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106 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 5 technique MYOFASCIAL TECHNIQUES Vertebral Mobility By Til Luchau The somites (or segments) of the emerging spine in an embryo at about 20 days of development, ¹/ ¹² " (2.11mm) in length. Somites become not only the individual vertebrae, but also give rise to much of the musculoskeletal and connective tissues at their corresponding level of the body. Artist: Henry Vandyke Carter, from Henry Gray's Anatomy of the Human Body (1918). Public domain. 1 There is no structure in the body that quite compares to the spine. Its centrality, size, and crucial role in support and movement, as well as its integral relationship with the central and peripheral nervous systems, all mean that the spine has a unique and important role in hands-on work. The importance of the spine is reflected in the way we use its name in everyday speech. Roget's Thesaurus lists the word spine as a synonym for "core," "foundation," and "basis" (as in "the spine of his philosophy"), as well as for "perseverance," "decisiveness," nerve," and "fearlessness." 1 Think about what it means to "have a backbone," or to be "spineless"; linguistically, we relate our spine to our very character, strength, and human resilience. Embryologically and evolutionarily, the spine's precursor (the notochord) is one of the first structures to distinguish itself from the matrix of rapidly dividing cells in a developing. After just 20 days, a human embryo has segmented its midline into the somites that will become our individual vertebrae (Image 1). These proto-vertebrae give rise to other structures as well: many of our musculoskeletal and connective tissue structures develop outward from this longitudinal arrangement of cells as we grow, making the spine the root structure for much of our musculoskeletal form. 2 The spine and vertebrae are directly involved in several of the most common client complaints, including: • Rib pain (since the ribs articulate directly with the vertebrae at the ligamentous costovertebral joints). • Neck pain or injury, including whiplash (the neck being the uppermost section of the spine, and thus dependent on the supporting sections below for its stability and ease). • Sacroiliac issues (the sacrum and its paired sacroiliac joints being the base of support for the entire spine, and in turn subject to the forces of flexing, extending, bending, and twisting coming from the long lever of the spine above). • Sciatic pain (especially axial sciatic pain, as discussed in "Assessing Sciatic Pain," Massage & Bodywork, July/August 2011, page 110). • And of course, back pain itself (which affects 9 in 10 people at some point in their lives 3 ), as well as other spine- related issues such as scoliosis, spondylolisthesis, etc. The mobility of the spine, both of individual vertebra and of the entire structure, plays a role in each of these issues. Since "increased options for movement" is one of the primary goals of Advanced Myofascial Techniques work, we can often play a helpful role for our clients with these spine-related issues. 4 Primitive segments Neurenteric canal Neural folds