Issue link: https://www.massageandbodyworkdigital.com/i/68005
movement range, disrupt alignment, and bind the structures they surround. Imagine trying to move in a wet suit that is a size too small—the outer layers of the neck can bind, distort, and constrain movement in the same way. SEEING SUPERFICIAL RESTRICTIONS Try this: watch a friend turn his or her head from side to side. Watch what happens with the superficial layers of the neck, shoulders, chest, and back. Are there areas of the torso's fascia that move along with the head and neck? Or, do you see lines of tension and pull appearing in the skin and outer layers? Often, these signs of fascial restriction will be most visible at the extremes or end-range of the movement. Look from both the front and the back. Compare left and right sides for any differences. Then, look again as he or she gently looks up and down (being careful, of course, to avoid any posterior cervical compression when looking up). Your friend might feel different kinds of restrictions when moving, including pulls in the deeper musculature, or catches involving neck articulations or the upper ribs. For now, we're going to leave these aside and focus on the outer layers first. Sometimes superficial fascial tension will be visible as linear patterns "tug" in the skin (Image 3). In other cases, a whole sheet of fascia will move or creep along with the rotating or nodding head. Linear "tug" patterns are more commonly seen in the thinner layers of the anterior neck and chest, while the "creep" of whole fascial sheets is seen more often when looking at the thicker posterior layers of the back. If it is difficult to see restrictions in the superficial layers, you can use your hands to feel for tugs and pulls in the outer layers while your client rotates his or her head. Whether watching or feeling, note any areas that don't have smooth, An example of fascial strain visible as "tugging" of the outer layers when moving. The Over-the-Edge technique releases the superficial layers of the upper back and shoulders. Although relatively safe, head-down positions are usually contraindicated for clients with uncontrolled high blood pressure, a history or risk of stokes, or vertigo, or acute sinus issues. even lengthening of the dermis and superficial fasciae when the head moves. We are constructed like onions: layered, from superficial to deep. When testing for fascial tension with movement, don't confuse movements of deeper structures for movement in the superficial fascia. For example, you'll sometimes see the rib cage turning along with the head, or a shoulder roll forward, etc. Some of this movement is normal; if you see exaggerated or asymmetrical movement of the rib cage or shoulder, this might be because of deeper restrictions. Make a note to check for and address these patterns later, but remember that since these deeper movements might be caused by restrictions in the outer layers, releasing the superficial layers is the logical first step. Unless you're working with a scalpel and are cutting right through, you need to gently peel away the outer layers to get to the core. RELEASING SUPERFICIAL RESTRICTIONS Once you've seen or felt where your client/friend's outer layers are tugging or creeping along with head and neck movement, you can go to work. A word about sequencing your superficial work on the upper torso: in most cases, you'll begin by releasing the posterior restrictions of the upper back, and end by working the anterior restrictions. This is the order we're using in this article. Why this back- to-front progression? Since most of us tend to have our heads forward of the coronal midline and be narrower across the front of our chest than across our upper back, the anterior fascial layers of the chest and shoulders tend to be shorter than the posterior layers of the shoulders and back. Ending by lengthening the shorter anterior restrictions balances the earlier work on the posterior side and leaves the client with a greater sense of anterior width, length, and freedom, and therefore helps with overall alignment. A possible exception to this ordering: if your visit massageandbodywork.com to access your digital magazine 123