Fascia as a Sensory and Emotional Organ with Robert Schleip PhD MA

Recent research indicates that the muscular connective tissues (fasciae) serve a more active role than previously assumed. This includes the capacity to regulate their stiffness independently from neuromuscular coordination, the role of fascia as a potential pain generator, and its role as our richest sensory organ for feeling our own body. In addition, new insights about an intricate connection between fascia and the autonomic nervous system as well as emotional aspects have become available. These new perspectives offer valuable suggestions for practical clinical applications in working with post-traumatic stress disorders as well as other common aspects in musculoskeletal medicine.

Dr. Robert Schleip will review the most important insights from the field of fascia research related to this intriguing topic and will demonstrate practical translations into hands-on myofascial applications.

Theoretical part

• Fascia as sensory organ: the basis for proprioception, the so called 6th sense.
• The four mechanoreceptor types in fasciae: Golgi-, Pacini-, Ruffini- and free nerve endings. Their preferred locations, mechanical sensitivity and expected physiological responses.
• Implications of the recent Nobel award – devoted to new insights about two interesting sensory receptors in the human body.

• Regulating tissue stiffness independently from neuromuscular coordination. Connection between fascial tonicity and the autonomic nervous system.

• Fascia and interoception. Implications for post-traumatic stress disorders. Related importance of predictive coding.
• The new discovery of ‘pleasant deep touch’ and related A-delta nerve endings (in contrast to gentle caressing touch). New perspectives for supporting clients with autism spectrum symptoms or with attention deficit hyperactivity symptoms.
• Embodiment and mindfulness with a fascial perspective.
• Interactions between fascial fibroblasts, chronic sympathetic activation, and the immune system. Implications for fibromyalgia, depression, and the systemic regulation of the fascial microbiome.

Practical applications:

• Golgi receptor stimulation: application for correction of shoulder protraction.

• Pacini stimulation: application to spinal facet joints and costovertebral junctions.
• Ruffini stimulation: application on upper trapezius, with downstream e!ects on vagal tonicity and heart rate variability.
• Mirror neurons and empathy: practical application with the CAKE technique (constructive anticipatory kinesthetic empathy).
• Fascial techniques for the treatment of acute low back pain.
• Fascial techniques for the treatment of myofascial neck tension syndromes.
• Working with Post-Traumatic Stress Disorders in the setting of a physiotherapeutic or movement educator environment.
• Inclusion of mindful micro movements of the patient during the hands-on work.

References:

• Schleip R (2022) The fascial network – our richest sensory organ. Massage & Bodywork, September/October 2022, p. 40-51
• Schleip R, Stecco C (2021). Fascia as a sensory organ. In: Schleip R et al.: Fascia in Sport and Movement, Jessica Kingsley Publishers, Edinburgh, p.169-179.
• Schleip R (2022). Fascia as an organ of communication. In: Schleip R et al.: Fascia – the tensional network of the human body. Elsevier Limited, London, p. 156-159.
• Suarez-Rodriguez, V., Fede, C., Pirri, C., Petrelli, L., Loro-Ferrer, J. F., Rodriguez-Ruiz, D., De Caro, R., & Stecco, C. (2022). Fascial Innervation: A Systematic Review of the Literature.International journal of molecular sciences, 23(10), 5674.

Learning goals

• Understand the different stimulation effects of Pacini, Ruffini, Golgi receptors and free nerve endings.
• Understand how fascia acts as a dynamic mediator between the autonomic nervous system, emotions and immune regulation.
• Understand which currently known factors influence the overall health of the fascial microbiome.
• Be able to practice constructive anticipatory somatic empathy as a practitioner.
• Be able to practice several fascia oriented manual techniques related to low back pain.
• Be able to practice several fascia oriented manual techniques related to myofascial pain the neck/shoulder region.
• Be able to differentiate when a more proprioception oriented focus of mindful attention is advocated and when a more intoreceptive focus might be better.
• Be able to include mindful micro movements of the patient during the hands-on work.