The Frontier of Myofascial Medicine

                        

   The greatest depths of our oceans remain a mystery to us, even more so than our knowledge of their comparably distant stretches in outer space. Yet still more deficient is our body of research into the deep world of fascia which exists beneath our very own skin. 

      To be unconsciously incompetent is blissful. We don’t know what we don’t know, until we eventually piece together its prerequisites. To be consciously incompetent, however, is a substantial burden. For the ambitiously curious, it implies a responsibility to connect the dots, to define the congruency between variables which we separately know to be true. Conscious incompetence is a call to action.

      As a species, we fall prey to egocentric bias, patting ourselves on the back for our accounted knowledge, for that which we have consciously understood.


                     

      We are truly only beginning to knock on the gates of fundamental medical mysteries. For example, our ability to treat Alzheimer’s, our ability to regenerate a damaged spinal cord, to cure cancer, to treat mental illness, or to rehabilitate traumatic brain injury. These fields of medical science exist in a black hole of undefined research expectancies.

      The constraints of time hold us captive in a medical arms race to relieve our suffering, a suffering which is exponentially contained in comparison to our ancestors, and equivalently tumultuous in comparison to what will be for our descendants. Such is the nature of human progress.

                     

      
      In the name of progress, its imperative that we acknowledge a notoriously under researched, yet wildly important field of medical science. The myofascial network which encapsulates our musculoskeletal system remains disproportionately neglected in the U.S medical system. These layers beneath the skin host a large collagenous sheath, a fibrous network of responsive and adaptive connective tissue which is as consequential as it is malleable. A rapidly evolving piece of the human organism, working in tandem with the underlying muscle bellies and their firing sequences, force transmissions, and structural lines of pull against gravity.


                     

      At this very moment, your myofascial structure creates tension against gravity by stabilizing along global myofascial meridians. Your neurons simultaneously send information to your brain through mechanoreceptors located within each tissue, and your circulatory system hydrates these tissues with the nutrients you consume.

                     

      Those who exist on the cutting edge of the medical field have already integrated their approaches through multiple modalities and scopes of analysis. Many physical therapists and chiropractors incorporate myofascial interventions in varying capacities. While some providers are more competent in working with soft tissue than others, the overall structure of the insurance reimbursement model is not built to reward such skillsets. When skill sets are not rewarded, they are correspondingly under developed in providers.

      A structural understanding of myofascial tissue possesses life changing power. Connective tissues are responsible for both local and global recruitment signals which cascade patterns along the kinetic chain. Kinesthetic literacy enables us to better diagnose myofascial dysfunction, and to manually restructure fascial tissues to facilitate better movement.


                     

      Yet still there remains a disconnect among pain patients, our culture remains largely illiterate in regard to movement, and its role in joint health. Our healthcare system continues to over prescribe pain medication, over utilize expensive and counterproductive surgeries, and leave patients with no answers.

      It’s safe to say that a large portion of Americans are disappointed in the level of orthopedic healthcare they receive in comparison to its astronomical cost, particularly in the monstrous amount of people suffering from chronic pain. Myofascial intervention doesn’t generate high profit margins for the medical system. From a revenue perspective, large corporate hospital executives are most concerned with maximizing expensive procedures and prescriptions. These billing codes generate the largest profit for the least amount of time and energy. When the natural course of business practice and revenue generation have a tendency to control the options of medical professionals, patients ultimately bear the costs, both financially, and with their quality of care.

      When applied correctly by a well-trained practitioner, manual bodywork is ironically of tremendous value to the PATIENTS themselves. Correctly applied bodywork will often attack the primary, underlying myofascial causes of musculoskeletal pain. This is in many cases the missing link in our system, and can connect the dots for patients who are struggling to see improvement.

      The business of healthcare seems to inhibit the practice of healthcare, limiting providers in their ability to maximize patient outcomes. The insurance reimbursement model is archaic in comparison to our restorative capabilities. In fact, there are physical therapists right here in North Carolina who have left the insurance reimbursement system entirely. A growing number of cash based physical therapy practices are opening up their doors around the country. Many healthcare providers are seeing more efficient treatment, better patient outcomes, and higher quality interactions when they leave the shackles of insurance. After coming to this realization, I was disenfranchised in my dreams of completing physical therapy school.

      So here we exist on the frontier of myofascial medicine, a renaissance propagated by the internet and it’s ever deepening pool of collaborative resources. Myofascial bodyworkers are working thanklessly forward on a trajectory which gives them diminishing marginal financial incentive to perform hands on treatment. We are more consciously competent than ever in regard to the substantial myofascial variables of orthopedic care, yet the administrative and political forces at the forefront of medicine remain gridlocked. Many patients need myofascial treatments which are monumentally beneficial to their health, yet financially de-incentivized and circumstantially unavailable thanks to an archaic medical industrial complex.

      Manual bodywork is becoming increasingly respected for a reason. It’s inherent value guarantees its continuation among privatized circles, available only to the wealthy and those with independent resources. As society’s movement literacy improves, as we are not only consciously competent in myofascial medicine, but furthermore incentivized to culturally educate and provide it, we can see drastic improvements in medical outcomes. The manual re-structuring of connective tissue has an understated and underappreciated role in not only recovering from injury, but in optimizing health and the human experience.