Osteopathy Where
Above Below

Hierarchy of Protection Mechanism – FASCIA/DURA – dysfunctions

Andrew T. Still, DO, said the body protects different tissues in a Hierarchy of Importance

 1. Vascular, Lymphatics, and FASCIA (in this order)*
2. Nervous System
3. Organs (Viscera)
4. Endocrine System
5. Musculo-skeletal System
     * Vascular, lymphatics, and fascia are integrated, but begin with vascular

FACTS OF FASCIA – Myofascial Meridians
“Anatomy Trains” Thomas W. Myers

Anatomy Trains provides a “longitudinal anatomy” of twelve individual sets of maps with tracks,
stations, and switches. It is a systemic point of view offered as a supplement to the standard
analysis of muscular action. ANT uses the Anatomy Trains map as a base for developing a canine/
feline series of fascia maps.

Fascia is a dense meshwork of irregular connective tissue that covers all of our tissues in our bodies.
It is around our muscles, organs, joints, brain ligaments, capsules, tendons, vascular and lymph
vessels, and nerves (epineurium). (Schleip 2003)

Fascia is the largest sensory system in the body, with a rich vascular and nerve supply present
in the outer layers of deep fascia. In the deeper layers we find intra-fascial nerve fibers where the
interstitital myofascial tissue receptors are located (Stecco, et al 2008). They are sensory Type
III and Type IV receptors (nociceptive and/or mechano-receptors). They are sensitive to stretch,
thermal, and chemical stimuli.

Fascia is a common factor in many systems, such as the outer layer of blood vessels, lymph

vessels (adventitia) and nodes, and the epineurium (50%) of the nerves all have Type III and
IV receptors. These nerve endings run in parallel with the sympathetic nerves. When they are
stimulated, they connect with sympathetic neurons in the grey horn of the spinal cord, and then
in turn, connect via efferent fibers to the respective vessel or nerve. These are spinal reflex arches,
and they cause constriction of the vessels (smooth muscles in tunica media) and nodes. Constriction
of the epineurium causes a reduction in the fascial glide and thereby influences musculoskeletal
mechanics (Schleib R, et al) such as joint glide and slide.

Fascia follows the body’s connective tissue forming traceable ‘meridians’. The word ‘meridian’ is
usually used in the context of the energetic lines of transmission in the domain of acupuncture.
The myofascial meridian lines are not acupuncture meridians, but lines of pull, based on standard
Western anatomy; that is, lines that transmit strain and movement through the body’s myofascia
around the skeleton. They have some overlap with the meridians of acupuncture, but the two
are not equivalent.

The plantar surface of the foot is often a source of trouble that communicates up through the rest
of the line on myofascial tracks and bony stations to the head. With this in mind, Patricia M.
Kortekaas, found reflex points that would aid in the communication of a fascial line and named
them “breakers”. She continued to identify more “breakers” on other points on the feet and hands.

Breakers can be used to restore and normalize the innvervation of dysfunctional fascial line.
Using the “Anatomy Trains” work by Thomas Meyers, Patricia M. Kortekaas’s colleague, Rikke M. Schultz, DVM in Denmark mapped equine fascial lines. From her work, Patricia has mapped the canine fascial lines and uses veterinary anatomical terminology for each of them.

   The advanced ANT students learn to address the
   connection between the fascial lines on a macroscopic
   level and the joint capsules/ligamentous structures on a
   microscopic level. They scan for fascial tension along the

myofascial track by drawing in at the “breaker”. Charts for canine and equine bony stations are used
as directional guides for each of the tracks.

A fascial “trauma” is a sudden unexpected pull, compression or shearing force, or a chronic
slow impact on a fascial line that will result in a fascial line contraction and neurological dysfunction.
Simply, the fascial line has lost its capability to glide and slide at the appropriate time.

The fibers from the joint capsules and ligaments support the glide and slide mechanisms in
the joints and need to follow the gross movements from the fascial lines to a well-integrated
movement pattern. Every movement is a combination of micro and macro fascia connections
in the whole body, even up to the fascia of the organs and the connection with the fascia
surrounding the vascular and lymphatic systems.

Our fascia can be considered our “mechanical brain”. Every neurological input from the brain
must innervate the big fascial lines as well as the joint capsules that simultaneously support
the smooth and well-coordinated movement patterns in the body So, it is safe to say that each
joint capsule most likely has a combination of connecting fibers to the spiral, the ventral/dorsal
and lateral lines, depending on the osteopathic form/shape of that individual joint.

Myers, T. W. Anatomy Trains, 2nd edition, Churchill Livingston, 2009, 295 pp.

Schleip, R., JBMT, Jan 2003 “Fascial Plasticity: A new Neurobiological Explanation
Stecco et al, 2008. “The expansions of the pectoral girdle muscles onto the brachial fascia:
morphological aspects and spatial disposition
“. Cells Tissues Organs. 188:320-9.

Stepping on cat's tail

Rikke M. Schultz, DVM