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TECHNIQUE MYOFASCIAL TECHNIQUES Working with Rib Restrictions By Til Luchau Take a breath. How much did your rib cage move, and where? Take another breath, this time without moving your ribs quite as much. Was it an unpleasant, hard-to-breathe sensation? That's what restricted rib motion feels like, whether the restrictions are from connective tissue constriction, pain, posture, or habit. Breath efficacy affects many functions, from metabolic processes to our energy level, alertness, and mood.1 Because we take approximately 24,000 breaths in a day, even small changes in our respiratory efficiency will have cumulative and far-reaching body-mind effects. Fortunately, this multiplying effect works both ways: not only can breath restrictions make us feel bad, but even small, incremental improvements in rib freedom can improve well-being on many levels. Restricted rib motion can arise from the usual things that cause us to lose mobility: stress, postural and habitual stance, inactivity, disease, pain, or injury. No matter what the cause, skilled hands-on work can be an effective way to help reestablish lost motion. I'll discuss three techniques for restoring rib cage mobility, taken from Advanced-Trainings.com's Advanced Myofascial Techniques series. We'll begin with the back. ERECTOR TECHNIQUE Your work with rib restrictions will be more effective if you take time to release the larger, more superficial rib structures first. Within the erector spinae group (Image 1), the iliocostalis and longissimus thoracis connect ribs to other structures, and will restrict breath mobility when tight (both connective tissue tightness and high muscle tone are common here). You will also find it easier to assess the movement of the ribs themselves in the subsequent techniques if you release the erector spinae group first. The forearm tool (Image 2) is an effective way to work with the erectors. Without using oil (which would eliminate the slight friction necessary to differentiate individual layers), use your forearm to apply a bit of caudal (downward) pressure on the erectors, feeling for their lateral edge. At first, feel for variations in tissue density, rather than attempting to release or change anything. Keep your other, nonworking hand on your client, close to your forearm. This will help make your body position more stable, and give you a bigger "footprint" in your client's awareness, ultimately helping him or her to relax into your touch. Allow the slow release of the tissue to set the pace for your gradual gliding movement down the back. Begin with moderate pressure, in order to prepare and warm the superficial layers. Once they've released, on your successive passes feel deeper into the back's myofascia, working slowly, layer by layer. Don't be too concerned about the precise name of the erector subgroups you're feeling; your palpatory skill will show you where the restrictions are. You might ask your client to gently let the breath expand under your touch, releasing from the inside the same places you're working from the outside. Work the entire length of the erectors, but be extra sensitive over the lower floating ribs and lumbars. COSTOVERTEBRAL JOINT TECHNIQUE One of the most commonly overlooked places that ribs lose mobility is at the costovertebral joints, where the ribs articulate with the spine. Deep to the erectors, the area around these key joints is filled with ligaments and small muscles which, when shortened or hard, can bind the 112 massage & bodywork january/february 2012