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Dr. Brian Abelson

Fascial Expansion: MSR Hip Protocol

Updated: Oct 16


Fascial Expansion the Hip

Fascial expansions provide a powerful tool in treating hip pain, drawing on our current scientific understanding of the fascia's role in connecting various elements within the body. We forge a comprehensive method by combining this approach with the principles of Soft Tissue Manipulation, Kinetic chain relationships, and aspects of traditional Chinese medicine like acupuncture. This article explores the fascinating integration of fascial layers with acupuncture points GB30, GB29, and GB34.


These techniques should be paired with soft tissue and osseous manipulations alongside a thoughtfully planned set of functional exercises for optimal healing. These insights on fascial expansion form an integral part of Dr. Abelson's Motion Specific Release courses, contributing to a holistic and evidence-based approach to health.


Article Index:

 

Fascia: A Dynamic Interconnected System


Fascia Defined: Fascia is more than a mere sheath of connective tissue; it's an interconnected network that adapts its structure and density to meet local tensional demands. When balanced and functioning optimally, fascia's role is paramount in distributing forces throughout the body, enabling us to store and release energy needed for movement. Conversely, an imbalance, hypertensive condition, or restriction in fascial tension can lead to multiple dysfunctions, becoming a hindrance rather than a support system.


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Fascial Planes and Their Connection to the Hip

The complexity and integrity of fascial planes have significant implications on hip function. They can be addressed and fine-tuned through various methodologies, including acupuncture and hands-on manipulations encompassing soft tissue and skeletal procedures. The interplay of fascial planes in the hip is not just a matter of mechanics but an intricate relationship that demands thoughtful consideration. Here are the primary regions that require attention:


1. Gluteal Fascia:

  • Structure: Encloses gluteus maximus and tensor fascia lata muscles, connecting the thoracolumbar fascia to the fascia lata.

  • Relation to Hip Pain: The balance and coordination facilitated by the gluteal fascia are vital for proper hip function. Dysfunction or restriction can lead to imbalanced forces, potentially causing or contributing to hip pain.

2. Gluteus Medius Fascia:

  • Structure: This thin connective layer allows gliding between the gluteus medius and maximus muscles, merging distally with the gluteus maximus fascia.

  • Relation to Hip Pain: Since it forms part of the iliotibial tract and connects to major hip structures, inflammation or restriction in this fascia can directly affect hip alignment and movement, leading to pain or discomfort.

3. Piriformis Fascia:

  • Structure: A thin but firm layer adhering to the piriformis muscle, extending laterally to cover the gluteus minimus, associating with sacral and sciatic nerves.

  • Relation to Hip Pain: Dysfunction here can contribute to piriformis syndrome, a common cause of hip pain. This fascia's relationship with the sciatic nerve also means that disturbances can lead to sciatica, often experienced as radiating hip pain.

4. Iliopsoas Fascia:

  • Structure: It is a continuation of the transversus abdominis muscle fascia, which covers the iliopsoas and quadratus lumborum muscles and connects to various body parts.

  • Relation to Hip Pain: Since the iliopsoas fascia is integral to the function of core and hip muscles, imbalance or restrictions in this fascia can alter hip biomechanics. This may contribute to hip pain, particularly in movements that engage the core and hip flexors.


These insights enhance our understanding of how various fascial structures within the hip region relate to hip pain. It is a complex interplay where even minor imbalances or restrictions can have a pronounced effect on hip function, potentially leading to discomfort or chronic issues. This knowledge underscores the importance of a comprehensive and nuanced approach to diagnosing and treating hip pain, considering the multifaceted roles of fascia in movement and stability.


 

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Acupuncture/Acupressure


In Traditional Chinese Medicine (TCM), acupuncture points, or acupoints, are specific locations on the body known for their therapeutic potential. These points are strategically situated along meridians or channels that guide the flow of energy, or "Qi" (pronounced "chi"), throughout the body. Acupressure, a related practice, involves manually stimulating these points to achieve similar therapeutic effects.


Stimulating acupuncture points in TCM is believed to restore equilibrium, regulate Qi circulation, alleviate pain, and promote healing. This ancient approach aims to maintain harmony and balance within the body's energy system.


Contemporary scientific research supports the physiological basis of these practices. Acupuncture points often coincide with regions dense in nerve endings, blood vessels, and lymphatic vessels, as well as areas with enhanced electrical conductivity. Stimulating these points may trigger physiological responses such as releasing endorphins, neurotransmitters, and other pain-relieving substances and influence blood flow regulation and immune responses.


Acupuncture/Pressure Techniques


In acupuncture, needles are not merely inserted into the skin; they are rotated and manipulated until the acupuncturist perceives a response in the tissue, often referred to as a "tug response." Similarly, acupressure involves more than just moving the tissue around the acupuncture point. It requires considering the exact location, surrounding anatomical structures, and direct fascial connections. The practitioner must palpate for any restrictions in the surrounding area that may be connected to the local acupuncture point being treated.


The acupuncture point is treated with various motions, including clockwise and counterclockwise rotations and fascial kneading of the soft tissue. This often involves rolling the tissue and moving it in multiple directions. While focusing on specific points, it is also essential to consider the fascial kinetic web and the larger kinetic chain that affects the entire body. This technique aims to activate the nervous system, modulate immune function, and release tension within the interconnected fascial network, ultimately alleviating discomfort through precise, targeted stimulation. Understanding the principles of tensegrity further highlights the interconnectedness and dynamic balance of the fascial system.


Specific Acupuncture Points for Hip Pain:

In hip pain, acupuncture points GB30, GB29, and GB34 are often used. These points are typically identified using the Chinese measurement unit "cun," employed in acupuncture to pinpoint locations on the body. One cun is approximately the width of the patient's thumb at the knuckle, 1.5 cun matches the combined width of the index and middle fingers, and 3 cun is equivalent to the width of the patient's four fingers when placed together.


GB30 (Huantiao):

GB30 (Huantiao):

  • Location: It is positioned at the junction where the hip meets the thigh. Specifically, one-third of the way along a line connecting the sacral hiatus to the greater trochanter of the femur.

  • Function: Known as the "Jumping Circle" in TCM, GB30 is often utilized for treating sciatica and hip pain by encouraging the smooth flow of Qi and blood in the Gallbladder meridian. Its stimulation is believed to clear blockages, thus alleviating pain and improving mobility in the hip region.

  • Contraindications: GB 30 should be avoided during pregnancy and in cases of local injury, trauma, or skin infections in the hip or buttock area due to its strong effects on the lower body.


GB29 (Juliao)

GB29 (Juliao - Stationary Crevice):

  • Location: It is situated at the hip joint, specifically in the depression anterior to the greater trochanter of the femur.

  • Function: In TCM, GB29 is referred to as the "Squatting Bone Hole" to clear dampness and cold that may accumulate in the Gallbladder meridian, causing stiffness and pain. By targeting GB29, acupuncturists aim to restore flexibility and alleviate hip pain, particularly when associated with arthritis or other inflammatory hip ailments.

  • Contraindications: The contraindications for the GB 29 acupuncture point include avoiding needling in cases of local skin infections, open wounds, or fractures in the hip area.


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GB34 (Yanglingquan):

  • Location: GB34 (Yanglingquan) is positioned on the outer aspect of the leg, just below the knee, in a depression anterior and inferior to the head of the fibula. This makes it easily palpable in most individuals, particularly in a sitting or flexed knee position.

  • Function: In Traditional Chinese Medicine (TCM), GB34 is known as the "Hui Meeting Point of the Sinews" and is crucial for treating musculoskeletal issues, particularly related to tendons and ligaments. It is often used to alleviate muscle tension, stiffness, and pain, especially in the legs, knees, and hips. While GB34 is frequently applied to hip pain, its influence extends to treating tendonitis, bursitis, sciatica, and general joint discomfort in various regions of the body. Stimulating GB34 is believed to improve Qi circulation (energy flow) and blood circulation, thereby reducing inflammation and enhancing the function of affected joints and muscles. In Western terms, this point is valued for its effects on reducing muscle tension, improving mobility, and relieving pain, particularly in the hip, knee, and lower leg regions.

  • Contraindications: GB34 should be avoided in cases where there are local skin infections, open wounds, or significant inflammation near the knee. Caution is advised when there are fractures, trauma, or recent surgery in the surrounding area, as direct stimulation could aggravate the condition.



Fascial Expansion Demonstration

MSR Fascial Expansion Demonstration

Utilizing fascial expansions in Hip pain management presents an effective strategy that merges contemporary insights in fascia, kinetic chain relationships, and core principles of acupuncture or traditional Chinese medicine. In this video, Dr. Abelson, the Motion Specific Release (MSR) developer, demonstrates using fascial expansions to treat Hip Pain.



 


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Conclusion - MSR Hip Pain Protocol


Hip pain, a multifaceted problem many encounter, finds a nuanced solution in the integrated approach of fascial expansions, kinetic chain relationships, soft tissue manipulation, and acupuncture. This confluence of ancient wisdom and modern scientific understanding provides a holistic method for managing and alleviating hip pain:

  • Fascia's Role: The importance of fascia as a dynamic interconnected system cannot be overstated. It is not merely structural support but a complex network that responds to the body's needs, affecting mobility, stability, and pain in the hip region.

  • Acupuncture and Fascial Integration: Blending acupuncture principles with an understanding of fascial planes presents an innovative path for hip pain treatment. Specific acupuncture points like GB30, GB29, and GB34 embody this synergistic approach, bridging TCM with a modern comprehension of body mechanics.

  • Holistic Treatment Approach: Integrating various methodologies, including soft and osseous manipulations, functional exercises, and insights from traditional Chinese medicine, fosters a comprehensive and evidence-based approach to health. This method respects the intricate interplay of different body components, considering the symptoms and underlying causes of hip pain.


 

References


  1. Bordoni, B., & Zanier, E. (2014). Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary Healthcare, 7, 299-310. doi: 10.2147/JMDH.S66724

  2. Deadman, P., Al-Khafaji, M., & Baker, K. (2007). "A Manual of Acupuncture." Journal of Chinese Medicine Publications.

  3. Ernst, E., & White, A. R. (1998). "Acupuncture for back pain: a meta-analysis of randomized controlled trials." Archives of Internal Medicine, 158(20), 2235-2241.

  4. Guimberteau, J. C., & Armstrong, C. (2015). "Architecture of Human Living Fascia: The Extracellular Matrix and Cells Revealed Through Endoscopy." Handspring Publishing.

  5. Kaptchuk, T. J. (2000). The Web That Has No Weaver: Understanding Chinese Medicine. McGraw-Hill Education.

  6. Kjaer, M., et al. (2018). "Textbook of Sports Medicine: Basic Science and Clinical Aspects of Sports Injury and Physical Activity." John Wiley & Sons.

  7. Langevin, H. M., & Yandow, J. A. (2002). "Relationship of acupuncture points and meridians to connective tissue planes." The Anatomical Record, 269(6), 257-265. DOI: 10.1002/ar.10185

  8. Maciocia, G. (2015). "The Foundations of Chinese Medicine: A Comprehensive Text." Elsevier Health Sciences.

  9. Maciocia, G. (2015). The Foundations of Chinese Medicine: A Comprehensive Text. Elsevier Health Sciences.

  10. Myers, T. W. (2001). "Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists." Churchill Livingstone.

  11. Schleip, R., & Müller, D. G. (2013). Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. Journal of Bodywork and Movement Therapies, 17(1), 103-115. doi: 10.1016/j.jbmt.2012.06.007

  12. Schleip, R., et al. (2012). "Fascia: The Tensional Network of the Human Body." Churchill Livingstone.

  13. Stecco, C., et al. (2014). "Functional Atlas of the Human Fascial System." Elsevier.

  14. Travell, J. G., Simons, D. G., & Simons, L. S. (1999). "Myofascial Pain and Dysfunction: The Trigger Point Manual." Lippincott Williams & Wilkins.

  15. Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., ... & Linde, K. (2018). Acupuncture for chronic pain: Update of an individual patient data meta-analysis. The Journal of Pain, 19(5), 455-474. doi: 10.1016/j.jpain.2017.11.005



 
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DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

Dr. Abelson is dedicated to using evidence-based practices to improve musculoskeletal health. At Kinetic Health in Calgary, Alberta, he combines the latest research with a compassionate, patient-focused approach. As the creator of the Motion Specific Release (MSR) Treatment Systems, he aims to educate and share techniques to benefit the broader healthcare community. His work continually emphasizes patient-centred care and advancing treatment methods.



 


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1件のコメント


Kamali at MSR
2月26日

Excellent article... I love the acupuncture point images that help me to visualize where we need to focus treatments, and the merging of multiple health perspectives into a cohesive whole. Keep this coming!😀

いいね!
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