Fascial Expansions: Neck Protocol
- Dr. Brian Abelson
- Jul 20, 2023
- 10 min read
Updated: Jan 16
Unlocking the potential of fascial expansions in treating neck pain offers a powerful and holistic approach, merging modern insights into fascia, kinetic chain dynamics, and the core principles of acupuncture and traditional Chinese medicine.
This article explores how fascial planes intersect with key acupuncture points such as GV20, GV16, SI15, TE17, SI10, and LI4, demonstrating their ability to significantly enhance treatment outcomes for conditions like whiplash and chronic neck pain.
Practitioners can achieve optimal results for their patients by integrating these techniques with soft tissue therapy, osseous adjustments, and personalized functional exercise programs.
Article Index
Fascia
Fascia is often defined as "one interconnected tensional network that adapts its fibre arrangement and density according to local tensional demands." When fascial tension is in good balance, fascia distributes force throughout the body, allowing us to store and release energy for propulsion. When fascial tension is out-of-balance, hypertensive, or restricted, fascia can become the source of various dysfunctions, including neck pain. (Image from "Functional Atlas of the Human Fascial System," I highly recommend this text by Carla Stecco. Click on the Image for the link)
Fascia of the Neck - Layer 1
The deep neck fascia's initial layer wraps the neck with a variable thickness. It partitions around the sternocleidomastoid and trapezius muscles, extending medially to unite with the contralateral fascia. It also fuses with the superficial fascia, creating the cervical linea alba. It attaches at several locations, including the lower border of the mandible, mastoid process, superior nuchal line, and the external occipital protuberance, while forming the angular and stylomandibular ligaments. This layer also links to the spine, acromion, clavicle, and sternum and connects with the fascia of various major muscles.
Fascia of the Neck – Layer 2
The second layer of the deep neck fascia encompasses four muscles: the splenii, levator scapulae, rhomboids, and serratus posterior superior. These muscles are encased by the neck's middle fascia layer, which merges with the serratus anterior muscle's fascia. Consequently, the neck's middle fascia layer forms a continuous structure with the thorax fascia's middle layer in the front and back.
Fascia of the Neck – Layer 3
The third layer of the neck's deep fascia, often termed the prevertebral fascia, primarily shields the anterior vertebral muscles and stretches laterally on the anterior, medius, and posterior scalenus. This deep layer also has a posterior part that covers the longissimus and semispinalis muscles. It additionally encompasses the rectus, longus capitis muscles, and sympathetic nerves.
Acupuncture/Acupressure
& Neck Pain
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, influencing 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 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
In Traditional Chinese Medicine (TCM), acupuncture points GV20, GV16, SI15, TH17, SI10, and LI4 are frequently used to alleviate neck pain. 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.
GB 20 (Fengchi):
Location: GB 20, also known as Fengchi, is a significant acupuncture point located in the depression between the upper portion of the sternocleidomastoid muscle and the trapezius muscle, just below the occipital bone.
MSK: This point can be used in musculoskeletal (MSK) conditions to alleviate neck stiffness, shoulder tension, and headaches caused by muscle tightness and poor posture.
TCM: In traditional Chinese medicine, GB 20 is also used to treat conditions such as dizziness, insomnia, common colds, and hypertension by promoting the circulation of Qi and blood and clearing wind and heat from the body.
Contraindications: GB 20 should be used with caution in individuals with severe cervical spine issues or fractures, and deep needling should be avoided to prevent injury to the spinal cord or brainstem.
GV16 (Fengfu):
Location: Positioned at the base of the skull, in the depression directly below the external occipital protuberance. It's midway between the mastoid processes. This point is often used for relieving neck pain, headaches, and certain eye problems.
Contraindication: GV16 (Fengfu) should be avoided in cases of acute head or neck trauma, high fever, severe hypertension, or localized infections at the point of application.
SI15 (Jianzhongshu):
Location: 2 cun lateral to the lower border of the spinous process of the seventh cervical vertebra (C7).
Function: This point typically treats upper back pain, shoulder tension, and respiratory issues like asthma.
Contraindication: This should be avoided in acute shoulder or neck trauma, severe respiratory conditions, and localized infections at the point of application.
TE17 (Yifeng):
Location: Located just behind the earlobe, in the depression between the mandible and the mastoid process. It's one cun posterior to the midpoint of the intertragic notch.
Function: TE17 (Yifeng) is beneficial for neck pain as it helps to improve circulation, reduce inflammation, and alleviate muscle tension in the neck region. This point is frequently used for ear and jaw problems, including tinnitus, ear infections, and TMJ disorders.
Contraindication: It should be avoided in cases of acute ear infections, mastoiditis, or any severe inflammation or infection around the ear area.
SI10 (Naoshu):
Location: When the arm is adducted (close to the body), it is on the posterior aspect of the shoulder, in the depression inferior to the scapular spine, directly above the posterior axillary fold.
Function in TCM: SI10 is a key point for alleviating shoulder pain and stiffness. It promotes the smooth flow of Qi and blood in the shoulder region, making it essential for treating shoulder-related issues.
Contraindication: avoided in cases of acute shoulder injuries, severe inflammation, or infection in the shoulder area.
LI4 (Hegu):
Location: It is found on the back of the hand, between the thumb and index finger. It's in the midpoint of the second metacarpal bone, radially towards the thumb.
Function: This point is commonly used to relieve headaches, toothaches, and various types of pain and to induce labor in pregnant women.
Contraindication: LI4 is contraindicated during pregnancy, especially in the first trimester and near term. Stimulating this point can potentially induce labour or cause uterine contractions, increasing the risk of miscarriage or premature birth.
Fascial Expansion Demonstration
Fascial Expansion: MSR Neck Pain Protocol
Utilizing fascial expansions in neck pain management presents an effective strategy that merges contemporary insights in fascia, kinetic chain relationships, and core acupuncture or traditional Chinese medicine principles. In this video, Dr. Abelson, the Motion Specific Release (MSR) developer, demonstrates using fascial expansions to treat neck pain.
Conclusion
Integrating fascial expansions with acupuncture points to treat neck pain presents a holistic and powerful approach that leverages a modern understanding of fascia, kinetic chain dynamics, and traditional Chinese medicine principles. By targeting specific acupuncture points such as GV20, GV16, SI15, TH17, SI10, and LI4, this method can significantly enhance treatment outcomes for various neck pain conditions, including whiplash and chronic neck pain.
Combining these techniques with soft tissue therapy, osseous adjustments, and a personalized functional exercise regimen is crucial for optimal results. This comprehensive strategy addresses the symptoms and targets the underlying causes of neck pain, promoting long-term relief and overall well-being. By embracing this integrative approach, practitioners can offer patients a path to recovery that is both effective and sustainable.
References
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DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 90%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.
As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.
A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.
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