Issue link: https://www.massageandbodyworkdigital.com/i/465652
F r e e m u s i c d o w n l o a d s f o r C e r t i f i e d m e m b e r s : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 107 providing structural support for the intestines, the mesentery encases the many nerves and rich vasculature of the digestive tract (Image 2). The mesentery's anatomy can be difficult to visualize. Picture a weighted fishing net hanging from its center (Image 3): the intestines would be analogous to the weights around the net's periphery, with the mesenteric root (Image 4) being the net's point of suspension on the front side of the low back. It is because of the mesentery's attachment to the fascia anterior to the lumbars that the pull of the intestines' weight can be implicated in low-back pain. The mesentery is itself part of a larger fascial continuity that includes the parietal peritoneum, a sac of thin, resilient fascia that surrounds the abdominal viscera (Image 5, page 108). Not only does the mesenteric "net" hang from the posterior abdominal wall, it is also continuous with a net (the peritoneum) that covers the wall, and lines the entire room (Image 6, page 108). MESENTERY TECHNIQUE Because of the very personal nature of the abdomen, the body-mind dimensions we mentioned earlier, or the fact that our abdomens are rarely touched by others outside of very intimate contexts, working with the abdomen is most appropriate when rapport and good client- practitioner communication have already been established. Fortunately, the complexities of the belly's nervous system, fascial anatomy, and interpersonal dimensions are all balanced by the extreme simplicity of the technique itself. Rolling the Peritoneal Bubble With your client on her side, gently cradle the abdominal contents, one hand in the space between the pelvis and the rib cage, and the other on the upper lumbars, behind the mesenteric root (Image 7, page 109). Your intention at this stage is simply to support and ease the organs encased in the peritoneal sac. The type of touch required is different than the touch used for other purposes. We are not trying to release or stretch the fascia; nor are we massaging the viscera. Because of its very sophisticated, sensitive neurology, and its looser, softer tissues, the belly responds well to very light, patient, and perceptive touch. Your client's enteric nervous system is sensing you, perhaps even The mesentery's anatomy is analogous to a weighted net, suspended from the mesenteric root. The mesenteric root (circled in red) on the front of the lumbar spine is revealed here by pulling the large and small intestines aside. Image courtesy Primal Pictures, used by permission. The mesentery's tissue layers surround the intestines along their entire 18–25 foot length, and provide a passageway for their rich vasculature and complex neural network. Image courtesy Göran Jönsson, used under CCA-SA 3.0. Mesentery Artery Nerve Myenteric plexus (Auerbach's plexus) Areolar connective tissue Epithelium Circular muscle Longitudinal muscle Vein Submucosal plexus (Meissner's plexus) Muscularis mucosae Lamina propris Mucosa: Epithelium Lymphatic tissue Submucosa 2 3 4 more than you're sensing it. With this in mind, hold the peritoneum as if you were holding a large, delicate, sentient soap bubble (Image 8, page 109). Before moving or manipulating, let your client become accustomed to your touch. You might invite slow, full breathing into the belly, and even slower, easy exhalation (which gently activates a parasympathetic response). Without stressing, stretching, or bursting the soap bubble, begin to roll the visceral sac in various