Working with Bone

By Til Luchau
[Myofascial Techniques]

When Michelangelo was a young man, he petitioned the senior sculptor Bertoldo di Giovanni to accept him as his student. Legend says Bertoldo gave Michelangelo a prerequisite. “You want to carve marble?” the mentor said. “First, go work as a stonecutter in the marble quarry. Get to know marble.”

“For how long?” asked Michelangelo, who, although just a teenager, was already an accomplished painter.

“Two years in the quarry,” said Giovanni. “Then, you can begin to sculpt.”

Whether fact or legend, this story tells us about the value of getting to know our media—the actual materials and substances we work with—before trying to become artists or masters. Those of us who do hands-on work with the body need facility in many media. Examples include fascia and other connective tissues, skin, or muscle when we do structural or tissue work; or blood flow and muscular tension when we’re performing classical massage. Likewise, our clients’ movement, coordination, and balance are our media when we’re working functionally; energy and flow come into play in energetic modalities; and the client’s autonomic state could be said to be our medium when our intent is to relax or calm. Each manual therapy modality is distinguished not only by what it aims to accomplish, but also by the media it works with to accomplish those ends.

We begin with bone in our Advanced Myofascial Techniques trainings. Although we work with many other tissues and systems, we start with bone in the same spirit that Michelangelo was asked to start in the quarry—to get to know the nature of one of the body’s fundamental tissues. In this edition of the Myofascial Techniques column, I’ll focus on bone as one of the primary media of our art.

the nature of Bone

In the embryo, bone arises from the mesoderm, the same tissue layer from which muscle and connective tissues such as fascia, tendons, and ligaments form. Like these other tissues, bone is composed of cells, fibers, and other components embedded within a surrounding matrix. In bone, this matrix is largely composed of phosphate and calcium in a microcrystalline form called hydroxylapatite. (The matrix accounts for about half of the bone’s weight.) Structurally, these apatite crystals are relatively weak by themselves—think of a piece of chalk. But in the body, these mineral nanocrystals are molecularly linked and interwoven with thin, flexible, elastic collagen fibers. This composite nanostructure of mineralized collagen fibrils keeps microscopic fractures from spreading, and adds surprising flexibility to the bones. Like synthetic fiber/matrix nanocomposites, it is also extremely strong—pound for pound, living bone is even stronger than cement. 

Unlike cement, however, living bone has qualities that we don’t usually consider based on our experiences with dried, dead bones in anatomy class. Living bones are up to one-third larger than dried bones, mostly due to the water they contain when alive. They are also softer and more adaptable, just as a living starfish is soft and pliable compared to a hard, brittle, dead specimen. 

Living bones are also very sensitive. The periosteum, or fibrous bone skin surrounding bones, is highly innervated. Its many mechanoreceptors help coordinate movement and balance by sensing the pull of skeletal muscles where their tendons blend with the bone’s periosteum at attachment sites. The articular ends of long bones are also particularly sensitive, assisting with proprioception and movement coordination. It has long been known that there are also numerous nerves inside of bones, such as the small myelinated nerve fibers winding about the spongy trabeculae deep within cancellous, or spongy, bones. The nerves within bone are one reason fractures and bone bruises can be so painful, and this also means your clients can literally feel your touch in their bones. 

In Advanced-Trainings.com’s Advanced Myofascial Techniques series, we use bone-focused techniques for three purposes: to feel for greater mobility, greater motility, or greater connection.

Feeling for Mobility

Mobility is defined as “the ability to be moved.” In our style of working, our methods often focus on “moving bones.” This is not a chiropractic or osseous adjustment; instead, we use bones as levers or handles to assess, mobilize, and release the surrounding myofascia. When working for greater mobility, the practitioner’s pressure is usually firm, as we are feeling for direct release of any shortened, tightened, or constricted connective-tissue structures that limit the bones’ mobility. 

This passive movement of the bones is useful when preparing for deep connective-tissue work, since it allows the practitioner to both assess and release gross movement restrictions at the articular level. However, we aren’t looking to indiscriminately increase the amount of gross movement at a joint; instead, we feel passive, boney mobility and compare one joint against another, or one direction against its complement, and work specifically to free the more restricted aspect. This brings balance to the release. 

Techniques that work with boney mobility also stimulate proprioceptive sensation at the very deepest levels, since the bones themselves have rich sensory innervation. Sensations produced by the work wake up and enliven the body sense, evoking greater body awareness that clients notice well after their session.

Examples of techniques that feel for mobility include:

•The Carpal Scrubbing Technique (Images 8 and 9) from “Working With Wrist and Carpal Bones” (Massage & Bodywork, May/June 2009, page 122). 

•The Sacroiliac Anterior/Posterior Release Technique from “Working With the Sacroiliac Joints” (Massage & Bodywork, November/December 2012, page 114).

Feeling for Motility 

Motility means “to be capable of motion on one’s own.” So, when we feel for motility in boney structures, we’re feeling for motion that is already happening. This necessitates a quieter, even more receptive touch than mobility work, typically using far less pressure. The motions we feel for can include the movement of breath; the small, adaptive movements always occurring at the joints; or slower, even smaller rhythmic oscillatory motions of bones, such as craniosacral motions. 

“Listening” with your hands for boney motion that’s happening on its own is useful in these circumstances:

• For assessing a bone or body part’s degree or direction of restricted motion; 

• For inviting motion into an area that has been structurally released by mobility work, but hasn’t yet been discovered by the body’s movement sense; 

• When direct mobilization work doesn’t yield the desired results; or,

• For inducing a state of profound relaxation and calm, which is especially useful at the close of a session when integration and completion, rather than further release, are the goals.

Motility work is also useful when the stronger mobility work might be aggravating or contraindicated (such as after acute injuries or surgery), when there is unresolved traumatic activation of the autonomic nervous system (such as with “hot” whiplash, as defined in “Working with Whiplash, Part 1: Hot Whiplash,” Massage & Bodywork, March/April 2010, page 108), when touch is painful (such as in fibromyalgia, or some kinds of chronic pain), or when dealing with a taxing medical condition (such as cancer). 

Motility is often subtle, and is therefore sometimes challenging to detect for practitioners used to more active mobilization work. But subtle does not mean insubstantial; motility techniques can be quite tangible, profound, and effective. 

One mobility technique that has appeared here is the Breath Motility Technique, from “Working with Whiplash, Part I” (Massage & Bodywork, March/April 2010, page 113). If you are inexperienced in motility work, this technique is a great place to start, as it uses the motions of the breath, which are easily palpated.

Feeling for Connection 

A third way that we work with bones is using them to feel for connection, alignment, and whole-body integration. Bones transmit force, both within their individual architecture, and in concert with other bones through long chains of related structures. One example of this is transmission of the upper body’s weight to the ground through the long chain of pelvis, leg, and foot bones (and conversely, the transmission of the ground’s reactive force back up through these same bones in gait, jumping, and running). When boney relationships are in alignment, the compression forces of standing are borne by the skeleton and require very little muscular effort. 

We employ this principle in integrative phases of the work, such as the Core Point Technique, where gentle but firm static pressure is applied to a sweet spot just distal to the calcaneus on the sole of the foot. This sends a gentle, compressive force through the limb and up through the torso. When the right spot and vector are found, the movement of this gentle pressure on the bottom of the foot will be transmitted through consecutively aligned bones and can be seen (and felt by the client) as far up as the atlanto-occipital joint. Once the connection is found, it is held with a static touch to allow it to be registered by the client’s awareness.

The purpose of this technique is to establish a proprioceptive sense of connection and integration, which is different than our previous goals of release, mobilization, listening, or following. In this way of working, the practitioner’s touch serves to light up a path of aligned force transmission in the client’s proprioceptive awareness, demonstrating the sensations of aligned and connected function. Following our artistic metaphor, you could say that the bones are the tools we use to paint on the canvas of proprioception, and we’re painting an image of alignment and connection for the client’s appreciation and education.

The Core Point Technique is usually employed as a finishing move once individual structures have been differentiated and released with mobility or motility work. It can also be adapted for the upper limb or head.

Michelangelo’s innate understanding of his medium, born out of his early years in the marble quarry, allowed him to make some of the most compelling and enduring sculptures in Western art. Although we all have a long way to go before we come close to Michelangelo’s mastery, spending time in the quarry with the fundamentals of our work can help our own genius flourish, at any stage of our practice and work.

 

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 the originator of the Advanced Myofascial Techniques approach. Contact him via info@advanced-trainings.com and Advanced-Trainings.com’s Facebook page.

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