This collaborative, research-driven handbook is an invaluable reference tool for manual therapists from many disciplines, as well as a fascinating read for anyone interested in learning more about how the human body works and the science behind fascial function. It highlights a few weaknesses in the world of hands-on fascial therapy as well as presents a wealth of encouraging findings for the future development of our work as structural integrators.
The first edition, published in 2014, was given to me for review in early 2020, and until extremely recently, it did not come to my attention that there is, indeed, a second edition (published in 2018). I wanted to see if any information presented in the first edition had been updated (specifically, that dealing with thixotropy and gel/sol theory) or disproven. I have vague memories from my studies at
the Dr. Ida Rolf Institute® (DIRI) and the instructors mentioning that research may change these concepts over time. But upon briefly checking the newer edition, that doesn’t seem to be the case. This review focuses on the first edition for simplicity, though some differences will be pointed out for the purpose of comparison.
The book has two parts, the first focuses on “Fascial Foundations.” More precisely, it begins with two chapters by Leon Chaitow, ND, DO, with a wealth of research about fascia and how it responds to various stimuli. Thomas Myers, author and founder of Anatomy Trains® Structural Integration, has a chapter on global assessment techniques. Section one concludes with some peer-reviewed
techniques for various therapeutic modalities used to improve the healing process and overall function of fascial tissues (including instrument-assisted soft tissue mobilization [IASTM], and
prolotherapy and others).
The second part of the book is devoted to a selection of descriptive writings by practitioners of many disciplines, from Bowen therapy, to Fascial Manipulation® method, unwinding technique, Myofascial Induction Therapy®, neuromuscular technique, and positional release techniques to name a few. These chapters included hands-on assessment and treatment techniques except the one about Rolfing® Structural Integration written by Jonathan Martine, former DIRI faculty. I found the lack of specific techniques in “our” section to be unsurprising, and understandable,
considering the tradition of hands-on learning passed down directly from master to student, a value which DIRI is built upon. And the fact that our training is worthy of protection.
Yet, I must mention some frustration as a relatively “new” Rolfer with a challenging career start due to the pandemic. It was only extremely recently that The Rolfing® Skillful Touch Handbook (2022, see page 60 for more information) was published with practical techniques. For most of us Rolfers, we’ve learned this work with no handbook. There is a reason for the emphasis on our oral tradition for the practical techniques, and the Rolfing SI chapter in Fascial Dysfunctions is a comprehensive roadmap for the potential student or client, nonetheless. It accomplishes its goal of description while maintaining an air of mystery that would be intriguing for many.
While a thorough reading of the new edition is certainly in order, the main differences I noted upon a quick review of the second edition are the following: the organization of the book has changed in
the sense that while it’s still split into two parts, the table of contents for each part is now split as well (the second table is now located at the beginning of the second part of the book rather than at the front of the book, directly following the table of contents for the first section as it is in the original edition). I immediately found this change clunky and inconvenient, as it’s more difficult to find sections quickly in the second edition.
Secondly, there are more illustrations overall in the second edition, the first half is far more robust, thus it is considerably longer. There have been changes in the modalities described in the second half of the book, IASTM was removed, Gua Sha was added in, for instance, which absolutely makes it worth further reading Interestingly enough, the chapter entitled “Selected Fascial Pathologies and Conditions” was greatly truncated in the second edition, and absorbed into another chapter. The first edition offers various therapeutic options for treating such issues as hypermobility, plantar fasciitis, and frozen shoulder, including dietary influences and other modalities such as
heat and cold. While it was an engrossing read, I occasionally pondered whether the information presented was out-ofscope (or perhaps just not as practically relevant) for certain practitioners. My
particular licensure allows me to prescribe heat, cold, and exercises to clients, for instance, but of course to defer to doctor’s recommendations and diagnoses.
However, the main elements of the first edition I found worth remarking on remain intact in the second edition, and I’m sure the additional research findings included in the second edition will be a highly worthwhile read.
I have a few critiques about the first edition, the first chapter was extremely dense and difficult to synthesize into practice.
I’ve studied biochemistry, anatomy, and physiology, yet I found myself wishing there was a professor handy so that I could raise my hand and ask, “So what does this mean on a macroscopic level for manual therapists?” The answer I told myself is that we’re still figuring thesethings out, but we’re probably headed in the right direction.
Another element that struck me was that there is no fully agreed-upon definition of fascia. This is not a critique of the book, but rather an observation of our manual therapy corner of the world of science.
This seems like a huge limiting force when it comes to therapeutics as a whole, not to mention the absence of acceptance of fascia research by the wider world of medicine. Yet functionally, we are making meaningful changes in the lives of actual humans, and manual therapy focusing on fascial tissue continues to gain legitimacy and approval, especially as more and more research is done.
In the section on pathology, I was excited to learn of the correlations between global hypermobility, chest breathing, hyperventilation, fibromyalgia, and anxiety. I’m very interested to see what future research reveals on all of the above issues.
The assessment methods by Myers and Chaitow are very helpful, the former being an in-depth introduction to the Anatomy Trains method, including many photos of people used as case studies for postural evaluation. One caveat I’d give is that Myers occasionally uses subjective descriptors of his human participants, such as saying a person has an “I am strong” attitude in their posture. That
gives me pause to vocalize, because not every client appreciates those sorts of assumptions being made of their personalities based on their outward appearance, insightful or not.
Chaitow also gives a helpful reminder that hands-on tissue assessment methods are not objective, and the importance of gathering other information when needed (such as ultrasound imaging). I appreciate the reminder to practitioners not to get “too big for their britches,” when it comes
to evaluations.
Finally, as I mentioned before, some of the information presented in the book may not be relevant or appropriate to all practitioners, and the inconclusive nature of some of the research findings
presented may be too confounding for practical application at this point. The newer edition may clarify some of this.
Overall, this book is a stellar collection of an impressive range of hard science that lends both credibility and a deeper understanding of the current use of fascial therapeutic disciplines and excitement for the discoveries to come.
Reference
Anderson, Neal, Bethany Ward, and Lu
Mueller-Kaul. 2022. The Rolfing
® Skillful
Touch Handbook. Boulder, Colorado: Dr.
Ida Rolf Institute.
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