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MYOFASCIAL TECHNIQUES 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 109 Although preparation, sensitivity, patience, rapport, and skill are all important when working at these deep levels, the often dramatic improvements in low-back mobility and comfort of the low back will make it all very worth the effort. Notes 1. Andry Vleeming, Vert Mooney, and Rob Stoeckart, Movement, Stability & Lumbopelvic Pain (Edinburgh: Elsevier, 2007): 64–73. 2. Helene M. Langevin et al., "Ultrasound Evidence of Altered Lumbar Connective Tissue Structure in Human Subjects with Chronic Low Back Pain," BMC Musculoskeletal Disorders 10 (2009): 151. 3. Antonio Stecco et al., "Ultrasonography in Myofascial Neck Pain: Randomized Clinical Trial for Diagnosis and Follow-Up," Surgical and Radiologic Anatomy 36, no. 3 (2013): 243–53. 4. Janet G. Travell and David G. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual—The Lower Extremities (Lippincott Williams & Wilkins, 1998). 5. J. Y. Maigne and R. Maigne, "Trigger Point of the Posterior Iliac Crest: Painful Iliolumbar Ligament Insertion or Cutaneous Dorsal Ramus Pain? An Anatomic Study," Archives of Physical Medicine and Rehabilitation 72, no. 10 (1991): 734–7. 6. Ida P. Rolf, IPR Audio Files, Tape A2, 8:50, accessed September 2014, www.rolfguild.org/av/rolfa2.html. 7. Ida P. Rolf, IPR Audio Files, Tape A2, 13:00, accessed September 2014, www.rolfguild.org/av/rolfa2.html. 8. Diane Lee, The Pelvic Girdle, 3rd ed. (Churchill Livingstone, 2004). 9. Robert Schleip, "Fascial Plasticity—A New Neurobiological Explanation, Part I," Journal of Bodywork and Movement Therapies 7, no. 1 (2003): 14. Til Luchau is a member of the Advanced-Trainings.com faculty, which offers distance learning and in-person seminars throughout the United States and abroad. He is a Certified Advanced Rolfer and originator of the Advanced Myofascial Techniques approach. Contact him via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. The 12th Rib Technique. After thorough preparation, use static pressure on the lower margin of the 12th rib, in combination with active client breathing, to increase tissue elasticity and rib mobility. Avoid uncomfortable pressure directly on the rib's end or on the transverse processes. Images courtesy Advanced-Trainings.com. 6 5 4 The 12th rib (purple) defines the upper margin of the lumbar space. The TLF (green) attaches to this rib, as does the serratus posterior inferior (transparent). Image courtesy Primal Pictures. pausing in each place to facilitate increased elasticity and awareness. The lateral arcuate ligament is a thickening in the most anterior layer of the TLF, similar to the iliolumbar ligament at its lower attachment— in this case, just anterior to the 12th rib. Although it is probably too small and too far anterior to be directly palpated, your work to free the 12th rib's mobility will indirectly affect this ligament as well. SUMMARY These two techniques work the dense, ligamentous parts of the thoracolumbar fascia at the upper and lower extremes of the lumbar space. As with the TLF in our last column, using these two techniques on acute or unstable back conditions, including acute disk problems, is contraindicated in most cases—at least until you have gained a considerable amount of experience in their application, and are very familiar with how your individual client responds to direct work. But applied correctly, they are quite safe, and with most mild to moderate low-back pain, you'll see obvious and gratifying results.