Today I have just delivered an internal clinical training session which was prompted by one of my colleagues having just attended a course on myofascial release and fascial lines / patterns.
I thought I would share with them my thoughts and experiences on one of the so called fascial lines and help my colleagues deepen their understanding and clinical reasoning and help them treat their patients in a more integrated and holistic way. They were fascinated and all fired up as they began to “join the dots” in their existing knowledge in a way which will help us all care for our patients better.
So what are myofascial lines? “Myo” means muscle and “fascia” is a connective tissue which is like a web going all over the body and connecting organs to the skeleton. Some research suggests there is an information transfer occurring throughout this connective tissue – in addition to the nervous system and indeed these lines do seem to correlate with acupuncture meridians.
Muscles tend to work in systems and groups rather than in isolation. We “move” in patterns and so the muscles “work” in patterns. One such pattern is referred to as the Deep Front Line.
The muscles involved in the deep front line as outlined below:
This is the most commonly “faulty” or problematic pattern in our part of the world in my experience. Why? 2 main reasons:
- Firstly we sit such a lot which means these muscles tend to shorten.
- Secondly many people live stressful lives with a constant drip of stress hormones in our body. Our body responds to stress by increasing muscle activity in this muscle group. Think about the shape we and all animals adopt when feeling threatened – like a curled up hedgehog! This is to protect the more vulnerable front aspect of our body.
Whilst these are the main reasons for a whole pattern of tension occurring at once there are other more localised issues which might later spread to the wider muscles in the group.
It can also come about due to foot biomechanics issues and we may prescribe orthotics to help this or exercises to control movement in the lower limb.
Sometimes our breathing can be the cause of the issue. Take a look at the picture below and you can see that the diaphragm muscle is part of this system – sitting tucked inside the ribs. With abnormal breathing patterns we tend to alter function of the diaphragm and overuse neck and shoulder muscles also shown in the image below. The hyoid muscles are also connected to the lower jaw and so clicking and painful jaws often arise from problems with this muscle group, along muscles in the head and face you can see in the image below – namely Temporalis and Masseter. Abnormal breathing is often associated with chronic stress or of course other breathing issues like asthma.
Poor posture altering the weight bearing lines through our legs may affect muscles in the feet and calf and instigate tension issues which ripple out to the rest of this muscle system.
So, what symptoms might commonly exist with problems in the deep front line?
- back pain
- neck pain,
- jaw pain / clicking
- tension feelings in the groin
- tension feelings in the rib-cage, chest and throat
But what is fascinating with the fascial system is that it connects everything. In my experience, most myofascial therapists seem only to look at the muscle system and superficial fascial system and do not look at the deep fascial connections to the internal organs or how it might relate to Chinese medicine and energy flow.
There is a muscle called Psoas in the lower back which is a big cause of back pain and hip problems including clicking hips and impingement.
Attached to the front of Psoas and to the underside of the diaphragm is the kidney and supra-renal glands otherwise known as the Adrenal glands. These secrete hormones into the body – Adrenalin, cortisol and corticosteroids to mention a few. Altered tension on the kidney and adrenals from abnormal tension within this deep front line can alter kidney function and adrenal function and so hormone secretion. Adrenalin and cortisol are associated with stress and our fear fight flight reactions.
So we can see a loop here. Stress is more likely to come from this posture as well as be caused by this posture. A vicious circle.
Of course the kidneys are also associated with water retention and excretion and as such are closely related to blood pressure regulation. So blood pressure issues are not uncommonly connected with problems in the deep front line.
The oesophagus (our food swallowing pipe) pierces through the diaphragm – see image above and enters the stomach on the left side just below the diaphragm – not shown in the above diagram. The diaphragm is a muscle with a nerve supply – the Phrenic nerve shown below. Tension in the neck muscles within this system can irritate the phrenic nerve so affecting the diaphragm again. Again – part of this viscious circle / loop again.
So what – well increased tension in the diaphragm may affect the tension around the oesophagus so causing restriction and Hiatus Hernia / indigestion type symptoms.
Overall we can see that an issue with this myofascial system can cause a wide array of symptoms ranging from muscular aches and pains, neck and back pain to headaches but also more “constitutional” issues like blood pressure problems, fluid retention, breathing issues, stomach digestion issues and hiatus hernia along with adrenal fatigue and or stress.
It is also interesting to look at the Kidney meridian as depicted in Chinese medicine and acupuncture. It follows a similar path I feel! A coincidence? I wonder why this meridian was so named especially given the links to the kidney discussed here. Fascinating I feel.
In Ayurvedic medicine, the base Chakra sits deep at the base of the pelvis and the kidney meridian runs through it. Another fascinating coincidence!
My specialism is Integrated Medicine and many of my patients are amazed to understand finally how so many issues they have suffered for so long might be connected and finally make sense.
So how can we treat this?
- Gentle myofascial release techniques
- Various forms of hands on Energy treatments
- A variety of soft tissue techniques like positional release
- Posture and gait correction
- Stress management strategies including meditation and mindfulness.
- Stretches and postures like those used in Yoga – Salutation to the Sun is well known to many who have studied yoga. Look at the posture / shape. This really helps open up and stretch the deep front line. There is a foundation to yoga Practices – even though they may not have necessarily understood it the way we might now they devised postures and exercises for a reason – because they saw it worked! Again – an old system of health care / therapy which fits with all the other ideas.
These systems of medicine might not be so different after all. Perhaps we should take the best of all approaches to medicine including conventional Western medicine of course. This is Integrated Medicine.
I hope to share my insights into other myofascial pattern problems in our internal training sessions again soon and see what other perspectives my colleagues might bring which as yet I might not have thought about! Perhaps then I shall share them with you all. Of course it goes without saying that if you have any questions regarding this post and whether I might be able to help you then please do not hesitate to give me a call or email me and I am more than happy to discuss things with you.