therein, the original twists will remain.
e. Ribs 1-5, which have a tendency to lodge and fixate, are located directly over the central aspects of the cardiovascular system. Release and decompression of the mid to upper thoracic will benefit the cardiovascular system within. Arguably the quickest route to affect systemic fluid pressure is through decompression of the cardiovascular system, spatially and neurologically.
Freeing the Cardiovascular
It is interesting to note that Ida Rolf’s ‘ten-series’ began with fascial work on the anterior chest and ribs. While her assessment looked at the body from the feet up, she understood the value of first attending to the more central cardiovascular area. From a practitioner’s perspective, the first session of the Rolf series also saw a very high degree of client satisfaction. The first session often “sold” the remaining 9 of a ten-session series. The release of the anterior thoracic fascia, allowed for a degree of ease in respiration for many clients, and this was accompanied by feelings of lightness... and happiness. Oxygen, of course, gets you high. But aside from subjective feelings, oxygen intake is considerably crucial to all function in the human body, and even a slight change here can have larger repercussions throughout the whole, including the ease and quality of sleep (and recovery).
It is interesting to note that Ida Rolf’s ‘ten-series’ began with fascial work on the anterior chest and ribs. While her assessment looked at the body from the feet up, she understood the value of first attending to the more central cardiovascular area. From a practitioner’s perspective, the first session of the Rolf series also saw a very high degree of client satisfaction. The first session often “sold” the remaining 9 of a ten-session series. The release of the anterior thoracic fascia, allowed for a degree of ease in respiration for many clients, and this was accompanied by feelings of lightness... and happiness. Oxygen, of course, gets you high. But aside from subjective feelings, oxygen intake is considerably crucial to all function in the human body, and even a slight change here can have larger repercussions throughout the whole, including the ease and quality of sleep (and recovery).
Four sessions of gentle interosseous unwinding over 3 months. The client complained of a rib acutely “out” in the middle thoracics. Here we are unwinding and decompressing starting with the lateral (sides) and anterior thoracic (chest): central cardiovascular. A systemic change can be noted, and the posterior, where relatively little work was done, appears broader and much more relaxed. Respiration is easier.
The Sides
From a practical perspective, where the ribs of the thoracic seem to always struggle for space and movement is on the sides (axillary) of the body. In palpitation, often a rib that seems large and robust in the anterior chest will narrow its physically accessible aspects to a mere sliver of bone by the time it makes it’s way into the armpit.
Rolf Structural Integration is notable for its longstanding work through the axillary area. Session 3 of the Rolf ten-series, is often found to be the most profound of all the sessions in terms of visible physical change as well as subjective client satisfaction. Why? Well, Rolf work did what very few other modalities ever even consider - releasing through the sides where space in general is arguably in short supply.
As to why we lose appreciably more space in the axillary of the ribcage, some clues may be had from examining the spinal patterns and physicality at play. The major attachment points for the ribs are the spine and the sternum, essentially at the center of the body. The vertical axis of rotation in the field of gravity is here. As ribs rotate and counter-rotate, where the patterns essentially cross is not at the center attachments, but rather at the sides of the body.
Viewed from the top down, the rib ‘cage’ has centered attachments into the spine and sternum.
Right rotation of Rib 5 around a center axis.
With a center axis of rotation, patterns will cross at the sides.
With a rotation and counter-rotation of ribs, the pattern will ‘cross’ at the sides. A scissor-like effect, complicated in the upper axillary, acromial, and scapula areas by issues of accessibility. To address much of the area, often a practitioner must unwind through other bones (scapula, acromion, clavicle, glenoid fossa), as well as heavy and dense tissue. But, as complex and difficult to address as it may be, in terms of smart sequencing, when addressing the thoracic (and cardiovascular), there are several good reasons to have an early focus on the axillary.
Additionally, the tendency to fixate at the sides becomes heightened as we travel upwards to Ribs 2-4 and into the armpit and under the scapula. Here the weight and density of the shoulder girdle (acromiom, scapula, clavicle) add to the already present tendency of these ribs to laterally fixate. As noted previously, this difficult area is rarely addressed in the human body. It deserves attention.
Additionally, the tendency to fixate at the sides becomes heightened as we travel upwards to Ribs 2-4 and into the armpit and under the scapula. Here the weight and density of the shoulder girdle (acromiom, scapula, clavicle) add to the already present tendency of these ribs to laterally fixate. As noted previously, this difficult area is rarely addressed in the human body. It deserves attention.
Unwinding
Application of Technique
The practical application and methodology herein is derived from theoretical considerations-- essentially that we are working with a fluid body, one of a complex system of pressurized membranes. A vast number of techniques were tried and considered. Eventually, unwinding was the clear winner in terms of effectiveness and gentleness. In this application, unwinding is the method for creating the space for something to move into -- the path of least resistance. Where we are softening and making space is mostly in the layers of fascia. Fascial membranes are fluid-filled, and as we soften these layers, an internal change in fluid pressure occurs. The decrease in fluid pressure creates a movement tendency in an adjoining bony segment in the same direction as the release.
The technique is also used directly into joints and joint capsules, gently manipulating internal fluid pressures to release joints from the inside-out.
Space, in the human body, is king.
The practical application and methodology herein is derived from theoretical considerations-- essentially that we are working with a fluid body, one of a complex system of pressurized membranes. A vast number of techniques were tried and considered. Eventually, unwinding was the clear winner in terms of effectiveness and gentleness. In this application, unwinding is the method for creating the space for something to move into -- the path of least resistance. Where we are softening and making space is mostly in the layers of fascia. Fascial membranes are fluid-filled, and as we soften these layers, an internal change in fluid pressure occurs. The decrease in fluid pressure creates a movement tendency in an adjoining bony segment in the same direction as the release.
The technique is also used directly into joints and joint capsules, gently manipulating internal fluid pressures to release joints from the inside-out.
Space, in the human body, is king.
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To grasp the concept of making space, and to start on where to apply technique, it helps to begin with some very basic and simplified approaches to the same problem. We’ll start with a fictitious 2-dimensional, three-vertebrate creature in a fascial membrane that is distorted and wishing very much to be upright in the field of gravity. From there we’ll look at some different approaches and assessments of the problem from differing fields, again, quite overly simplified.
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Fictitious, distorted 3-vertebrae organism, upright in the field of gravity.
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In Eastern Medicine such as Traditional Chinese Medicine, a depressed or sunken area of the body may well be associated with stagnation of Chi. Treatment options vary.
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A Tensegrity/Myofascial approach as seen in much of Rolf work and some modalities of therapeutic massage may see a practitioner focusing on tight muscles and fascia on the visibly shorter side.
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In the Physical Therapy world, rather than purely comparing relative length of soft tissue, as seen in Tensegrity and Myofascial work, PT’s often look at relative strength vs. weakness of muscle and often attempt to solve structural issues through stretching and strengthening. |
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A traditional chiropractic approach to a vertebral distortion is to push the “subluxed” or ‘out of place’ vertebrae quickly and abruptly ‘back’ into place.
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Spinal Unwinding: make space and soften where you want things to go....
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With our more fluid understanding of the body, we might opt for unwinding the tissue - essentially - a fascial membrane, and making ‘space’ for a vertebral segment, creating a tendency for the vertebral segment to move into that space. This is followed by creating space for other adjoining segments in a comprehensive fashion.
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If we take that same basic idea and extrapolate, in simplistic 2-D, we might see our interventions - ie: where we are releasing tissue, to look something like this. Here we are looking at both how the vertebrae relate to each other as well as how they relate to a center line. Comprehensive treatment requires attention to each and every vertebrae. Bear in mind we are only looking at anterior to posterior shift patterns here in 2-D. A three dimensional model and a human body is more complex, but the same basic understanding of technique applies.
... At this point, we are now starting to put it all together into a methodology for unwinding the spine. ...If we understand our own innate tendencies in the spine and ribcage towards distortion and where those are more likely to happen, we may begin to understand the process of unwinding and decompressing in any human structure. Now that we are getting a deeper sense of where we will be applying technique, let's look deeper at unwinding. |
Unwinding
Jan Sultan and Michael Salveson of the Rolf Institute gave me my first lessons in unwinding in a scoliosis class, both with soft tissue and as well as interosseous space -- mostly at the feet and ankles. For joint space in the feet and ankles, we’d often be gently pushing two bones together and into their articulation, until an “engagement” was felt. We would hold and maintain a gentle pressure here until the restricted and compressed joint space would start to fluctuate and the two bones would seemingly move by themselves -- a tiny wandering dance eventually slowing to a resolve.
For soft tissue we would gently and slowly work into held tissue again until an engagement was felt. Holding pressure here, the tissue would start to dance under the fingers and release. We would follow the release to its conclusion.
The idea with both applications was that we were working into a restriction, rather trying to pull out of it - such as in traction. The method is of the indirect variety, and extremely gentle. Extremely powerful as well. At that time, a world of possibilities was opening and my thinking soon turned to how to apply such techniques more particularly to the spine and ribcage.
With visceral manipulation bodywork classes, we would gently unwind through the ribcage and into an organ such as the liver or lung. This idea of working through the ribcage opened up a significant number of possibilities for me with spinal work. Soon thereafter I began to wonder if it were possible to address and release into the seemingly unreachable anterior thoracic spine -- everything under the ribs.
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The pursuit of an understanding of structure that included a fluid and pressure perspective gave more insights into the mysterious unwinding process. In the engagement and release of soft tissue, all of which is a vast network of fluid-filled, pressurized fascial membranes, my interventions were softening those membranes, and hence, changing the fluid pressures within. Naturally, there was a movement under the fingers.
Pressure is a force per unit area, and in physics, ‘particles’ in a high pressure will naturally be pushed towards a lower pressure. The same action occurs with fluid pressures. So, as a local pressure opens, and fluid movements occur, the movement of bony segments may also occur as the bone moves away from a higher pressure area and into an opened, lower-pressure area. Really, we're just creating a tendency for movement.
In practice I wasn’t sure just how much of an effect I could create with such a gentle, indirect technique. I had been socialized into “no pain, no gain” and the idea that great change had to be accompanied by great force still lingered. But I also knew that if I could generate even slight movement or change at joint -- less than a millimeter, I could have an effect. In all likelihood, even a percentage of a millimeter was a big deal to a compressed nerve.
Thus, I began to incorporate the idea that the movement of a spinal segment could be influenced simply by opening the space in which you wanted it to go. For a while, I worked both indirectly and directly - i.e.: both opening a space and then directly but slowly pushing the bony segment towards it. It was not long however before the necessity of a direct technique came to a close -- there was simply no need for it, and the indirect method was far more acceptable to the body.
With unwinding between two bones, what I had learned in unwinding ankles I applied to fixated ribs, essentially pushing the two bones together, into the restriction. From a fluid and pressure perspective, I was again changing fluid pressure within the restricted area -- essentially, temporarily changing fluid pressure, which required a local fluid pressure equalization process to occur. An end-around approach, the response was a change in available space for the bones.
Ultimately, whether I was unwinding soft tissue or joint space (or both at the same time), where I was working was essentially in the holes of the body, and having tried most every available method to facilitate change in the body over many years, here I was essentially doing what Neal Powers had shown me on day-1 of Rolf class, just with more particularity, a different technique, and a lot more insight as to why.
Jan Sultan and Michael Salveson of the Rolf Institute gave me my first lessons in unwinding in a scoliosis class, both with soft tissue and as well as interosseous space -- mostly at the feet and ankles. For joint space in the feet and ankles, we’d often be gently pushing two bones together and into their articulation, until an “engagement” was felt. We would hold and maintain a gentle pressure here until the restricted and compressed joint space would start to fluctuate and the two bones would seemingly move by themselves -- a tiny wandering dance eventually slowing to a resolve.
For soft tissue we would gently and slowly work into held tissue again until an engagement was felt. Holding pressure here, the tissue would start to dance under the fingers and release. We would follow the release to its conclusion.
The idea with both applications was that we were working into a restriction, rather trying to pull out of it - such as in traction. The method is of the indirect variety, and extremely gentle. Extremely powerful as well. At that time, a world of possibilities was opening and my thinking soon turned to how to apply such techniques more particularly to the spine and ribcage.
With visceral manipulation bodywork classes, we would gently unwind through the ribcage and into an organ such as the liver or lung. This idea of working through the ribcage opened up a significant number of possibilities for me with spinal work. Soon thereafter I began to wonder if it were possible to address and release into the seemingly unreachable anterior thoracic spine -- everything under the ribs.
...
The pursuit of an understanding of structure that included a fluid and pressure perspective gave more insights into the mysterious unwinding process. In the engagement and release of soft tissue, all of which is a vast network of fluid-filled, pressurized fascial membranes, my interventions were softening those membranes, and hence, changing the fluid pressures within. Naturally, there was a movement under the fingers.
Pressure is a force per unit area, and in physics, ‘particles’ in a high pressure will naturally be pushed towards a lower pressure. The same action occurs with fluid pressures. So, as a local pressure opens, and fluid movements occur, the movement of bony segments may also occur as the bone moves away from a higher pressure area and into an opened, lower-pressure area. Really, we're just creating a tendency for movement.
In practice I wasn’t sure just how much of an effect I could create with such a gentle, indirect technique. I had been socialized into “no pain, no gain” and the idea that great change had to be accompanied by great force still lingered. But I also knew that if I could generate even slight movement or change at joint -- less than a millimeter, I could have an effect. In all likelihood, even a percentage of a millimeter was a big deal to a compressed nerve.
Thus, I began to incorporate the idea that the movement of a spinal segment could be influenced simply by opening the space in which you wanted it to go. For a while, I worked both indirectly and directly - i.e.: both opening a space and then directly but slowly pushing the bony segment towards it. It was not long however before the necessity of a direct technique came to a close -- there was simply no need for it, and the indirect method was far more acceptable to the body.
With unwinding between two bones, what I had learned in unwinding ankles I applied to fixated ribs, essentially pushing the two bones together, into the restriction. From a fluid and pressure perspective, I was again changing fluid pressure within the restricted area -- essentially, temporarily changing fluid pressure, which required a local fluid pressure equalization process to occur. An end-around approach, the response was a change in available space for the bones.
Ultimately, whether I was unwinding soft tissue or joint space (or both at the same time), where I was working was essentially in the holes of the body, and having tried most every available method to facilitate change in the body over many years, here I was essentially doing what Neal Powers had shown me on day-1 of Rolf class, just with more particularity, a different technique, and a lot more insight as to why.
The Anterior Thoracic
The following is a chart of approximate access points in the ribs and sternal area for the deep anterior aspects of each vertebrae. We are working through both bone and organs in order to release into and create space in the front of the anterior vertebra. Bear in mind, these points are an approximation on what is essentially a perfect skeleton, and where you might access a particular vertebrae will vary with each individual and will change substantially with structural distortion. Most drawings and models show a ‘perfect’ ribcage, free of distortion. This picture (Gray’s Anatomy) notwithstanding.
The following is a chart of approximate access points in the ribs and sternal area for the deep anterior aspects of each vertebrae. We are working through both bone and organs in order to release into and create space in the front of the anterior vertebra. Bear in mind, these points are an approximation on what is essentially a perfect skeleton, and where you might access a particular vertebrae will vary with each individual and will change substantially with structural distortion. Most drawings and models show a ‘perfect’ ribcage, free of distortion. This picture (Gray’s Anatomy) notwithstanding.
A method to check anterior accuracy is to begin with the client on his or her side, then count each spinous process to the desired level. Keeping your hand on that process, then have the client slowly turn to supine (face-up). From there place your free hand on the anterior, above and slightly cephalad (towards the head) (note that the spinous process of each vertebrae is slightly below the level of the body of each vertebrae). From here, it is possible to unwind through the ribs and organs and into the anterior aspects of the spine.
Note also that in order to access the more lateral anterior aspects of a vertebrae -- i.e.: from the sides, the slope of the ribcage will also alter the ribs through which the vertebrae is accessed.
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Rotations/Shifts
To resolve distortions, an unwinding intervention may seek to address multiple aspects of the distortion at the same time. Many vertebrae, to altering degrees, will have combinations of rotational and shift distortion. A smart intervention may address both. For example:
Note also that in order to access the more lateral anterior aspects of a vertebrae -- i.e.: from the sides, the slope of the ribcage will also alter the ribs through which the vertebrae is accessed.
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Rotations/Shifts
To resolve distortions, an unwinding intervention may seek to address multiple aspects of the distortion at the same time. Many vertebrae, to altering degrees, will have combinations of rotational and shift distortion. A smart intervention may address both. For example:
Here, strategic unwinding addresses two spatial distortions at the same time. A forward shifted vertebrae may see a substantial focus on the back of the vertebrae. (conversely, a back-shifted vertebrae may see a focus on its anterior aspect). Rotational distortion is addressed by creating space for the vertebrae to rotate in the opposite direction.
Audible Movements - Visceral and Fluid Response
In my initial Rolf training with Neal Powers and the Guild for Structural Integration, I was given a worksheet that, in one section, asked me note when any audible visceral or fluid motions were heard. At the time I gave this little thought. While I wasn’t focusing my attentions by listening for sounds, I was however on alert for them or something out of the ordinary. I didn’t hear much, or I missed it.
After Neal’s class I mostly forgot about noises and audible fluid movements. For many years doing Rolf and myofascial work, nothing of note ever really popped up. It wasn’t until I began trying to create space in the body in order to resolve rotational patterns that I began to hear sounds out of the ordinary. Initially they were simply just a curious occurrence, or coincidence. After a short while they became too consistent to ignore and their occurrences were correlating to interventions happening at the same time. Releases through my own body with specific unwinding were accompanied by the same audible sounds. And often the sounds weren’t just heard, they were felt. Clients reported the same. An audible release was at times accompanied by a registered reduction in local pressure distortion at the point of release -- or somewhere else. Subjectively, it also registered as a feeling of “lightness”, and in many clients; almost an immediate state of calm. That calm most often translates into sleep. In my work, very rarely is a client not in and out of a light sleep pattern while I’m working. Yes I work very quietly. Yes I’m exceedingly boring. Still, it’s quite a departure from what is normal in bodywork and what was normal in my practice prior to working in this manner.
With audible sounds, a good session became a seamless concerto of gurgles and squirts, at each vertebral level. While in and of itself not a measure of success, the audible sounds helped greatly to guide the work and the development of a practical. While they were not indicative in-and-of-themselves of a successful intervention, they were indicative of something happening -- something moving. Sounds most often occurred from the abdomen. Often they were also heard at the point of release. They varied in intensity, duration, and character.
In my initial Rolf training with Neal Powers and the Guild for Structural Integration, I was given a worksheet that, in one section, asked me note when any audible visceral or fluid motions were heard. At the time I gave this little thought. While I wasn’t focusing my attentions by listening for sounds, I was however on alert for them or something out of the ordinary. I didn’t hear much, or I missed it.
After Neal’s class I mostly forgot about noises and audible fluid movements. For many years doing Rolf and myofascial work, nothing of note ever really popped up. It wasn’t until I began trying to create space in the body in order to resolve rotational patterns that I began to hear sounds out of the ordinary. Initially they were simply just a curious occurrence, or coincidence. After a short while they became too consistent to ignore and their occurrences were correlating to interventions happening at the same time. Releases through my own body with specific unwinding were accompanied by the same audible sounds. And often the sounds weren’t just heard, they were felt. Clients reported the same. An audible release was at times accompanied by a registered reduction in local pressure distortion at the point of release -- or somewhere else. Subjectively, it also registered as a feeling of “lightness”, and in many clients; almost an immediate state of calm. That calm most often translates into sleep. In my work, very rarely is a client not in and out of a light sleep pattern while I’m working. Yes I work very quietly. Yes I’m exceedingly boring. Still, it’s quite a departure from what is normal in bodywork and what was normal in my practice prior to working in this manner.
With audible sounds, a good session became a seamless concerto of gurgles and squirts, at each vertebral level. While in and of itself not a measure of success, the audible sounds helped greatly to guide the work and the development of a practical. While they were not indicative in-and-of-themselves of a successful intervention, they were indicative of something happening -- something moving. Sounds most often occurred from the abdomen. Often they were also heard at the point of release. They varied in intensity, duration, and character.
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Unwinding demonstration with audible sounds
The sounds here were recorded with two microphones - a small lapel mic on the client and a shotgun mic on the camera. This clip was recorded from the first 20 minutes of a session. The above link will open a YouTube with the video. To enter the URL manually: https://youtu.be/pTpiew__mGg The explanation for the sounds went hand in hand with what was both theorized and observed in the process of compensation in the body - a local change in fluid pressure will be accompanied by fluid movements as well as change, via pressure, elsewhere -- an immediate compensatory response. |
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The “release” in bodywork is a rather curious thing. And one of the most difficult aspects to the release is, as a practitioner, having awareness of when it has happened, and certainly, if it has happened at all. What an audible cue can provide is some evidentiary basis for a release that is happening. Importantly, a sound is factually measurable, and thus, releases through the body may also be, on some level, be quantifiable. In terms of scientific method, in my mind few things could be of greater significance than a factual method to track the releases that are so central to the work.
With audible cues, strategic considerations could thus also be considered -- what is working and what is not, where to access a distortion, in what order, etc. Equally important, accuracy could be gauged as well as the quality of the intervention.
With audible cues, strategic considerations could thus also be considered -- what is working and what is not, where to access a distortion, in what order, etc. Equally important, accuracy could be gauged as well as the quality of the intervention.
Practical Notes
Age and Surgery
In surgical realms, age is a consideration, as complications and failure rates generally rise with age. Generally, modern medicine is aware of both complication and failure rates associated with increased age. Elderly patients are “high risk”. Quite fairly, the medical community, which performs an enormous amount of spinal surgeries every year, finds that “Increased age per se should not be a contraindication for surgery.”
See: http://bmcsurg.biomedcentral.com/articles/10.1186/1471-2482-10-34
http://unmhospitalist.pbworks.com/f/lumbar+spine+surgery+in+elderly.pdf
Bodyworkers are often faced with much greater structural issues in the older population -- loss of disc space, bony changes, etc… these naturally limit how effective an outcome may be. “Success” becomes defined as something relative to the age bracket in which one is working. The same may be said with surgical options.
Now, how do these two things relate?
Age and Surgery
In surgical realms, age is a consideration, as complications and failure rates generally rise with age. Generally, modern medicine is aware of both complication and failure rates associated with increased age. Elderly patients are “high risk”. Quite fairly, the medical community, which performs an enormous amount of spinal surgeries every year, finds that “Increased age per se should not be a contraindication for surgery.”
See: http://bmcsurg.biomedcentral.com/articles/10.1186/1471-2482-10-34
http://unmhospitalist.pbworks.com/f/lumbar+spine+surgery+in+elderly.pdf
Bodyworkers are often faced with much greater structural issues in the older population -- loss of disc space, bony changes, etc… these naturally limit how effective an outcome may be. “Success” becomes defined as something relative to the age bracket in which one is working. The same may be said with surgical options.
Now, how do these two things relate?
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While various pre-existing issues such as osteoporosis that are often present in the elder population are recognized as contributors to the issues and dangers inherent with surgery, a full explanation remains elusive.
I would however attribute the declining success of surgery with age much to the loss of space that occurs over time in the human body and in particular to the joint space of the human body. With a surgery, such as a fusion, essentially a joint space is jacked-open, resulting in a change in fluid pressure within the neural system, as well as a compensatory demand up the chain. So what is essentially a change in local neural pressure - at the site of the fusion, requires a balancing throughout the system. Whether this pressure and structural change in the chain equates to a successful outcome generally has a lot to do with whether the rest of the system is able to change and adapt with it. Naturally, with an older individual, the ability to structurally change is limited over time by loss of space. Thus, the ability to compensate to a surgery which changes both structure and local pressure requires the physical space to do so. In the older population, that space is generally lacking. And lacking everywhere. But while the space to compensate is lacking overall, the area that tends to first fixate in the human body and also remains the most resistant to change and compensation, is the middle and upper thoracic. So with surgeries such as lumbar fusions, the demand for compensatory change would be driven up the spine. In the already fixated thoracic, that action would create a considerable degree of strain directly at the cardiovascular level. It is certainly more than curious to note that heart attacks and are common occurrences following spinal surgeries: http://www.healthcentral.com/chronic-pain/c/240381/162219/surgeries-attacks/ http://www.medscape.com/viewarticle/807862 https://www.ncbi.nlm.nih.gov/pubmed/23637664 |
About twice a year I work with my 88 year old Dad. I do as much for him in the time we have. It is difficult to stay ahead of the 88 year old-curve and change is hard to come by, but we do get some. This picture is a before and after 4-5 very slow, gentle unwinding sessions in a week. He had suffered an ice fall over the winter. He remains active and quite mobile. Engineer, marine, wrestler, an early lumbar injury eventually became a laminectomy at L4/L5 in his late 40’s. In his mid-70’s he fell from a roof, the result a direct blow to the thoracic. Post fall, he seemed to be increasingly losing both height and space. His thoracic was compressing. Interventions focus there.
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The Sacroiliac
One interesting feature of the Sacroiliac joint (“SI”) is the size of the articulation space (the joint space) and its orientation with respect to gravity.
One interesting feature of the Sacroiliac joint (“SI”) is the size of the articulation space (the joint space) and its orientation with respect to gravity.
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In looking at primary rotational patterns I explored the possibility that the SI joint may twist along a vertical axis, followed by an additional twist at the coccyx. The possibility was encouraged by working with other supposedly fused joints -- the sutures of the cranium. My experience there told me that the joints historically-thought fused after a certain age were instead not completely fused but rather reflected a degree of mobility that typically decreased over time and trauma. Could the same apply to the sacrum? And if so, where would a twist likely occur? I began to separate my work to address the area at three levels - SI upper, SI lower, and Coccyx.
Theoretically, it was possible that the primary rotational pattern in the sacral area looked like: Vert Rotation L4 L L5 R SI upper L SI lower R Coccyx L Rotational patterns are difficult to see anywhere in the body and the sacral area is certainly no exception. I began working this way based on theory, not necessarily what I saw in the bone. The coccyx, typically when distorted, turned left. Most of the sacrum, generally turned left as well. But what if there were a sneaky right in there? Would that help explain the complex patterning I saw through the legs? If the rest of the body twisted, then why not the sacral area? In practice the strategy has seen a good deal of success. |
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Curiously, when we add two more twists to our list of primary rotations; the sum of the primary rotations in the human body then becomes divisible by the number 3. 27 rotations / 3 = 9 groups of 3.
Three is, of course, a supposed “magic” number. I’ll leave it at that. For our purposes, groups of three may help us devise intervention strategies. We are also interjecting basic math into our spinal work. Our present system of counting and naming vertebrae is not a math-based system. The system is rather based on terms of art for where vertebrae are located in the body. These terms of art are necessary, but ultimately, they also creates bias in how we view and understand the body. Nature and math being inseparable, we will simply try to understand rotational patterns in groups of three. Hence:
With primary rotational patterns divided into groups of three we have either groups of:
L,R,L
or
R,L,R
In either group, by addressing the middle vertebrae, the two adjoining vertebrae may be affected and their rotational pattern eased. Conceptually, the middle vertebrae is the “linchpin” in each group.
Three is, of course, a supposed “magic” number. I’ll leave it at that. For our purposes, groups of three may help us devise intervention strategies. We are also interjecting basic math into our spinal work. Our present system of counting and naming vertebrae is not a math-based system. The system is rather based on terms of art for where vertebrae are located in the body. These terms of art are necessary, but ultimately, they also creates bias in how we view and understand the body. Nature and math being inseparable, we will simply try to understand rotational patterns in groups of three. Hence:
With primary rotational patterns divided into groups of three we have either groups of:
L,R,L
or
R,L,R
In either group, by addressing the middle vertebrae, the two adjoining vertebrae may be affected and their rotational pattern eased. Conceptually, the middle vertebrae is the “linchpin” in each group.