Updated: Nov 2
Fascial expansions encompass a vast network of fascial planes connecting anatomical structures like the jaw, shoulder, and hip. Composed mainly of collagen, fascia surrounds and weaves through muscles, bones, and organs, offering support and aiding biomechanical interactions. These planes are adaptive, changing their structure in response to mechanical forces, facilitating force distribution essential for biomechanics and musculoskeletal health. They also play a role in energy storage and release during motion.
Recognizing the fascial system's interconnectedness aids in understanding and treating musculoskeletal conditions. Restrictions in one fascial region can cause issues elsewhere, leading to pain and movement restrictions. Therapies focusing on the fascial system, including manual therapies and acupuncture, are effective in addressing these issues, ensuring balanced force distribution.
Fascial Expansions and TCM
Addressing temporomandibular joint disorders (TMJ/TMD) by leveraging fascial expansions provides a well-rounded method that brings together the latest fascial research, the understanding of kinetic chain connections, and the time-tested principles of acupuncture or traditional Chinese medicine. In this article, we'll explore how fascial layers interact with acupuncture points Yin Tang, GB20, TH5, LI4, and B60. To achieve the best outcomes, it's important to combine this approach with both soft tissue and osseous techniques, as well as incorporate a routine of functional exercises.
Headache Fascial Planes
Addressing restrictions in fascial planes is possible through various techniques, such as acupuncture and hands-on manipulation (soft tissue and skeletal procedures). The fascial planes outlined below play a significant role in the development of headaches, making it essential to consider these primary regions:
Epicranial Fascia: This fascinating fascia connects the occipitalis and frontalis muscles, seamlessly extending to the temporal fascia that wraps around the temporalis muscle. As you move forward, the epicranial fascia transforms into Tenon's fascia.
Tenon's Fascia: Acting as a protective sheath, Tenon's fascia surrounds the levator muscle of the upper eyelid. Interestingly, the rear third of Tenon's fascia combines with the orbital fat, ultimately connecting to the optic nerve's protective covering.
Deep Temporal Fascia: A dense layer surrounding the temporalis muscle, offering attachment for superficial fibers. It connects with the epicranial fascia superiorly and adheres to the superior temporal line. Inferiorly, it splits into superficial and deep laminae, attaching to the zygomatic arch's lateral and medial edges.[11,12].
Image: Stecco, Carla; Stecco, Carla. Functional Atlas of the Human Fascial System (p. 109). Elsevier Health Sciences. Kindle Edition. I highly recommend this atlas, click the link or the above image.
Acupressure: A Closer Look
Acupuncture points, also known as acupoints or simply points, are specific locations on the body identified in Traditional Chinese Medicine (TCM) to possess therapeutic effects when stimulated. These points are located along meridians or channels, believed to be pathways of energy flow called "Qi" (pronounced "chi") throughout the body. According to TCM, stimulating acupuncture points can help restore balance, regulate the flow of Qi, alleviate pain, and promote healing in the body.
Recent research has shown that acupuncture points often correspond to areas with a high density of nerve endings, blood vessels, and lymphatic vessels, as well as increased electrical conductivity. This suggests that the stimulation of acupuncture points may have physiological effects, such as the release of endorphins, neurotransmitters, and other pain-relieving substances, as well as the regulation of blood flow and the immune system.
Regarding acupuncture techniques, needles are not merely inserted; they are rotated and pulled back and forth until the acupuncturist perceives a response in the tissue (sometimes referred to as a tug response).
Acupressure follows a similar approach: stimulating a region to activate the nervous system and release tension within a fascial network of interconnected tissue.
Specific Acupuncture Points
In Traditional Chinese Medicine (TCM), acupuncture points Yin Tang, GB20, TH5, LI4, and B60 commonly alleviate pain associated with headaches.
Note: We employ the same point when utilizing acupressure instead of acupuncture. The choice of technique depends on your professional scope of practice. It's crucial to remember that we're working on the acupuncture point and releasing the surrounding fascia.
The location of these points is often described using the Chinese term "cun," a unit of measurement employed in acupuncture for locating points on the body. One cun is approximately equal to the width of the patient's thumb at the knuckle:
Yin Tang (Hall of Impression)
Location: Positioned midway between the medial ends of the eyebrows, above the bridge of the nose.
Indications: Headaches, nasal congestion, sinusitis, stress, and anxiety.
GB20 (Feng Chi)
Location: Located at the base of the skull, in the depression between the upper attachments of the sternocleidomastoid and trapezius muscles.
Indications: Headaches, neck stiffness, dizziness, vertigo, and hypertension.
Location: Located on the forearm, approximately two finger widths proximal to the wrist crease, between the ulna and radius.
Indications: Headaches, pain in the upper extremities, wrist pain, and fever.
LI4 (He Gu)
Location: Found in the fleshy area between the thumb and index finger, at the highest point of the muscle when the thumb and index finger are brought together.
Indications: Headaches, toothaches, facial pain, and neck pain.
B60 (Kun Lun)
Location: Situated between the Achilles tendon and the lateral malleolus on the foot.
Indications: Headaches, lower back pain, ankle pain, and leg pain.
Fascial Expansion Demonstration
Headache: Fascial Expansion
In this video Dr. Abelson discusses the fascial planes directly related to headaches in this video. He then demonstrates how practitioners combine this knowledge with Traditional Chinese Medicine (Acupuncture/Acupressure). By understanding the interconnected nature of fascial planes, their effect on jaw function, and the specific acupuncture points and techniques used in TCM, practitioners can effectively alleviate pain for patients with Headaches. Note: Acupressure section LI 4 acupuncture point should NOT be used during pregnancy. This video is available June 7th/2023.
In conclusion, fascial planes' intricate and interconnected nature plays a significant role in our understanding of musculoskeletal health and treating various conditions, including headaches. By combining the latest fascial research, knowledge of kinetic chain connections, and time-tested principles of Traditional Chinese Medicine, practitioners can leverage a well-rounded approach to address temporomandibular joint disorders and other musculoskeletal issues.
Acupuncture and acupressure techniques that target specific points like Yin Tang, GB20, TH5, LI4, and B60 can effectively alleviate pain and restore balance in the body. By integrating these techniques with soft tissue and osseous manipulation, as well as functional exercises, practitioners can promote optimal force transmission, enhance biomechanics, and ultimately improve patients' overall health and well-being.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson is committed to running an evidence-based practice (EBP) incorporating the most up-to-date research evidence. He combines his clinical expertise with each patient's specific values and needs to deliver effective, patient-centred personalized care.
As the Motion Specific Release (MSR) Treatment Systems developer, Dr. Abelson operates a clinical practice in Calgary, Alberta, under Kinetic Health. He has authored ten publications and continues offering online courses and his live programs to healthcare professionals seeking to expand their knowledge and skills in treating musculoskeletal conditions. By staying current with the latest research and offering innovative treatment options, Dr. Abelson is dedicated to helping his patients achieve optimal health and wellness.
Despite being in the field for over three decades, Dr. Abelson remains open to welcoming new patients at Kinetic Health, save for the periods he dedicates to teaching or enjoying travels with his cherished wife, Kamali. However, be forewarned, he will anticipate your commitment to carry out the prescribed exercises and punctuality for your appointments (smile). His dedication towards your health is absolute, particularly in ensuring that you can revel in life unimpeded. He genuinely delights in greeting both new faces and familiar ones at the clinic (403-241-3772).
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Attend our courses to equip yourself with innovative soft-tissue and osseous techniques that seamlessly integrate into your clinical practice and empower your patients by relieving their pain and restoring function. Our curriculum marries medical science with creative therapeutic approaches and provides a comprehensive understanding of musculoskeletal diagnosis and treatment methods.
Our system offers a blend of orthopedic and neurological assessments, myofascial interventions, osseous manipulations, acupressure techniques, kinetic chain explorations, and functional exercise plans.
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