Receptors and Fascia
John Wilks
www.cyma.org.uk
Fascial Mechanoreceptors and
their potential role in deep tissue
manipulation
Robert Schleip
University of Ulm
Fascia is the most richly
innervated tissue in the body
The largest sense organ in
the body with high density of
proprioreceptors
Does Fascia contract?
Contraction vs
Contracture
What structures do we move
over?
Found in:
•  Muscles
•  Tendons
•  Ligaments
•  Nerves
•  Joints
•  Blood vessels
•  Others?
Intrafascial Mechanoreceptors
•  Respond to different types of touch
•  Have different physiological effects on the
body
•  Golgi
•  Pacini
•  Ruffini
•  Interstitial
What do Bowen moves do?
•  Bowen moves involve a stimulation of intrafascial
mechanoreceptors. Their stimulation leads to an altered
proprioceptive input to the central nervous system, which then
results in a changed tonus regulation of motor units associated
with this tissue.
•  In the case of a slow deep pressure, the related
mechanoreceptors are most likely the slowly adapting Ruffini
endings and some of the interstitial receptors; yet other
receptors might be involved too, (e.g. spindle receptors in
affected muscle fibers nearby and possibly some intrafascial
Golgi receptors).
What does research tell us?
•  Bowen helps hydration of the myofascia
•  Bowen stimulates efficient nerve and blood supply by creating
more fluidity in the surrounding connective tissue
•  Bowen aids relaxation by lowering the stress response and
increasing vagal tone
•  Bowen allows proprioceptive pathways to change resulting in
long-term changes in posture
“The soul of man, with all the
streams of pure living water,
seems to dwell in the fascia of
his body.”
AT Still MD
Types of Fascia:
•  Superficial Fascia –
•  Deep Fascia (Axial or Investing Fascia)
•  Meningeal Fascia
•  Visceral Fascia
‘Fascial recoil’
Apneuroses tend to act rather like
a bungie – eg effortless running.
Aponeuroses
o  Aponeurosis, a flat sheet or ribbon of tendonlike
material that anchors a muscle or connects it with
the part that the muscle moves. The aponeurosis is
composed of dense fibrous connective tissue
containing fibroblasts (collagen-secreting spindleshaped cells) and bundles of collagenous fibres in
ordered arrays. Aponeuroses are structurally similar
to tendons and ligaments.
Thoracolumbar aponeurosis
3 layers:
•  Thin outer layer of collagen fibres oriented
transversely
•  Thick middle layer of massive collagen bundles
running obliquely
•  Thin inner layer of loose connective tissue
Epimysium
Perimysium
Endomysium
Mae Wan Ho, Robert Becker &
James Oschman
 Impulses are created in the collagen fibres by light
pressure.
 Stressing collagen fibres by applying gentle pressure
creates a small electrical charge which has strong healing
properties.
 Impulses are affected by heat.
 The conductivity of collagen increases strongly
depending on how hydrated it is.
 Impulses created at certain points in the fascial tracts
will be amplified via the action of proteins in liquid
crystals.
 Impulses will travel more strongly along the orientation
of the collagen fibres as opposed to other directions.
  Conductivity along the lines of collagen fibres is
adversely affected by certain substances, for example
anaesthetics and cortico-steroids.
Intrafascial Mechanoreceptors
•  Respond to different types of touch
•  Have different physiological effects on the
body
•  Golgi
•  Pacini
•  Ruffini
•  Interstitial
Golgi Receptors
Found in:
•  Myotendinous junctions (Golgi Tendon Organs) &
attachment areas of aponeuroses
•  Tendons (only 10% are found here)
•  Ligaments (Golgi End Organs) and peripheral joints
•  Joint capsules (the ligaments)
Golgi Receptors
Respond to:
•  Slow, strong, deep stretching
•  Working close to attachments essential otherwise
most of the stretch is taken up by the muscle fibres
(Jami 1992)
•  Might be assisted by active movement of the client
(as in yoga stretches)
Golgi Receptors
•  Golgi receptors are said to be found all over in dense proper
connective tissues.
•  They exist in ligaments (called Golgi end organs), in joint
capsules, as well as around myotendinous junctions (here called
Golgi tendon organs). These sensory receptors are arranged in
series with fascial fibers and respond to slow stretch by
influencing the alpha motor neurons via the spinal cord to lower
their firing rate, i.e. to soften related muscle fibers.
•  Cottingham suggested that during soft tissue manipulation – as
well as in Hatha yoga postures and slow active stretching –
these Golgi receptors are stimulated, which results in a lower
firing rate of specific Alpha motor neurons, which then
translates into a tonus decrease of the related tissues.
Which Bowen moves are
involved?
•
•
•
•
Hit the Lat
Move 2 Pelvic
Hamstring move 1
Hamstring move 4 & 5?
Ruffini Receptors
Respond to:
•  Lateral shearing forces
Stimulation results in:
•  a global inhibition of sympathetic activity
Ruffini Receptors
Found in:
•  Ligaments of peripheral joints
•  Dura mater
•  Outer capsular layers
•  All types of dense proper connective tissue, i.e. in
muscle fascia, tendons, ligaments, aponeuroses, and
joint capsules
Ruffini Receptors
Respond to:
•  Slow melting pressure
•  combined with lateral shearing
Ruffini Receptors
The smaller and more longitudinal Ruffini organs
which do not adapt as quickly and therefore respond
also to long term pressure.
It seems likely that the Pacinian receptors are being
stimulated only by high velocity thrust manipulations
as well as in vibratory techniques, whereas the Ruffini
endings will also be activated by slow and deep
‘melting quality’ soft tissue techniques.
Ruffini
The Ruffini endings are specially dense in tissues associated with
regular stretching like the outer layer of joint capsules, the Dura
mater, the ligaments of peripheral joints, and the deep dorsal
fascia of the hand.
At the knee joint the Ruffini endings are more frequent at anterior
and posterior ligamentous and capsular structures, whereas
Pacinian bodies are more accumulated medially and laterally of
the joint (van den Berg & Capri 1999).
Ruffini’s
It is of interest to note that Ruffini endings are specially responsive
to tangential forces and lateral stretch (Kruger 1987) and that
stimulation of Ruffini corpuscles is assumed to result in a
lowering of sympathetic nervous system activity (van den Berg
& Capri 1999).
This seems to fit to the common clinical finding, that slow deep
tissue techniques tend to have a relaxing effect on local tissues
as well as on the whole organism.
Ruffini’s and Vagal tone
•  An increase in vagal tone does not only trigger changes in the
autonomic nervous system and related inner organs, but also
tends to activate the anterior lobe of the hypothalamus.
•  Such a ‘trophotropic tuning’ of the hypothalamus then induces a
lower overall muscle tonus, more quiet emotional activity, and
an increase in synchronous cortical activity, both in cats as well
as in humans (Gellhorn 1967).
•  It therefore appears that deep manual pressure – specifically if
it is slow or steady- stimulates interstitial and Ruffini
mechanoreceptors, which results in an increase of vagal activity,
which then changes not only local fluid dynamics and tissue
metabolism, but also results in global muscle relaxation, as well
as a more peaceful mind and less emotional arousal.
Pacini Receptors
Functions:
•  Proprioreceptive feedback for movement
coordination
•  Stimulation by practitioner tends to increase local
proprioceptive attention and self-regulation
Pacini Receptors
Respond to:
•  Sudden pressure release
•  High velocity adjustments
•  Vibratory tools
•  Rocking, shaking, rhythmic joint compression
Pacini’s and Ruffini’s
Both types of intrafascial mechanoreceptors, the Pacinian/
Paciniform and the Ruffini bodies, are found in all types of
dense proper connective tissue, i.e. in muscle fascia, tendons,
ligaments, aponeuroses, and joint capsules. In myotendinous
junctions the Pacinian corpuscles are more frequent on the
tendinous site (as opposed to the Golgi tendon organs which
are more frequent on the muscular site). They have also been
shown to be more frequent in the deeper portions of joint
capsules, in deeper spinal ligaments, and in investing (or
enveloping) muscular fasciae like the antebrachial, crural,
abdominal fascia or the fascia of the masseter, the lateral thigh,
in plantar as well as palmar tissues, and in the peritoneum
(Stilwell 1957).
Interstitial Receptors
•  50% high threshold fibres
•  50% responsive to very subtle stimulation (eg skin
touch such as brushing)
•  Most abundant receptor in the body
•  Found almost everywhere, even inside bones
•  Highest density in the periosteum (outer layer of
bones)
Chronic pain
People with chronic lower back pain have been found
to have an absence of the normal number of
proprioceptors in the lower lumbar fascia but a larger
area in the cortex associated with pain reception for
the lower back.
One way to redress the balance which has shown to
be effective in Bowen work is to stimulate the nerve
endings in the fascia in the lower lumbar area (eg
kidney work etc)
Chronic Pain
•  Recent insights into the physiology of pain have shown that
several interstitial tissue receptors function both as
mechanoreceptors and as pain receptors.
•  In the presence of pain – and the support of various
neuropeptides - their sensitivity changes such that normal
physiological pressure changes often lead to strong and chronic
firing of these receptors. This explains why current research has
revealed that pain often exists without any mechanical irritation
of nervous structures as was frequently assumed by the rootcompression model (Chaitow & DeLany 2000).
Interstitial Receptors
•  Strong stimulation can increase vasodilation and
plasma extrusion (ie brings fluidity into an area)
•  Also used for interoception (and probably
proprioception)
•  Can function as mechanoreceptors and/or
nociceptors
•  Almost certainly involved in chronic pain situations
•  Receptor sensitivity is frequently modulated by
neurotransmitters (eg cytokines)
Interstitial Receptors
Ways of working with them:
•  Work with periosteum, interosseous membranes and
other fasciae connected with bones
•  Work with the intention of re-sensitizing the
interstitial mechanoreceptors (ie without eliciting a
pain response)
•  If you get an autonomic response you know you
have hit the mark
Fibroblasts & Myofibroblasts
Most prominent cells in Fascia
•  Act as construction workers, cleaners and
repair handymen
•  Have a life-span of a few months
•  Stress has a role in converting fibroblasts to
myofibroblasts
•  People with hypermobility syndrome appear
to have less myofibroblasts in the fascia
•
Myofibroblasts
  Slow to respond
  Affected by pH
  Affected by
emotional stress
Myofibroblasts
Found in large fascial sheets and aponeuroses
•  Affected by stretching which increases the amount
and alignment of the contractile actin molecules
•  There is more Myofibroblasts in ‘Frozen’ tissue such
as frozen shoulder or lumbar pain.
•  They are affected by inflammatory conditions – ie
an anti-inflammatory diet would be beneficial
•  Affected by stress and SNS activation – SNS
activation will tend to encourage fibroblasts to
become myofibroblasts
•  They express a rhythmic oscillation of about 90
seconds
•
Hydration of Fascia and
Ground Substance
Water molecules in contact with collagen fibres:
Water bound within the triple helix of .the collagen
molecules
Water molecules bound on the surface of the triple
helix
Actually, in a balanced body
Free water within the space
the fibrils
thebetween
soft tissues
support the
skeleton
Hydration of fascia occurs after:
•  Gentle stretching
•  Pressure applied and then waiting
•  Waiting time essential – 2.5% after half an hour
•  Repetitive squeezing and release with pauses
•  Dehydration occurs through under-use and ageing –
mostly occurs in the ground substance.
Ground Substance
Found in all of the body's connective tissues,
Like raw egg whites in appearance and consistency
Surrounds all the cells in the body
Produced by cells which are among the earliest specialized
cells to emerge from the embryonic mesoderm, the
fibroblasts.
Its make-up varies from location to location
They influence the passage of all sorts of gases, nutrients,
wastes, hormones, antibodies, and white blood cells between
the capillaries and the tissues
Liquid Crystal
Connective tissue in its various forms can be regarded as a
fluid crystal, a largely non-living material that can be adjusted
over a wide range from sol to gel-here watery, there gelatinous,
here dense and elastic, there hard as a stone
Thixotrophy
Mechanical motion and friction caused by muscular activity provides
much of the energy and warmth that maintains the fluid qualities of
ground substance.
R.B. Taylor, an osteopathic physician, has stated that, "Manipulative
pressure and stretching are the most effective ways of modifying the
energy potentials of abnormal tissues.”
By means of pressure and stretching, and the friction they generate, the
temperature and therefore the energy level of the tissue is raised slightly.
This added energy in turn promotes a more fluid ground substance in
which nutrients and cellular wastes can conduct their exchanges more
efficiently.
Skillful manipulation simply raises energy levels and creates a greater
degree of sol (fluidity) in organic systems that are already there, but are
behaving sluggishly. The effect can be analogous to that of turning up
the temperature and humidity in a greenhouse that has been too dry and
cold.
Thank you for taking part!
The following webinars have been arranged so far for 2013:
14 May - Working with Babies and Pregnancy with John Wilks
21 May - Releasing the Psoas with Louise Tremblay (Canada)
11 June – FREE WEBINAR on Bowen in Palliative Care - Nickatie
DiMarco and others – contact for details
30 July - Bowen, fascial lines and tensegrity with Kelly Clancy (USA)
31 August (Saturday morning) - Bowen and the Energetic Interface
with Margaret Spicer (Australia)
17 September - Promoting your Bowen business with Alexia
Munroe (USA)
Dr John Coleman (Australia) will also be presenting a webinar on
working with Parkinsons (date TBA)
Details at: www.cyma.org.uk