What is a ‘Neurofascial’ Approach?

An intercostal nerve being drawn medially. (c) Hamm 2009

A neurofascial approach is any method of bodywork aimed at the interface of the nervous system and related tissues.

The neurofascia is a connected system of nerves and fasciae that traverses the whole body.  Using a dynamic interplay of mechanics and signaling, the neurofascia coordinates our movement, fluid dynamics, and inflammatory response.  The disruption of these functions is a core factor in chronic pain, motion restriction, and nerve entrapment.

Courses in Neurofascial bodywork deliver an intuitive sense of neurofascial anatomy and a full range of nerve-oriented manual techniques.  Each workshop is organized around a specific theme that can be immediately applied in bodywork practice.  Curious students will also be given resources to deepen their knowledge of cutting-edge research in the neurofascial field.

This curriculum will enliven your practice and help you get results with complex physical conditions.  (See Upcoming Classes.)


Frequently Asked Questions (FAQ)


1. Why is this stuff worth learning?

Whatever your basic method, it’s worth knowing how to work effectively and confidently near nerve tissue, and to include in your work the responses of the nervous system.  This allows the therapist to combine techniques and think globally to create mobility, tensile balance, and functional health in nerves and related tissues..

Suprascapular nerve as it passes from brachial plexus to the posterior rotator cuff.


2. What does it mean to emphasize ‘approach’ over ‘modality’? 

As bodyworkers we tend to get caught up in this or that method.  We love to add tools to our toolbox.  But pretty soon, the tools matter a lot less than the person deploying them.  Ask any skilled carpenter how many tools they need on a daily basis, and they will not list many.  Far more important for any complex artform is the ability to slow down, see things clearly, combine tools effectively, and learn from mistakes.

So it is with bodywork:  Direct or indirect fascial release, craniosacral work, neuromuscular techniques, visceral manipulation — each of these modalities can be useful depending on the tissue being contacted and the human being receiving the work.  The problem is, each of these methods has different theoretical underpinnings, many of which are by no means accepted by the wider medical community.  What governs your decision to switch from this or that modality?  How to you speak about your work without making erroneous claims?

Courses in Neurofascial Approach are designed to guide students from basic anatomical knowledge to confident palpation skills, and then to clear intentions, and then to consistent results.  Each course builds an integrated awareness of a given region or condition, so that practitioners walk away with not just a new technique but a better way of moving between them.

The goal of any treatment approach is to be intuitive, effective, and adaptable.  This requires confidence with the anatomy and the ability to think across modalities.

3. Why would a clinician care about the nerve-fascia relationship?

Nerve divisions from one spinal segment.

Most manual therapists have occasionally suspected that nerves deserve more of their attention. But they often lack a safe and intuitive method of engaging with nerve tissue.  They have learned nerve anatomy as a segmented system, dissected away from its neighboring fascia. This artificial separation results in a profound difficulty for therapists when trying to palpate nerve tissue, or when trying to figure out how to treat it effectively.

The truth is that we already work on nerve tissue, all the time.  The psoas muscle, celebrated for its role in pelvic posture and low back pain, is thickly perforated and then pressed against by the lumbar plexus.  The piriformis, too, would feel very different if not for its grip on the sciatic nerve.  In fact, if we go looking in most places where our bodywork seems most needed — that plantar fasciitis on the medial heel, that trigger point in levator scapula, those stubborn adhesions in the IT band — we will find sizable nerves in the direct vicinity.

So we can’t avoid touching nerves, and we’re also finding that the health of nerves can be greatly influenced by their mechanical relationship to the body’s fasciae .   Blood supply, axoplasmic flow, nerve conduction, and inflammation are all modified when a nerve is stretched or compressed.   Conditions like carpal tunnel syndrome, sciatica, tension headaches, trigger points, and radicular pain are common

The Stomach meridian. (Wikipedia)

ailments seen in our treatment rooms, and each is caused or helped along by nerve entrapment.   Even in patients where no nerve involvement is suspected, we find that our musculoskeletal models are missing something important about the function and feel of nerve tissue.

When we exclude fascia from our conception of the nervous system, we’re left with overly simplistic models for nerve pathology.  Likewise, fascial release techniques can be aimless or even harmful if fascia is conceived without its neural axis.  Movement disciplines that gloss over the body’s nerve mechanics are robbed of key insights into proprioception, alignment, and chronic restriction.

Most importantly, an awareness of the neurofascia gives rise to a powerful  language that allows practitioners and researchers from different paradigms to communicate effectively.  Folks who’ve spent their careers in structural bodywork, orthopedic surgery, meridian therapies, and body-mind integration are often at a loss when trying to understand each other’s disciplines.  Neurofascial anatomy is a promising “rosetta stone” that allows far-flung experts to express their knowledge in universal terms.