Fascial tracks are continuous from head to toe and influence our movement and our sense of stiffness. Understanding how fascial tracks can contribute to or limit movement is helpful for effective hands on treatment.
The popular Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists work by Tom Myers presents the notion of continuous fascial tracks connecting the body in an integrated system of tension and balance. Movement restriction anywhere in the system affects every other part of the system. Specifically, restriction along fascial track, like the superficial back line, will have an influence on the rest of the line.
For example, the superficial back line is a continuous line of fascia running from the bottom on the foot, up the posterior body, to the top of the head. Restriction along this line may include what people experience as tight hamstrings, stiff hips, restricted rotational movement of the Thoracic spine or limited motion in the neck.
A sense of tightness is often blamed on muscles and stretching is thought to be the answer. Stretching is often focused on isolating a specific muscle with little attention to the integrating fascial structures. By expanding our perspective to include fascial structure we may more accurately see the cause of the stiffness.
For this skill building tip we will focus on trunk rotation and examine how fascia and muscles interact to generate or limit motion. Trunk rotation is used to evaluate proper motion of the thoracic spine on the lumbar spine. We also look at how the hips, pelvis, shoulders and neck influence T-Spine movement.
Try these movements and note the results. For each movement, note the rotation quantity in terms of degrees for all movements and observe any asymmetries from side to side. Asymmetrical movement, greater rotation to one side than the other, may be a more important finding for function than limited motion that is equal on both sides.
Note the quality of the movement in terms of ease of movement and any asymmetries or movement compensations. Compensations may include side bending, head and neck rotation, scapular protraction. Movements should be performed slowly and with control.
Also get feedback from the client on their sensations. Ask about what they feel when making a movement. What stops the movement? Is there any pain or discomfort? Is there any sense of spasm?
1. perform seated trunk rotation in both directions with arms crossed in front of the body and hands on opposite shoulder. Note the quality and quantity of the movement.
2. perform seated trunk rotation in both directions with a dowel across the anterior shoulders and arms crossed to hold the dowel on the opposite shoulder. Hips and knees should be in line and the ankles uncrossed
3. perform the same movement as #2 with a foam roll or yoga block held between the knees. The gentle contraction required to hold the foam roll in place between the knees will anchor the hips and pelvis. The body can no longer borrow movement from the hips and pelvis to accomplish trunk rotation.
4. perform the same movement, without the dowel, with the elbows raised and hands behind the head
5. perform trunk rotation with shoulders flexed to 90 degrees, arms extended in front and palms touching in prayer position
6. perform trunk rotation with the head projected anteriorly in an exaggerated head forward posture
7. experiment with other combinations of restrictions and movement
Gather client feedback in terms of the sensations perceived while performing the rotational movements. Clients may note tightness, stiffness, restriction, pain, mild discomfort, or spasm. Note the location of the sensation. Possible areas of sensation include neck, shoulders, erectors, low back and hips.
Client feedback is useful and may lead to identifying areas of restriction limiting motion. If there is motion restriction in this controlled setting there is certainly restriction going on in normal life.
Functional movement limitations can show up distant from the actual restriction. When the body works around a restriction to create movement in another way we call it “compensation”.
Compensations can lead to other complaints at some distance from the actual limitation. For example, T-Spine rotational limitation can lead to exaggerated scapulothoracic movement. The body creatively borrows movement from the shoulder to make up for what is lacking in the T-Spine rotation. The client may present with shoulder protraction, instability and pain because the shoulder is trying to do a job it is not intended to do.
These are not diagnostic or orthopedic tests but they do provide lots of useful information. Question: What do you feel when you stretch a healthy muscle? Answer: Nothing. The sensations and locations can help us identify areas that need some quality body work and/or some corrective exercise.
The foam roll mechanically anchors the hips and pelvis and limits the body’s ability to recruit these structures to increase rotational movement. The raised elbows and shoulder flexion limit the interaction between the scapulothoracic joint and thoracic spine rotation.
When allowed to perform trunk rotation without anchoring, the body will recruit movement from areas distant from the rotational segments. As the body encounters tissue resistance to rotation it will compensate by “stealing” movement from indirectly related areas. The reality of this is demonstrated in the restricted movement clients experience when mechanical anchoring is implemented with the foam roll and shoulder movement.
Don Miller, MA, LMT