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myodural bridge

Myodural Bridge, Enix DE et al 2014 J Can Chiropr Assoc 58: 184

Myodural Bridges

This is a great review of connections between the sub occipital muscles and the cervical dura. There are some more images in the article. Here is David Butler discussing the anatomy:

The Myodural Bridge
‘What a name! I was always intrigued by the difference between a group of patients who could quite easily elongate their upper cervical extensor muscles (“pull your chin in”) and another group where upper cervical flexion was particularly sensitive and easily evoked headache. The repeated clinical anecdote is that the second group can flex their upper cervical spines more easily in sitting or even better, in supine with their knees flexed. This may well unload the myodural bridge.
Myodural bridges are connections between the cervical dura mater and the cervical extensor muscles. These connections probably anchor the dura and stop it folding in on the cord when you look up and extend your head back (Hack et al 1995, Rutten et al. 1997). This may have been an evolutionary advantage to our ancestors as they gazed up in awe at the firmament! There is a great recent review out by Enix et al (2014), updating the anatomy of the bridges including sub occipital bridges and proposing clinical implications. Think of it next time you are having a look at a patient’s posture as they sit in front of you with their worries and concerns? or ask someone to tuck their chin in. It also remind us that everything is kind of joined up in the body; discrete anatomy is for the textbooks.‘ David Butler NOI notes July 2014

Enix DE et al (2014) The cervical myodural bridge, a review of literature and clinical implications. J Can Chiropr Assoc 58: 184

Atlantoaxial Instability

Here is a good article on why it pays to be cautious in bodywork. I am so glad I do not introduce strong forces into the neck when I work. The biodynamic paradigm makes working with the upper neck and cranial base much safer. I was taught tests for vertebrobasilar insufficiency at chiropractic college but not that much about atlantoaxial instability.

‘Either atlantoaxial instability or vertebrobasilar insufficiency causes severe dizziness and vomiting after massage therapy, with lessons for health care consumers’

http://saveyourself.ca/articles/my-barber.php

Image

Above is a fresh dissection showing a superior view of the cranial base with the dural lining intact, tentorium removed. The image is taken from here. You can see the olfactory and optic nerves passing through the dura. Fabulous. How shiny is the fascia lining the skull? This is very different from the dead bones you normally see.

Note how the shapes of each middle cranial fossa are quite different between the left and the right. The left greater wing seems to be anterior (towards the nose/ top of the picture). It does not look like a side bend to me – there is no bulge to the left? In Sutherland’s framework, probably a left lateral shear?

In palpating a clients head on a table, orienting to a squashed fluid balloon head, this pattern might present as the left hand towards the ceiling and the right hand towards the table. Often these are the obvious shapes and directions you feel in lateral shears, rather than feeling lateral translation of sphenoid.

Whatever we name it, and it is easy to get confused here, there is clearly experience and shaping by conditional forces. A great clinical approach is to try and work out the forces that have acted on the babies skull to generate the shapes you perceive.

For comparison here are three more real skulls, showing a variety of shapes.

 

Cranial base - three real skulls side by side

Cranial base – three real skulls side by side

cranial base labelled

 

 

I recently came across Jerry Hesch writing on alignment and treatment of the sacrum. He makes a convincing case for the most common sacral misalignments being torsion on one of the two oblique axis as shown below. The graphic is mine (I found his images a bit hard to follow). The model is really simple, feel for the most posterior quadrant of the sacrum and you can work out how the sacrum is torsioned using the graphic below. Hesch says the most common pattern is posterior low left sacrum.

Sacrum Hesch_edited-2

From my experience of holding lots of sacrums over the last 13 years, I would agree sacrums are often torsioned along these oblique axis. It feels a really simple way to assess the sacrum and has helped me quickly clarify my experience during treatment this week.

He includes more testing in his full assessment of the sacrum, including springing (‘springing with awareness’) the ‘four corners’ or quadrants of the sacrum in childs pose. The most posterior corner will also be the stiffest, with no anterior posterior recoil. His treatment is really simple as well, sustained anterior posterior pressure of upto 20lbs for 2 mins.

The chapter is in a new book on soft tissue work by Eric Dalton. He has commissioned chapters from most of the leading fascia researchers and practitioners around right now. I have not heard of Hesch before, but he is in very good company in Eric Dalton’s book. Here is a video of him introducing his chapter.

Reference

Jerry Hesch chapter in (2013) Dalton E. (2013) Dynamic Body: Exploring Form, Expanding Function. http://erikdalton.com/products/textbook/

He obviously is a detailed thinker, you can access more of his writing here. (I have not explored in depth.)

http://www.heschinstitute.com/hesch-method-basics.html

Steve and Ged talking away on fascia, is the body more than cells, the nature of the self, can we sense across a room and why is it hard to meditate on a plane? All essential questions.

‘Pain is 100% all the time produced by the brain’

After 3 to 6 months tissue damage will be repaired – chronic pain is from the brain

‘You can retrain the brain’

 

 

 

I have recently discovered Gil Hedley’s videos, just fabulous. This video, ‘The “Fuzz” Speech’, will change your relationship to stretching forever. Check out the fuzzed up left scapula compared to the unfuzzy right scapula about half way through, and then try to not want to move your shoulders.

Cells (blue) moving through a matrix of fibres (green)

http://www.zurichminds.com/videos/ruth_schwartlaender.html

Click on the link, or the picture, to see a 7 min video ‘Ruth Schwartländer: “Why Nano in Technology?”‘ Her talk describes how cells communicate with their environment by introducing forces into the surrounding complex 3D network of fibres. There is a short film in the video showing cells moving and shaping the surrounding matrix, the still above is from the film. I met Ruth at a social evening in Geneva and really enjoyed talking to her about her research. It was inspiring to meet someone so smart and who could explain some tricky concepts to someone not in her field.

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Ever wonder what intuition actually is? Well look no further than your fascial matrix which covers all your muscles, nerves, arteries and veins, organs, bones: in fact every structure in your body. It’s the skin of things. Everything needs a skin to contain and support itself. It also acts as the communication system of the body through which the blood and nerve supplies travel and most of the immune system exists within it. It’s also the most sensitive part of your body and carries the general senses. Most of the time we orient to the world around us through our special senses especially our vision and hearing but that is just a small part of the body’s overall sensory system. The vast majority of our senses are located in our fascia. Feelings of pressure, proprioception and interoception are all located here. The brain needs to know how the body is internally and in relationship to movement.

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I was sitting on a train the other day and suddenly into my perceptual field came into strong focus everybody’s bag. They had been there all along I just hadn’t noticed them as anything significant. Maybe it was because the train was full and people were having to deal with their bags that I noticed them as they were moving them into a new position on their shoulders or putting them between their feet or holding them differently. There wasn’t enough room for the bags all of a sudden, just people. Anyway there was a train full of bags glaring at me and it struck me that we are obsessed by bags. Everyone has a bag or two or three and there are shops that sell them and we need them of course for putting things in. It also struck me that everything is a bag. The whole of life, the universe and everything is a bag. And I chuckled to myself when I thought that because it’s true. Chances are that the bags I was looking at contained other bags inside them plus never mind the bags what about us. We are a bag too – a series of bags really. There’s the obvious bag of the skin, that we wear other bags over – trousers, shirts, dresses, they are all body bags, shoes are foot bags, gloves are hand bags! Hats are head bags. It goes on. All clothes are bags therefore. Cars and trains and planes are too. They are metal bags we get in that enfold us. Then there’s the rest of the body which in many ways is a whole series of bags or skins that wrap individual muscles and organs and nerves and bones. And when you think there must be something in these bags that are the real thing and not bags and you start to look at the microscopic side of things you see that there’s wrappings in there too. Each nerve fibre is wrapped, each muscle fibre and then you look even closer and see that they are all made of cells that are bags too. Each cell has a membrane, that’s a bag and in the cell there’s objects (organelles) but when you really look at them they too are cleverly disguised bags wrapped into all kinds of different shapes and then when you get down to the nano level of things you are looking at molecules and atoms and they too have shells that wrap around the nucleus of the atom which is more and more looking like its composed of nothing. So basically I saw a great truth I think, that we carry bags to remind us that the whole universe macro and micro is made of cleverly disguised bags with ultimately nothing in them. All we have to do is get past the bags then we will see what the Buddha saw. Here’s a picture of one of my favourite bags.

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