The Pain Solution
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New Dimensions in the Treatment of
Fascial Tissue
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| "The
word 'tensegrity' is an invention: a contraction of 'tensional
integrity.' Tensegrity describes a structural-relationship principle
in which structural shape is guaranteed by the finitely closed,
comprehensively continuous, tensional behaviors of the system
and not by the discontinuous and exclusively local compression
member behaviors. Tensegrity provides the ability to yield increasingly
without ultimately breaking or coming asunder." IntroductionMatrix Repatterning is a new approach to the understanding of the mechanism of injury, and the manner in which the human body responds to these forces. It is based on a revolutionary model of the underlying structure of organic tissue – the Tensegrity Structural Model – which explains the complex interrelationship of all the structural components of the body. It extends the basic concept of the primacy of restriction, beyond the level of joint, muscle and ligament, to include all of the tissues of the body, as potential sources of dysfunction. Symptoms, especially in chronic conditions, are often the result of the compensatory tensions and stresses created within the body in response to the primary lesion. The source of the compensatory pattern is usually asymptomatic. This can be compared to a person wearing a cast on their ankle. They usually feel no pain in the immobilized joint but, often experience pain and discomfort in the knee, hip, lower back or neckas these structures must compensate with an altered range-of-motion (hypermobile) for the loss of mobility imposed on the ankle. Diagnosis and treatment, based on the area of symptoms, is often frustrating and fruitless, since it acts only on the peripheral effects of the primary condition. Matrix Repatterning is a manual approach, which addresses primary sources of tension in the connective tissue-fascial system in an efficient and effective manner. Treatment is gentle and painless, and can often result in global reorganization and postural stabilization, encouraging the body towards normal, pain-free function. The Connective Tissue ConnectionThe connective tissue-fascial system forms a complex web, which provides stability, flexibility and mobility. A dynamic balance is continually maintained within this extensive system to allow for adaptation to the demands of different activities and to the restrictions, which may be imposed by traumatic lesions within these tissues. The connective tissue system is organized into three layers. The superficial fascia is associated with subdermal tissues, muscles and joints. The deep fascia surrounds and supports the viscera. The meninges form the membrane system around the brain and spinal cord. Mechanoreceptors and pain receptors are present within the fascial system and help to continually monitor the changing tensions and metabolic conditions, which may influence this system. The Tensegrity Structural Model (TSM) of the body, as elaborated by Stephen Levin, M.D. and Donald Ingber, M.D., Ph.D., holds that the body tissues are composed of interconnected tension icosohedra (complex triangular trusses) which inherently provide a balance between stability and mobility. This structural model explains many of the observed phenomena related to body support, movement, response to stress and trauma, as well as the effects of various therapeutic interventions. This theory has been verified by several studies in recent years. According to Ingber, a key investigator who has proven the existence of this structural model: “…an increase in tension in one of
the members [within the icosohedral structure] results in increased
tension in members throughout the structure – even ones
on the opposite side. When the ability of the tissues to adapt or compensate becomes overwhelmed by mechanical or physiologic stress, the fascial system responds by altering the patterns of tension and elasticity. Physiological processes are initiated which affect the chemistry of the collagen matrix, increasing the cross-linkages and resulting in reduced elasticity and shortening of overall fibre length. Prolonged irritation may also replace much of the elastin tissue with thicker, less tensile collagen fibers. Primary LesionsSince the fascial system is one continuous structure, fixation will cause compensatory changes throughout the body. The result of these changes will be expressed as postural and motion aberrations. Therapy directed at the compensations rather than the primary lesions will be less effective and less efficient. Careful consideration is given to all of the tissues of the body, since fascial structure is inherently interconnected. It should be noted that post-traumatic studies of pigs, found that internal organs (heart, kidneys, liver and spleen) were almost always injured in simulated motor vehicle accidents. These structures are fluid filled and are therefore very dense, in relation to other tissues of the body. In the event of a traumatic blow to the body, these structures and their intervening fascia will absorb the force of impact most readily. The potential for intraosseous lesions is also recognized as an important factor in many dysfunctional patterns. It has been our experience that these tissues are often the sites of primary lesions in, otherwise, resistant cases. The issue of hypermobility is one that has plagued many practitioners of manual medicine. It has been found that Matrix Repatterning® readily addresses this dilemma. Treatment of the primary site of involvement will often restore the hypermobile or lax tissues to their normal state – usually instantaneously. We have often found that lax posterior or anterior cruciate ligaments and hypermobile lumbar segments regain normal tone immediately after treatment. AssessmentTensegrity assessment focuses on the primary source of the dysfunction pattern. It utilizes a rational approach to the assessment of tension within all of the tissues and incorporates the interconnecting links within the tissues to systematically eliminate the restrictions, which are secondary in nature. This process, known as tension inhibition, allows for the detection of the primary levels of involvement in a manner, which is dependent solely on the objective condition of the tissues and is totally independent of the subjective symptomatology presented by the patient. Tension inhibition is a direct application of the principles of the tensegrity structural model and involves a careful evaluation of tissue tensions. One practical screening method involves the use of sternal compression. The practitioner stands at the side of the patient, at chest level, and places the cephalad hand on the sternal body, with the fingers pointing caudally. For female patients, it is recommended that permission be sought to place the hand in the center of the chest, between the breasts, before proceeding. The sternum is then compressed in a posterior and caudal direction and the degree of compressibility is noted. The caudal hand is then placed over various structures of the body with a moderate amount of compression. This action is thought to create a temporary dampening and alteration of local fascial restrictions, therefore causing a change in the kinetic chain tension pattern. A change in the compressibility of the chest indicates a possible lesion site, and this is noted. Through a process of elimination, the primary site or sites can be discerned by comparing one suspected lesion with another. “He who treats the site of pain is lost.” TreatmentMatrix Repatterning incorporates several specific manipulative techniques. These approaches focus on primary areas of involvement and can quickly and effectively release the source of tension. The principle of treatment is the release of fascial restrictions within the tensegrity structure – at the molecular level. It is theorized that compression of tissues results in a piezo-electric effect. This causes the electrons, which are associated with the chemical bonds in the involved tissues, to generate a form of intrinsic current. This effect has been demonstrated in bone repair and occurs when it is placed under compression. The resulting flow of electrons may allow for a change in the relationship of cross-linkages, which form at the level of the collagen matrix and which maintain the state of restriction at the site of the primary lesion. A gentle, gradual pressure, referred to as induction, or a sudden movement, referred to as directional recoil, may be utilized. The traditional chiropractic adjustment may also accomplish this change, when applied to the appropriate site of involvement. Treatments are generally painless and work in harmony with the body’s healing processes. The result of acting on the primary foci can be readily observed in the often dramatic and immediate changes, which occur upon re-examination. Case StudyThe following case study is fairly typical the type of response seen with Matrix Repatterning. A 31-year-old Caucasian female presented with acute low back pain and radiation into the left anterior thigh on the left and radiation in the right leg to the dorsum of the foot. Pain was aggravated by sitting, flexion and lateral flexion to the right. The patient used the arms to support the weight of the trunk in order to avoid pressure on the sacrum. There were two previous acute episodes dating back seven years since a severe fall on the “tailbone” after slipping on the deck of a boat. Chronic low back stiffness and moderate, occasional pain was present between acute episodes and the patient had been receiving regular chiropractic care over the years. Examination revealed extremely limited flexion and lateral flexion to the right. Meningeal stretch aggravated symptoms and neurological signs were nominal. The right sacro-iliac was in an ‘upslip’ pattern and the sacrum was severely deformed in a state of intrinsic flexion (intraosseous). The right ilium was also compressed in a vertical pattern (intraosseous). The lumbar spine was hypermobile at the level of L4 and L5. The left knee demonstrated a positive posterior drawer test for the posterior cruciate ligament (the patient subsequently mentioned a recurring pain in that knee on descending stairs). The mid-cervical spine was significantly rotated to the left and the ipsilateral articular processes were very tender to palpation. Visceral fascial lesions were found in the area of Glisson’s capsule of the liver and the right kidney. Treatment was applied to the sacro-iliac, sacrum, ilium, kidney and liver fascia, and the meninges. Re-examination revealed a 50% improvement in lumbar motion, stabilization of the lumbar spine and the left knee and the patient was able to sit comfortably for the first time in over a week. Follow-up therapy was directed at scar tissue resulting from two episiotomies. After four treatments, the patient was completely symptom-free and orthopedic indices are normal. References:
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