The unwinding process can be applied to the whole body or any part of the body, especially the limbs and neck. The neck or extremities can be treated regionally or used as a lever to manipulate the trunk. When whole-body relaxation is to be performed on an adult patient, the collaboration of two therapists is usually necessary. In this case, if the patient is lying on his back, a therapist lifts and holds both legs against the ankles; while a colleague raises and holds his head, the patient`s arms raised between the osteopath`s elbow and trunk, and the patient`s hands resting on the osteopath`s flanks (Fig. 1). Both therapists focus on the areas of major restriction of the fascia in the respective halves of the body. Simultaneous unwinding can then take place, which usually requires a handle change and constant monitoring of the patient`s position. If the adult patient is constitutionally smaller than the operator, or if the patient is a child, a single therapist can easily perform complete relaxation of the body. In a young patient, relaxation of the whole body can be initiated by occipital intake with the baby in the supine position (Fig. 40.2).
Again, effective movement is perceived as a spontaneous expression of the tension of dysfunctional tissues until release is felt. Continuing education is a prerequisite for maintaining our bachelor`s degrees in physiotherapy and massage therapy. In June, 6 Practical Physical Therapy (HOPT) therapists traveled together to Sedona to attend a myofascial release class. It is truly a rare event for all HOPT therapists that they can meet at the same time, in the same place, for each event. This particular class was « Advanced Unwinding ». Many of you reading this may be familiar with the outcome as part of your myofascial release treatment, while others may ask, « What is the outcome »? Unfolding is a spontaneous movement inherent in the fabric. We are about 60-70% water. Fascia is the most abundant tissue in our body and is continuous from head to toe without interruption. When we calm down and allow ourselves to feel inside, this spontaneous movement can take place anywhere in the body. When tissues are released, stored memories and emotions can be released. If this is a new concept for you, I hope this information will inspire you to take your myofascial release treatment to a new and deeper level. Articles, books on manual therapy and scientific articles were reviewed and synthesized to find a possible explanation for the denouement process.
Based on this synthesis, I propose a hypothetical model to describe how and why the outcome occurs. Finally, to relate inversion to Schleip`s body model(5), the process can be seen as an application of the neurobiological concept using the dynamical systems theory of self-regulation. The therapist works as a moderator – induces the parasympathetic system; pay attention to the state of the autonomic nervous system; creation of unusual sensations with subtle stimulation, including immediate feedback; and the active participation of macro-movements. Fernández-Perez, A. M., Peralta-Ramírez, M. I., Pilat, A., et al. 2008 Effects of myofascial induction techniques on physiologic and psychologic parameters: a randomized controlled trial. J Altern Complement Med 14:807-811. Nowadays, FU is formally described as: « a manual technique that involves constant feedback to the osteopathic therapist who passively moves a part of the patient`s body in response to the sensation of movement » (ECOP, 2011). In this sense, FU was considered a form of indirect myofascial release: « Dysfunctional tissues are guided on the path of least resistance until free movement is achieved. » Keywords: fascia; Symbolism; indirect techniques; Massage; mind-body relationships; musculoskeletal manipulations; myofascial release; Palpation.
Indirect stimulation of the autonomic nervous system (i.e. the parasympathetic nervous system), which leads to overall muscle relaxation and a more peaceful state of mind, represents the heart of the changes that are so important for many manual therapies. Milder types of myofascial stretching and cranial techniques have also long been recognized to affect the parasympathetic nervous system. (25) Bertolucci(20) noted that when a client is treated with a muscle repositioning technique, he begins to experience involuntary motor reactions – reactions that include the involuntary action of related muscles and rapid eye movements. Several studies have examined physiological changes in the autonomic nervous system that occur as a result of craniosacral and MFR interventions, (21,26) clinically known techniques that can trigger the outcome process. Since the denouement is a creative and intuitive process, it brings balance to the areas of our body that are underutilized. When we go through a sequence of unusual movements, we tap into places that can be narrow, weak, dehydrated, and/or demanding in stimulation. Imagine that your soft tissues are like a sponge that hasn`t been squeezed in a long time, and they`re dry and brittle.
Then imagine what it would be like to move in such a way that all the dry sponges are slowly and carefully crushed and moisture and food can return to them. The idea of « twisted » fascia patterns, which exist under healthy conditions as a result of postural adaptation, was later recalled and adapted by Gordon Zink in the 1970s. He hypothesized that alternating myofascial patterns occurs in healthy individuals at the diaphragms of the body and shows preferred rotations and inclinations around the corresponding transition zones of the spine (Zink and Lawson, 1979). Zinc defined it as common patterns that show a preferred left-right-left-right rotation from top to bottom. Ideally, the diaphragms should be aligned and move rhythmically, in a coordinated manner during breathing. However, they often rotate and bend around their structural pivot points, around various physiological forces (e.g., uneven fetal positions during pregnancy, motor brain dominance, etc.) or non-physiological stressors (e.g., leg length deviation, etc.). Balance. (Pope, 2003). According to Zink`s model, an individual`s state of health corresponds to his or her ability to compensate for a particular stressor so that the overall homeostatic potential remains essentially the same. In other words, the greater the adaptability of the individual, the better his state of health will be.
For this reason, central myofascial models that alternate functionally are so important and useful for maintaining the body`s self-regulation. When this function is submerged or disturbed, the myofascial structures lose their alternating pattern and successively show signs of rotation and lateral flexion in the same direction. This leads to a loss of adaptability in the area in question, increases energy consumption, alters function and affects posture by overloading the corresponding vertebral transition areas (Defeo & Hicks, 1993). These patterns can be evaluated and processed manually (Zink & Lawson, 1979), either by position or by patient cooperation through voluntary muscle contraction (Chaitow, 2005). Dorko(16) was the first to suggest that the unfolding of the fascia could simply be explained as an ideomotor movement. McCarthy et al.(29) were the first to document non-manipulation as an ideomotor manual therapy in the treatment of a patient with chronic neck pain. Their research has shown that a reduction in pain intensity and perceived disability can be achieved with the introduction of ideomotor treatment. The art of myofascial liberation is to feel that person`s limits and wait with gentle but firm and sustained pressure. Always wait at the barrier without forcing. This distinguishes my approach from other forms of myofascial liberation that attempt to force a system that cannot be enforced.
Violence protects our minds. As long as the mind is in this mode of protection, no healing is possible. The combination of structural myofascial release and myofascial regulation helps us move to another dimension of better and lasting results. bOsseoemotional release uses fascial relaxation to access a client`s emotions and primarily deals with the physical manifestations of emotional trauma. (1) Lewit, K., Olsanska, S. 2004 Clinical importance of active scars: abnormal scars as a cause of myofascial pain. J Manip Physiol Ther 27:399–402. UF is generally indicated for any myofascial condition, including those related to surgery or sports injuries, such as tennis elbow, plantar fasciitis, tibial splints, rehabilitation of muscle and tendon injuries (Weintraub, 2003) or repeatedly stretched or overused joints and related myofascial structures. aIn the direct MFR technique, the myofascial tissue resistant barrier for myofascial tissues is activated and the tissues are loaded with constant force until tissue release takes place. In contrast, in the indirect MFF, dysfunctional tissues are guided along the path of least resistance until free movement is achieved. (2) There has been no report in the literature that injuries are attributed to indirect or fascial techniques (Vick et al., 1996), with the exception of one isolated and documented case (Kerr, 1997) using the Rolfing method. However, it has been speculated that side effects are not fully or adequately reported in the osteopathic scientific literature (Vick et al., 1996).
In addition, it should be noted that in the first 12 hours after treatment, myalgic flicker may appear, which usually lasts no more than 24-48 hours (DiGiovanna, 2005), similar to muscle pain after vigorous training.