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96 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 7 technique MYOFASCIAL TECHNIQUES The Sympathetic Sacrum By Til Luchau Once more, it looks like we were wrong about one of the basic tenets of our work: the nerves of the sacral plexus are sympathetic, not parasympathetic as we were taught. We all learned that the sacral plexus (Image 1) was the second major center of parasympathetic neuron concentration (after the vagus nerve), and that these parasympathetic sacral nerves controlled bladder, bowel, and genital function. "Wait," someone always asked in Physiology class, "I thought parasympathetic nerves were about relaxing. You're saying sexual arousal is like digestion and going to sleep?" "Yes," we were assured, "the sympathetic nervous system's fight-or-flight function is complemented by the parasympathetic's feed-and-breed role." Since it was on the test that way, that's the way we learned it; and in the years since, that's how we teachers have continued teaching it. But a new study published in the November 18, 2016, issue of Science has me reasonably convinced we were wrong (Image 2). In a detailed comparison of these sacral nerves' characteristics with sympathetic and parasympathetic motor neurons elsewhere in the nervous system, the study's authors found sacral nerves matched sympathetic nerves in 15 out of 15 molecular features studied, but had zero matches with parasympathetic features. 1 If independently verified, this reclassification of sacral nerves as sympathetic means we need to revise many of our explanations about how hands-on work with the sacrum affects the autonomic nervous system (ANS). Sacral work has long been observed to be calming and settling. "A pelvic lift is always in order in an emergency," according to Ida Rolf, who finished most all her sessions with the osteopathy-inspired pelvic lift technique (Image 3, page 99). 2 In this technique, as in many types of sacral work, our favored explanation was that we were helping calm autonomic activation via the parasympathetic plexus of the sacrum 3 (which now turn out not to be parasympathetic after all). If this reclassification gains acceptance (and it appears likely that it will), not only will it mean revising large numbers of anatomical and neurological reference materials, but the numerous therapeutic disciplines that work with the sacrum may also need to rethink at least some of their rationales. Affected modalities could potentially include the aforementioned Rolfing and structural integration, as well as osteopathy and craniosacral therapy. (The parasympathetic system is actually called the cranio-sacral division, though the idea that craniosacral therapy owes its name to the now-in-question sites of parasympathetic concentration is most likely incorrect). 4 Trauma-oriented approaches such as David Berceli's Tension & Trauma Releasing Exercises and Stephen Porges's polyvagal theory may also need to revisit some of their rationales. And, unfortunately, a chapter in 1 The nerves of the sacral plexus and the sympathetic ganglia. Image courtesy Primal Pictures, used by permission.

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