Unwinding is a term used in many different manual therapeutic methods, broadly centered around these intentions:
— Take a person’s tissue interface, limb, or axial segment into a position of relative safety and ease: a ‘Local Neutral’.
— Try to find the exact point of greatest ease — where tensional and compressive forces seem to balance out — and if it seems to move, follow it.
— Notice changes to breath, reflexive guarding, range of motion, and autonomic tone. Notice as well if no change is taking place.
— Cyclically involve the conscious mind of your patient to perceive and investigate the changes.
— Use what you feel to identify structures and structural behaviors elsewhere in the body that seem linked to the present one.
How do you involve the conscious mind of your patient? It depends on the mind, and on your therapeutic relationship. But some common ways are: Attention to Breath, Premotor Ideation (Thinking about moving), Movement within a safe range, Verbal description of what is felt. If too much pain is being felt, these don’t tend to work, so focus first on pain reduction.
There is a separate discussion to have about the mechanisms underlying this interactive phenomenon. Is it all (or mostly) happening in the practitioner’s head? Is it a neuromuscular feedback loop between two attuned nervous systems? Is it a layered peeling free of physical adhesions? Most importantly: Is it a useful activity? And in what clinical situations?
Sensorimotor cascades, from Minasny, 2009 (http://ijtmb.org/index.php/ijtmb/article/view/43/75)
I must confess to you, anecdotally, that Unwinding is an amazing behavior of the body to witness. And sometimes it seems to be the pivotal moment where a surface-skating treatment session turns into a deeply effective one. Here I am working on a physical body and a human person, and this body-person is responding to my touch in ways that feel predictable, gradual, explicable.
Suddenly, when the executive will of both me and my patient have given a little ground, this dance emerges between us which seems far too intricate for simple reflex action, but too subtle and serpentine to be directed by conscious will. And each of us insists the other is leading!
If this is beginning to sound to you like the occult meanderings of a Ouija board, you’re on to an important clue. Both events seem to involve the process of Ideomotion: muscle actions that are influenced by conscious thought, but are subtle enough to evade a sense of “owning” the motion. (“I swear I’m not moving it, you are!”)
‘Tissue Response’ in this case, can be an intricate thing. (From Minasny 2009 http://ijtmb.org/index.php/ijtmb/article/view/43/75)
Is Unwinding not much more than a placeboic parlor trick? Or are am I describing a clinical method that, when intelligently applied, brings about meaningful change?
I really don’t know. So much of it is difficult to describe, let alone measure. But as long as it seems unharmful, intuitively useful, and I can do it without installing dysfunctional belief systems in my patient… Unwinding will continue to show up in my approach.
These are heady times for anatomy nerds. The onset of 3D visualizations of anatomy, and the presence of imaging techniques that don’t require dissection, has allowed us to ask new questions about the way human tissues develop and maintain their architecture.
Next month I (and hopefully some friends) are heading out to the Fourth International Fascia Congress, being held in Washington, D.C. on September 19th and 20th. For me, it will be a non-stop scribble, a hang-out with friends & colleagues, and an experience of the tremendous thrill of a new scientific field being born.
Some findings and assertions at this conference will be nothing more than interesting side channels of science. Little investigations into the beautiful and myriad ways to visualize and conceptualize fascia’s role in the body. But I have a prediction: Some things presented at this conference will end up being pivotal in guiding future medical practice.
The problem is, no one is quite agreed which findings are salient, useless, robust, or flimsy.
Does fascia science really matter? Does it affect what I visualize, or what decisions I make in practice, or what I intend when I work? How might a regular manual therapist / bodyworker incorporate these concepts into practice?
Here’s a table-side chat from my treatment room using the “IT Band” or “Iliotibial Tract” to illustrate some disparate aspects of fascia science. Sorry for the noise and the wobble.
Hope you enjoy it, and see you jokers at the Congress! ~M