TALKING TO FASCIA - CHANGING THE BRAIN
Explorations of the Neuro-Myofascial Net
by Robert Schleip
Article published in ROLF LINES March/April 1991:
About a year ago I wrote the following letter to all faculty members of the Rolf Institute:
"RE: THE IMPORTANCE OF FASCIA IN THE ALIGNMENT OF HUMAN BODIES
Dear Colleagues – Recently I had a challenging discussion with several leading Feldenkrais teachers and other bodyworkers in Australia. They questioned the importance of fascia and used a story by Milton Trager as an example that "everything is just in the brain". The story deals with an old man in an hospital whose body is very stiff and rigid. But under anesthesia his muscle tonus gets lowered and he is as limber and soft as a young baby. As soon as his consciousness returns he gets stiff and rigid again. So far the story by Milton Trager.
Since I tend to doubt the reliability of any kind of "stories" I looked for a chance to check this out myself. Recently I finally got an opportunity to do so. I participated at 3 arthroscopic knee operations involving general anesthesia in a modern hospital. I was allowed to do some passive joint range of motion testing with the 3 patients before and during anesthesia. With the patient in a supine position I elevated the arms superiorly above the head and noticed the freedom of movement in this direction. With one of the patients, the elbow dropped all the way to the table above the head before the anesthesia, and this was no different after he lost consciousness. However, with the other 2 patients I could not elevate their elbows all the way in their normal state, i.e. their elbows kept hanging somewhere in the air above the head. Five minutes later, when they had lost consciousness I again elevated their arms above the head and to my surprise, their elbows dropped all the way down to the table - no restrictions whatsoever, they just dropped!
Additionally I dorsiflexed the feet of all 3 patients. Here I could not detect any increased joint mobility during anesthesia. (I used my subjective comparison only, without any measuring devices).
I must say that I was quite shocked by the result of my tests. From my Rolfer's point of view I had expected that remaining fascial restrictions would prevent the arms dropping all the way under anesthesia. (I was not surprised by the unchanged mobility of the ankle joint, since none of the 3 patients seemed to have any limitations there that would concern me as a Rolfer). The question to ask now is: IS IT POSSIBLE THAT MOST OF THE STRUCTURALLY IMPORTANT RESTRICTIONS IN OUR CLIENT'S BODIES ARE JUST CAUSED BY A HIGH MUSCLE TONUS as determined by a high firing rate from the central nervous system? What about the clients who have chronically forward displaced shoulders (even when they lie relaxed on their back)? Or clients with a chronically anterior tilted pelvis? Would that change too as soon as their brain's influence is shut off? That would mean that fascial restrictions of normal body alignment would be rare and the Trager and Feldenkrais practitioner's opinion would be right, that "it's all in the brain".
I now have some serious questions on the importance of fascia in normal vs. random body structure. I decided to share those questions with the Faculty and the Anatomy Instructors in the form of this letter hoping that I can elicit some feedback and stimulations on this theme. ().
To be clearer, I am NOT yet convinced of Milton Trager's opinion that it's only the brain that makes most people stiff, rigid, and structurally unbalanced. But the findings of my experiment have made me less convinced now of our model of fascia as the most important limiting factor for normal body structure in our clients. I would like to get your input to the result of my experiment.
HERE ARE MY QUESTIONS:
1)Is my assumption true that the myofascial condition of the body under anesthesia can be seen as: usual state minus muscle tonus, with only fascial (plus ligamentous and osseous) restrictions being left? (I assume that there are no changes in the structure of collagen fibers or the ground substance of connective tissue under anesthesia).
2)Does anyone have more information about different bodies under anesthesia? How is the mobility of the hip joint in various directions (with straight knee and bent knee)? How about mobility of the spine? How soft or mobile is the ribcage? How is the arrangement of a vertically hanging arm that, for example, "normally" hangs with a slight flexion at the elbow and flexion within the hand? How are the arches of the foot when pressure is applied to the soles? How is the contact of the body in the supine position to the table behind the lumbars, or behind the knee, or behind the shoulders, or behind the neck?
IF it is the case that most of the structurally important restrictions are only determined by a high firing rate from the central nervous system to the motor end plates, this would have some important consequences for our work. Not only theoretically but also practically. As I pointed out in my article in Rolf Lines Winter '89 on "THE GOLGI TENDON REFLEX ARC AS A NEW EXPLANATION OF THE EFFECT OF ROLFING", applying pressure to fascial sheets would still be a most effective tool to lower high muscle tonus. But it would be most useful for us to learn more about the nervous system's role in body alignment and to include that in our thinking, our teaching, and out practice. For example: we Anatomy Instructors would have to go back to the books and study the neuromuscular system further, and then include that in our lead-in classes and pre-trainings. And the knowledge of our Movement teachers (which I assume they have) about how to change habitual neuromuscular patterns would have to be valued and expanded with a much higher priority.
But first we need to know more about some of the questions I raised here. If our theory is clear (and in congruence with experimental data) then we can be clearer about our practice. Please communicate any feedback or information you have on the above questions to me. - Sincerely yours"
So far my letter to all Rolfing teachers, Movement instructors and anatomy teachers as at April '90. The reply I received up to now consisted of a letter from Peter Melchior, indicating that it has been his conviction for some time that as Rolfers we primarily change people's "minds about their bodies", which then leads to physical body changes; and Stacey Mills' encouragement to continue researching this direction, including some special emphasis on the role of emotions in this.
Further elaborations with half a dozen anesthesiologists and other researchers have meanwhile strengthened my belief that it is time to replace our old model of fascial plasticity with more nervous system oriented models and descriptions. Clinical in vitro studies have shown that short term mechanical deformation of animal tissue results in elastic form changes only, whereas a long-term deformation of at least 10 minutes per spot would be necessary to cause any permanent `plastic' (viscous) changes. I am now fairly well convinced that what we experience as "fascial plasticity" during our very short term Rolfing strokes is, in fact due to the plasticity of the neuromuscular system. Skilful stimulation of various nerve receptors (specially Golgi organs) in fascial sheets can evoke changes in muscular holding patterns and furthermore in the brain's body image. So I suggest it is time we change our traditional self-image as `sculpturers' to one of `skilful communicators'.
I have used the last year to venture further into exploring the `Neuro-Myofascial Net' and the brain's influence on human structure. Let me share some of the discoveries, questions, troubles and insights that I have come across. My previous clear distinction between posture (muscular holding patterns) and structure (remaining connective tissue restrictions) had to be dropped in the light of my anesthesia examinations. Furthermore, I now tend to question the usefulness of our tradition of looking mainly (sometimes exclusively) at a very rare body position: the even balanced two legged stance. In most of my clients' lives, this position is very rare and does not always reflect their preferred habits in the majority of their body usage during the week. When client A tends to stand with a more anteriorly tilted pelvis than client B in the "Rolfing stance" this does not necessarily mean that this situation is similar in sitting, or in the majority of their daily body use.
So what is structure? As I see it now there is only movement (even standing is never without movement), and what we are looking at are movement patterns and habits. Those individual movement patterns that are most permanent in a person's behavior I call "structure". So structure consists of the most deeply ingrained habits of our motor nervous system. "Integration" then, for me means, to achieve more economy in one's movement habits in relation to gravity. In order to change structure it is necessary to seduce the brain to let go of some of its most rigid movement habits and/or to develop different habits.
It has been shown that our conscious awareness is limited to a maximum of 5 to 9 bits of information at any time. Muscular coordination of walking, standing, etc. includes hundreds of different elements and information. If our deep tissue manipulation (or Rolfing Movement Integration) wants to achieve any structural improvement it is therefore necessary to effect a change in the neural connections of the subconscious motor coordination. So what are the most effective ways to do that? The pursuit of this question will demand a closer cooperation between both work aspects of our school (Rolfing manipulation & Rolfing Movement). And we should not be afraid to "look over our fences" into some of the models, theories and research data that have come out of other educational or therapeutic methods in the last decade.
I have personally found the pursuit of those questions to be extremely exciting. It is a common assumption/observation that the changes achieved during the 10 session basic Rolfing process tend to be more permanent than in 10 session of massage or other forms of more superficial bodywork. Apart from our old (and now dubious) explanation of short term fascial plasticity, how can we now explain this in new ways? Professor Bruno D'Udine, an ethologist at the university in Florence, presented an interesting speculation to the European Annual Meeting in 1986: In several animal experiments he had observed an increased "behavioral plasticity" during and after high stress applications. This has been attributed to an evolutionary useful effect of stress triggered endorphins on the plasticity of the nervous system. As we know the release of endorphins usually triggers "morphium like" pleasant emotions and has been shown to be crucially involved in the mechanism of placebo effects as well as the analgesic effect of acupuncture. Based on his subjective experience of the Rolfing sessions Bruno D'Udine speculated that our stimulation of nerve receptors in deep tissue sheets - e.g. the periosteum - (which usually happens only in extreme survival situations in nature) tends to trigger a high release of endorphins similar to an extreme survival situation. If this is true it would explain how deep tissue manipulation could trigger deeper changes in neural brain connections than superficial manipulations.
If we are ready for this kind of questioning it should be possible to design some research into those assumptions. The research could be similar to the now famous placebo and acupuncture experiments where the researchers injected the endorphin blocker substance Naloxon in one treatment group, and then compared the therapeutic improvements of that group with a matched control group who had been treated the same, except for a placebo injection instead of Naloxon. How effective would Rolfing be if we blocked the effect of endorphins in a client?
I consider it quite possible that Bruno D`Udine's assumptions are true: that stimulation of deep tissue nerve receptors triggers a high amount of endorphins, which then leads to an increased "plasticity" of habitual programs in our nervous system. If this is true we could focus on finding more out about different ways of triggering and dealing with endorphins in our clients.
One of my persistent `koans' in touching bodies has been "What is the difference between a piece of meat and an alive body?";- or less dramatic but similar "What is the difference between a body (or body part) that feels healthy - juicy - alive, and a body (or body part) that feels less alive?" (Or when I am in a more philosophic mood "What is the essence of Life?"). Obviously, one direction for possible answers to those questions has to do with active movements, a lot actually with very subtle micromovements. One interesting aspect of these are those intrinsic micromovements that occur in response to outside stimuli (e.g. to the pressure of my hands). It seems every living organism has a specific dance or vibration that we can pick up (try hugging a tree with closed eyes). Like most other Rolfers I believe I can pick up somebody's "kinetic melody" (some people call it inner dance or life energy). I usually see it in the shape and quality of a person's balancing micromovements when standing, or - usually much stronger to me - when closing my eyes and picking up their inner dance with my touching hands on a standing client. The interesting thing for me is that the same quality or "melody" that I pick up this way shows itself again in the quality how the person organizes their breathing or other bigger movements and also in the particular `dance of responsiveness' how the tissue responds to the pressure just under my hands. Quite often the quality of this inner dance changes during the Rolfing process. We don't have a very differentiated vocabulary yet to describe those qualities, but I know that changes in them are considered as quite meaningful (and sometimes described in connection with the phrase "essence of a person") by many Rolfers and Rolfing instructors in their work. It has been shown that the basal ganglia play at least a major part in orchestrating the "kinetic melody" of our movements. It is possible to speculate that our work leads to a change of the subconscious engrams in the basal ganglia. But how important are those changes to the process of structural integration?
Apart from such speculations there are many things that are already known about our brain and its motor coordination. Dean Juhan's book `Job's Body' written about 5 years ago includes much fascinating stimulation for us Rolfers. Since then many new data and theories have been published that have been at least as fascinating and challenging to me. E.g. the recent connection of chaos science with Neural Net models in computer programming have produced some ways of looking at brain functions that will dramatically change our traditional concepts.
Equally important, new practical and theoretical approaches to movement have been developed, e.g. by the dancers Emilie Conrad D'aoud and Susan Harper. Their use of intrinsic micromovements has stimulated me (and several other Institute members) to evoke a much more refined active movement participation of our clients than in the classical style of "elbow out - elbow in", "foot up - foot down", etc.. It would be quite easy (but too lengthy for this article) to explain the neural mechanisms of the increased effectiveness of those micromovements.
As I see it we are far from having a complete understanding of what is actually happening in our sessions. And we probably always will be. But no bodyworker can avoid fabricating some more or less refined models to mentally represent and organize our experiences. Some of the models that many of us have operated on so far were based on the level of a mechanistic 17th century world view (e.g. the segmented "block model" as indicated by our logo picture). They proved to be useful to some extent. But I suggest it wouldn't hurt to add a few other - and maybe more up to date - ways of looking at our work. This will have the advantage of "multiple representations" which usually tends to increase behavioral options and refinement. Or to be a bit more provocative (which I always enjoy being): If we don't want to become like Neanderthaloids in the light of the present late-20th century, it is time we opened our minds to some newer concepts and descriptions.