INTEGRATIVE FASCIAL RELEASE COURSE – AUTONOMIC MANIPULATIONS – Cape Town

INTEGRATIVE FASCIAL RELEASE COURSE - AUTONOMIC MANIPULATIONS - Cape Town
When
03 Feb 2016 - 05 Feb 2016    
9:00 am - 5:00 pm
Bookings
Bookings closed
Where
met golf club
fritz sonnenberg drive, mouille point, Cape Town
Lecturer
Steven Goldstein
Short Description
CPD Points
21 attendance ceus and 3 free optional ethics home study ceus
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Important Information

THE INTEGRATIVE FASCIAL RELEASE (IFR) COURSE; PART 1 – Autonomic Manipulations – Cape Town; 3-5 Feb 2016; R3900

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Course material

MORE INFO

Syllabus Autonomic Manipulation-Foundations Workshop 2016 in South Africa By Steven Goldstein

Bachelor Arts in Education, Western Washington University 1984 & Bachelor Health Sciences Musculoskeletal Therapy, Australian College of Natural Medicine 2007

Syllabus

Foundations:  Autonomic Manipulation

Day One

Module 1 One

Introductions & Information     1. Hour/60min

Introductions and Information about Integrative Soft-Tissue Release

References and Reading List:

The Fascia: Serge Paoletti

Anatomy Trains 3nd Edition, Thomas Myers,

ARTICLE Neurobiology of Fascial Plasticity, Parts 1 & 2: Robert Schleip

Fascia: The Tensional Network of the Human Body: Robert Schleip

Assessment & Treatment of Muscle Imbalance – The Janda Approach: Page, Frank & Lardner

Integrative Manual Therapy for the Connective Tissue System Vol.IV, Giammatteo & Kain, 2005 North Atlantic Books

Biotensgrity-The Structural Basis of Life, Graham Scarr 2014 Handspring Press

 

  • MyoFascial Treatment Appraoches and Methods: Autonomic, Movement and Mechanical
  • Properties of Connective Tissue-Fascial Anatomy-Tensegrity
  • The Nervous System: Theory-Ability to Manipulate Touch Stimulating Sensory Receptors through Lighter Touch and Low Force Active Resistive
    • Two Point Holding Technique
    • ‘Stacking’ for three dimensional change
  • Expressions of the Autonomic Nervous System and Autonomic Exhaustion

 

Module 2 Two                            2 hour/120 min

Assessments Principles

Postural Considerations

  • Sum of all body positions

Functional Patterns for Assessment

  • Janda’s Cross Patterns

Myofascial Patterns

Global Myofascial Line Restrictions

  • Cardinal Line Restrictions: Anterior, Posterior & Lateral
  • Myers: Anatomy Trains: SFL, SBL, LL
  • Paoletti: Fascial Chains: Anterior, Posterior
  • Schleip; High Leverage Points in the Myofascial Net
  • Schultz: Endless Web-Body Straps: circumference restrictions

 

Muscular Patterns

 

  • Assessing muscular patterns is necessary to understand soft-tissue dysfunction
  • Basic patterns such as Upper and Lower cross syndrome (Janda)
  • Muscular subsystems functioning:
    • Lateral Subsystem LSS
    • Deep Longitudinal DLS
    • Posterior Oblique POS
    • Anterior Oblique AOS

 

  • MET Modified for ISTR
    • Lower Force Contractions 10% or less
    • Use of Reciprocal Inhibition to change pain or pressure sensation
    • Compound Resistive

Functional Assessment

 

Joint Accessory Motion Assessment-Fascial Articulations

  • All planes of gliding motion are needed for optimal function for all joints.
  • Assessment is:
    • Compression/Distraction
    • Lateral translatory glide
    • Anterior/posterior direction
    • Inferior/superior direction

 

Break .3 hour/ 20 min    

 

Ligaments:

  • Properties
  • Treatment

 

Assessment

Locating Myofascial Restrictions 

Areas to which fascia adheres:

  • Bony prominences
  • Musculotendinous junctures
  • Muscular boundaries and layers

 

Palpation: Ease and Bind As An Osteopathic Assessment:

  • Palpation and Motion Restrictions
    • Used for myofascial restrictions
    • Joint motion assessment
  • Application of Force

Tensegrity Techniques

  • Compression
  • Tension

 

Module 3 Three         2 hour/120 min

Active-Passive Techniques Utilized in ISTR:

  • Compression
  • Tension
  • Active Movement Participation
  • ‘Stacking’
  • Modified MET
  • Ligament ‘Friction’

Autonomic Nervous System Techniques

Coordinating the ‘eight diaphragms.’

Passive ‘holding’ techniques for parasympathetic stimulation

  • Use of the Two Point
  • Listening for ANS Parasympathetic Response
  • Ease & Bind for Tissue Change
  • Three cardinal planes of skin motility to assess superficial fascia
  • Application of the ‘Fulcrum’

 

Osteopathic Autonomic Nervous System Techniques

 Sequence 1.1   Two Point To Coordinate the Eight Diaphragms

Axial Spine  

Complete Protocol

Two-Point Technique for Coordinating the Eight Diaphragms.

  • Pelvic/Urogenital
  • Lumbar-Abdomen
  • Respiratory-Solar Plexus
  • Thoracic Outlet-Inlet
  • Hyoid
  • Cranial Base

Sequence 1.2  Integrating Two-Pointing for Lower Extremity Joints & Diaphragms

Protocol

  • Sacrum or Illiac Crest / Umbilical
  • Sacrum / Ischial Tuberosity
  • Inguinal Crease / Ischial Tuberosity
  • Patella / Politeal Fossa
  • Ankle / Calcaneal / Talus
  • Ankle / Lateral & Medial Malleolus
  • Transverse Arch

Sequence 1.3: 

Palpation Assessment Using Ease-Bind

  • Assess three planar direction of myofascia using skin direction to assess superficial fascia restriction
  • Assess ‘ease-bind’ to joint motion

 

Sequence 1.4 

Stacking with the 3D Planar Fulcrum (Giammatteo) -Two Point

  • Osteopathic ‘Stacking’: engaging multiple barriers in 3 planes/vectors through demonstration of technique.

Fulcrum Application

4 directions of compressive force are now occurring

Ease-Bind Assessment

  • Engagement of superficial fascia
  • Superior/inferior sagittal plane
  • Coronal plane clockwise/counterclockwise
  • Transverse plane medial or lateral directions
  • Do not release ‘fulcrum’, resist the urge to follow tissue.
  • Maintain fulcrum

 

Sequence 1.5:  Active Resistive Muscle Testing:

 Assessment for Facilitation/Inhibition of Muscular Units

The use of active resistive for muscle evaluation is a fundamental assessment tool and technique for sensory receptor manipulation through the motor control center to change muscular function.

Active muscle testing is used in which a minimum of force is first used to detect if the muscle is inhibited.

 

 

Muscle Firing Patterns  –  Functional Assessment

  • Muscular Firing Patterns
  • Compound Movement Relationships

 

Lunch  45 min- 1 hour

Module 4  Four                 2.5 hour/ 150 min

Cardinal Lines of Myofascial Tension

Line Palpation: Myers Anatomy Trains

  • Ease-Bind Palpation Assessment
  • Superficial Front Line
  • Superficial Back Line
  • Lateral Line

Sequence 2.1  Sidelying Static Compression for Lateral Line     

Direct Technique: Static Compression for the High Leverage Points 

Sidelying Position

  • Greater Trochanter
  • Serratus Anterior
  • Shoulder/Scapula/Thorax

Sequence 2.2   Sidelying  Sleeve Release: Superficial Front & Back Line

Sidelying Position

  • Ease-Bind Palpation Assessment
  • Superficial Front Line Sleeve Release
  • Superficial Back Line Sleeve Release

 

Leverage Compression/Tension for Hip & Pelvis

Sequence 3   Low Extremity Levers  

Sequence 3.1  Compression Long Levers-Straight Leg

  • Femoral Long Lever Neutral
  • Femoral Rotations
  • Engage Ease position first

Sequence 3.2: Low Extremity Short levers 

Short Levers-Bent Knee Three Positions:

  • Foot on table walking leg/thigh though flexion, abduction & return to straight leg on table
  • Foot on table, adding slight compression to foot on table through knee into SI Joint
  • Foot on or off table, re-enforcing SI Joint with forearm.
  • Foot off table, adding slight compression to foot on table through knee into SI Joint

Golgi Tendon Organ Release for Hamstrings & Rectus Femoris Musculature

Sequence 3.3   Tension Leg Pulls-‘Straight Leg Raise’

  • Ease-Bind Motion Assessment
  • Line of tension
  • Engaging tension
  • Stack various tension directions
  • Assess lower extremity twists
  • Engage thigh sleeve-counter-twist sural/crural sleeve

Module 5 Five                    .75 hour/ 45 min    

Leverage Compression for Hip & Pelvis

Sequence 3.4  Compression

Femoral Hip ‘Scour’

Supine

  • Circumduction of the hip joint with sustained compression while re-enforcing stability of SI Joint with bottom hand.

Sequence 3.5: Two Legged SI Joint Release          

  • Pelvic Hip Balancer
  • Straight- leg raise with both legs in long lever position
  • Light compression engagement of SI joint and release.

 

 

Day Two

 

Module 6 Six            .75 hour/ 45 min             

Revision day one material

 

Module 7 Seven       1 hour/ 60 min        

Introduction to Modified MET : Thoracic Spine Levers

Sequence 4: View Video

Joint Receptor Enhancement for the Thorax Utilizing LeversActive Resistive

Active Resistive  

Sequence 4.1  Thoracic Spine Levers Short Lever

Side Lying Position – ‘Prayer Position’

  • Bring both client’s arm across their body with 90° elbow flexion
  • Put in ‘prayer’ position
  • Apply paired resistive 5% or less in the following planes of motion:
  • flexion/extension
  • Both arms left
  • Both arms right
  • Push elbows towards ceiling
  • Lock elbows & ask for resistance into table

 

Sequence 4.2 Thoracic Spine Levers Long Lever

Side lying position

These are performed exactly the same as the Thoracic spine Short levers, except you address the thoracic spine with both arms extended in a straight-arm manner.

  • Ask your client to resist at 10% against the following directions:
  • Both hands pushing down into the table for SB/Rotation
  • Both hands pushing the opposite direction towards the ceiling for SB/Rotation
  • Both hands pushing cranially or superiorly for extension
  • Both hands pushing caudally or inferior for flexion
  • Both elbows ‘pulling apart’ scapular adduction
  • Both elbows ‘pulling’ together scapular abduction
  • Initiate a spiral or rotational push
  • Initiate a spiral or rotational pull.

 

Sequence 4.3

Active Resistive – Supine

Thoracic Receptor Enhancement

Paired Crossed Bent-Arm Humeral

  • Bring client’s brings both arms across their body with 45° elbow flexion
  • Apply active resistive 5% or less force in the following planes of motion:
  • Flexion/extension
  • Bent arm left
  • Bent arm right
  • Push elbow towards ceiling
  • Lift scapula with hand, ask for ‘pull towards table’
  • Apply to opposite shoulder.

 

Sequence 4.4

Uni-Lateral Crossed Bent-Arm Resistive

Supine

Bring client’s arm across their body with 45° elbow flexion

Apply resistive 5% or less in the following planes of motion:

  • flexion/extension
  • Bent arm left
  • Bent arm right
  • Assess and engage rotations
  • Push elbow towards ceiling
  • Lift scapula with hand, ask for ‘pull towards table’
  • Axillary pectoral fascia lateral translation with active resistive into bind
  • Straight arm – serratus anterior resistive pushing to ceiling or pulling scapula into table, upon release of resistive, mobilize in sagittal plane.

Apply to opposite shoulder.

 

Module 8  Eight  1.5hour/ 90 min

Sequence 5

Prone Superficial Back Line Releases

Sequence 5.1

MFR

Sacral ‘Twist’ Static

Compound posterior cervical sleeve with sacrum

  • Shift
  • Rotation
  • Superior/inferior

 

Sequence 5.2

Posterior Oblique System

 

  • Cross releases for Glutues Maximus and contralateral Latissimus Dorsi.
  • Check ‘ease-bind’ with hands coming together
  • Check ‘ease-bind’ with hands pulling apart
  • Check ‘ease-bind’ with both hands paired towards Latissimus
  • Check ‘ease-bind’ with both hands paired towards Glutueals

 

Sequence 5.3

Ligaments of the Sacrum and Pelvis

Sacrotuberous Ligament

Sacral Ligaments

Posterior S.I. Ligament

  • Palpation of taut ligamentous strands
  • ‘Strumming’ friction to release ligaments
  • Multi-directional friction
  • Rapid but light application of friction

 

Sequence 5.4

Tendon Receptor Stimulation

Golgi Tendon Organ

  • Static on Tendon
  • Wedge: with elbow on tendon lateral translation

 

Sequence 5.5

Ramic Adductors – Prone – Elbow

  • Forearm-elbow is placed to the medial aspect of the ischial tuberosity.
  • Ask your client to lightly actively ‘squeeze’ inward into your elbow for 3 seconds. Ask for light adduction.
  • Upon release passive roll into the ischial tuberosity in the opposite direction.
  • Normally if adhered you will ‘hear’, ‘feel’ a slight ‘pop’ or ‘crunch’ indicating the qrelease of the adhesion.

 

Sequence 5.6

Paired Femoral Lateral Flexion MET

Supine

  • Assess bind for lateral flexion by moving both paired legs together from medial to lateral.
  • Whichever is ease, place the paired legs in that position
  • Ask the client to resist 5-10% force into the direction of ‘bind’ first at the ankles
  • Then as above al the lateral aspect of the kness.
  • Place paired legs back into the middle neutral position, wait 20 seconds, re-assess and reapply if necessary.

 

Module 9 Nine         2 Hour/ 120 min

bilaterals releases

Sequence 6:

Sidelying Bilaterals Techniques-ITB-Passive

Side Lying Position

Sequence 6.1 : ITB

  • ‘Rolling & Pivot’
  • ITB lower portion
    • Externally rotated position release
    • Internally rotated position release

 

  • ITB upper portion
    • Externally rotated position release
    • Internally rotated position release

 

Lunch Break           .75-1 Hour/ 45-60 min

 

Bilaterals Techniques

Thorax Passive

Side Lying Position

Sequence 6.2 Intercostals

Transverse-intercostal/Vertebral-intercostal joint compression

  • From posterior externally rotated position release

 

Sequence 6.3 Sternum

  • Sternal/manubrial-costal
  • Internally rotated position release

 

Sequence 6.4 Illicostalis Line Release

  • Assess & engage mid-illiocostalis thoracicis
  • Let your palms rest near the boundary of the illiocostalis thoracicis, and your superior or cranial fingers curve or curl so the fingertips are on the lateral boundary of the illiocistalis.
  • With your cranial hand assess and ‘feel’ the barrier as you roll the lateral margin towards the spine or axial mid-line.
  • With your inferior or cephalic hand locate, assess, palpate and engage the longitudinal line barrier of the illiocostalis lumborum, where it anchors at the illium.

 

 

Sequence 6.5

Thorax Release: 1st Rib /Clavicle- 12th Rib/Illiac Crest

Sequence 6.5

Thoracic cage release

1st Rib /Clavicle- 12th Rib/Illiac Crest

  • Place hands as shown on the right
  • With both hands assess the ease and bind directions as follows:
  • Both hands move towards illium
  • Both hands move towards mastoid process
  • Both hands compress towards each other
  • Both hands tension away from each
  • Choose the first ease position from the above assessment and.
  • Ask your client move both positions towards the direction of bind.
  • If the client cannot perform compound activity, then ask them to move into bind first at the illium, then at the clavicle.
  • Upon release of the 5-10% contraction, mobilize into the bind, then the ease.

 

 

Sequence 6.6

Supine Sternal Comp ression

The sternal compression is a powerful technique to utilize the breath as the component to create capacity change to the thorax, and myofascial restriction from the ‘inside out’ so to speak.

  • It is the use of hydrostatic pressure supplied by the client when the point of contact, such as the sternum is ‘pinned’. This is similar to a pin & stretch
  • Is using compressive force palm and fingertips to ‘pin’ sternum with 5 kg of pressure and utilizing the breath to increase compressive force.
  • Steps
  • Place palm relaxed on sternum.
  • Ask client to take a deep breath
  • On exhale, follow the exhalation by taking ‘up the slack’ and pressing slightly stronger.
  • Upon inhalation do not yield the pressure
  • Do this 3x
  • On the third inhalation, the practitioner will feel the increased pressure, ‘like ‘surfing a wave’, and the instruction will be for the client to ‘push me off’ with a hard in breath
  • At the maximum point of inhalation release your sternal quickly.
  • If done correctly, there will be an audible ‘whoosh’.
  • At this point, some clients will appear to hyperventilate, or have a mild spell of dizziness.
  • Once the system settles, re-assess motion to the sternum.
  • The assessment should show increased movement of the superficial fascia and often greater ‘spring’ to the sternum when downward pressure is applied.

 

Module 10 Ten                  1.5hour/90 min

Introduction to Osteopathic MET Muscle Energy Technique Applied to Joints

 

  • MET Muscle Energy Technique modification for chronic pain
  • JET Joint Energy Technique
  • Resistive utilized for Myofascial & Ligamentous structures
  • Apply to Scapular Complex
  • Use 5-10% directional resistive based on restriction to motion.
  • Apply in all directions.

 

 

Day three

 

Module 11 Eleven    .5 hour/30 min

Review Day Two Material

  • ‘Two Point’
  • ‘Fulcrum’
  • Static Compression
  • Long Lever Compression
  • Long Lever Tension
  • Short Lever Compression
  • Review Cardinal Lines
  • Articular Receptor Enhancement

 

Module 12 Twelve  1 hour/60 min

Balance Between ANS & Structure:

The Expression of the Automomic Nervous System-Shea (1995)

  • Shea’s Postulates
  • Expression of the ANS
  • Tone Shifts
  • Release versus Discharge
  • Phenomena
  • Integration
  • Avoiding Autonomic Exhaustion

 

Module 13 Thirteen  1 hour/60min

Introduction to Upper Extremity Techniques

Palpation of Superficial/Deep- Front/Back Arm Lines (Myers)

  • Ease-Bind Palpation Assessment
  • Superficial Front Arm Line
  • Superficial Back Arm Line
  • Deep Front Arm Line
  • Deep Back Arm Line

Module 14 Fourteen

Sequence 7

Techniques for the Shoulder Complex

Sequence 7.1:  .5hour/30min

Two Point for Thoracic Outlet-Brachial Plexus

Supine Position

  • Thoracic Outlet
  • Brachial Plexus
  • GH Joint
  • Elbow Complex
  • Wrist Complex

 

Sequence 7.2

Brachial Plexus Release – Neurofascial Technique

Manipulation of the plexus is achieved by first understanding and visualising the branches location.

If supine position, Take the arm/shoulder into bent-arm flexion with 60°-90°abduction with about 30° flexion shoulder.

Use your body to brace the olecranon process and locate just lateral to the anterior scalene, applying gentle pin. With your other hand use the arm/forearm as a lever to apply the lightest of brachial stretches.

Normally the nerve pathway is very tight and restricted. It usually has never been released, you will have to ‘hang out’ for at lest 60-90 seconds before you’ll feel a give or release or ‘letting go’ of the cord or strands.

 

Sequence 7.3: .5hour/30min

Joint Humeral Levering Long & Short

Supine Positions 

  • Supine Bilateral Humeral Short Lever
  • Supine Bilateral Humeral Long Lever
  • Supine Unilateral Long Lever Sleeve Assessment
  • Supine Unilateral Long Lever Humeral Compression

 

 

Lunch Break  .75-1 hour/45-60 min

 

Module 15 Fifteen   3.5-4 Hours

Humeral Vertical levers

Sequence 7.4:                    

Joint Humeral Vertical Short Levers

Side Lying Position 

  • Olecranon crowd into GH Joint
  • “Corkscrew”
  • Add rotational ease position
  • Add rotational bind position
  • Tensional Lift versus Compression
  • Apply active resistive to ‘ease’ direction

 

Sequence 7.5

Joint Humeral Vertical Long Levers

SideLying Positions

  • Elbow must in extended relaxed lock position
  • No flexion whatsoever
  • Use your forearm to lock elbow into extension
  • ‘Stir scapular complex around thorax’
  • Tensional Lift versus Compression
  • Apply active resistive

 

Sequence 7.6:

Assessment of Scapula Motion Using Glenohumeral Joint

Side Lying Position

  • Assess three planes of motion restriction from neutral horizontal adducted lever position.
  • Assess elevation/depression
  • Assess protraction/retraction- abduction/adduction
  • Assess ’sleeve’ rotation
  • Assess internal/external rotation
  • Engage three planes in ‘ease’
  • Await release

 

Sequence 7.7

Joint Horizontally Adducted Humeral Long Levers –

Active Resisted

Side Lying Position

  • Practitioner seated anterior to client with humerus placed in a horizontally adducted position with 90° flexion, which is also 90° between abduction and adduction of the shoulder.
  • Assess sleeve rotational restrictions: Capsular, Brachial & Supination/Pronation of Radial/Ulnar
  • Engage mid-posterior deltoid and assess for bind. Use a static compress to release GH capsule.
  • Assess for rotational restriction and engage ease or bind once again.
  • Then ‘stir’ the scapula to mobilize the shoulder complex.
  • Engage Low Load Resistive

 

Sequence 7.8

Side Lying Position

Active Light Friction ‘Strum’

Humeral Intermuscular Septums Neurofascia Technique

MFR Arm Line Release          

(Refined palpation required)

  • Medial & Lateral Septums along Brachialis/Biceps & Triceps Lateral/Long head
  • Slight flick &/or movement of the artery, median-radial nerves & veins as they are adhered to the humeral inter-muscular septums.

 

Sequence 7.9

Passive

Rotational Sleeve Releases

  • Static compression combined with rotational bind ‘Twists in the Sleeve’ & Humeral Compressions
  • From sidelying position place arm comfortably on side of body in long lever position
  • Extend and internal rotate UE so it is placed slightly behind thorax in long lever position
  • Place positioned limb in bilateral hand positions. That is rotated limb is engaged simultaneously with thorax on the top while bottom hand is placed the same as in intercostal bilateral position

 

Sequence 7.10

Arm Lift Active Resistive

Side Lying Position

  • Ease-Bind Palpation Assessment
  • This is referred to as the ‘teeter totter’ technique
  • Ask client to resist with 5% or less force by pulling down with client hand as practitioner pulls upward while holding medial brachial aspect of arm.
  • Upon release pull superiorly to break collangenous adhesions at axillary fold.

 

 

 

 

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  • Day 1: 1:00pm – 8:30pm
  • Day 2: 9:00am – 5:00pm
  • Day 3: 9:00am – 5:00pm

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