MultiDimensional Healing

CHAPTER 1

TREATMENT OF THE

PHYSICAL BODY

MYOFASCIAL RE-STRUCTURING

            Ideas surrounding effective rehabilitation are evolving continuously. Take, for example, the treatment of low back pain.  In the 1960’s, physical therapy schools taught that the ‘magic bullet’ for low back pain was William’s Flexion Exercises.  Little effort was made to differentiate the possible causes of the pain, but the long ligament coming taught on the posterior aspect of the spinal vertebrae gave a lot of people relief and became the treatment of choice.  It wasn’t until Robin McKenzie discovered that spinal extension exercises could reduce symptoms of a bulging disk that assessment began to include whether flexion or extension should be the treatment of choice. Over the last decade, it has become more and more obvious that the spine requires decompression and appropriate alignment to heal and stay healthy, introducing the concept of neutral spine stabilization exercises.

            Despite the posture correction techniques being taught in the schools, re-alignment of the fascial system before toning and strengthening are begun is a concept that has not yet been fully embraced.   If a vehicle is out of alignment, no matter how often the tires are changed they will continue to wear unevenly until the alignment is corrected.  If a patient presents for treatment of a rotator cuff injury, pelvic and shoulder girdle asymmetries must be re-aligned and muscle re-education applied if the rotator cuff is to remain healthy when the patient returns to normal activity. In general, more rapid and long lasting results will be attained with less painful therapeutic intervention when the patient’s body is aligned as symmetrically as possible within the parameters of their disability.

            In the first half of the 20^th century, Ida Rolf, PhD was one of the first to popularize the ability to re-structure the body’s connective tissue to improve posture and health using a technique called Rolfing.¹ The osteopathic community has always addressed the musculo-skeletal/fascial system in promoting health.  Dr. Robert Ward, DO has included this work in great detail in his treatise Foundations for Osteopathic Medicine², and Dr. Chaitow, ND, DO has published extensively as well.³ Physical therapist John Barnes began teaching Myofascial Release to physical, occupational, and massage therapists through continuing education seminars in the 1970’s. ⁴ Since then many therapists have published wonderful manuals explaining release techniques.^5-9 About the same time Ida Rolf was developing her work, Dr. Janet Travell, MD was discovering a method of pain relief that involved ‘trigger points’.  The release of strategic areas of fascial restriction, trigger points, relieved pain in specific referred areas.¹⁰ Paul St. John, massage therapist, also teaches treatment of trigger points using his Neuromuscular Therapy (NMT).   In his work using EMG studies, St. John developed a particularly useful method of posture evaluation to assist the practitioner in finding fascial restrictions¹¹, and this work was extended to horses and riders by Halstead and Cameron in 1991.¹²  An enjoyable book written by Tom Meyers looks at what he calls anatomy ‘trains’, which is another way of looking at fascial planes/muscles that w